The Connor-Davidson Resilience Scale as a Positive Psychology Measure for People with Spinal Cord Injuries

ERIC Educational Resources Information Center

Fujikawa, Mayu; Lee, Eun-Jeong; Chan, Fong; Catalano, Denise; Hunter, Celeste; Bengtson, Kevin; Rahimi, Maryam

2013-01-01

The main objective of this study is to evaluate the measurement structure of the Connor-Davidson Resilience Scale (CD-RISC) as a positive psychology measure for people with spinal cord injuries (SCIs) using confirmatory factor analysis. The participants consisted of 274 Canadians with SCI living in the community. The result indicated that the…

Posttraumatic stress disorder among low-income women exposed to perinatal intimate partner violence : Posttraumatic stress disorder among women exposed to partner violence.

PubMed

Kastello, Jennifer C; Jacobsen, Kathryn H; Gaffney, Kathleen F; Kodadek, Marie P; Bullock, Linda C; Sharps, Phyllis W

2016-06-01

Women exposed to intimate partner violence (IPV) and other forms of lifetime trauma may be at risk for negative mental health outcomes including posttraumatic stress disorder (PTSD). The purpose of this study was to examine potential predictors of PTSD among low-income women exposed to perinatal IPV. This study analyzed baseline cross-sectional data from 239 low-income pregnant women in the USA who participated in a nurse home visitation intervention between 2006 and 2012 after reporting recent IPV. PTSD was assessed with the Davidson Trauma Scale (DTS) in which participants answer questions about the most disturbing traumatic event (MDTE) in their lifetime that affected them the week before the interview. In total, 40 % of the women were identified as having PTSD (DTS ≥40). PTSD prevalence significantly increased with age to nearly 80 % of women ages 30 and older (n = 23). Age was also the strongest predictor of PTSD (p < 0.001). Most participants (65 %) identified non-IPV-related traumas as their MDTEs. Psychological (94 %), physical (82 %), and sexual (44 %) violence were not significantly associated with PTSD status. Despite recent exposure to IPV, most participants identified other traumatic events as more disturbing than IPV-related trauma. Further, the risk for PTSD increased with age, suggesting that the cumulative effect of trauma, which may include IPV, increases the risk for PTSD over a lifetime. Implementing comprehensive screening for trauma during prenatal care may lead to the early identification and treatment of PTSD during pregnancy in a community setting.

The Roles of Resilience and Childhood Trauma History: Main and Moderating Effects on Postpartum Maternal Mental Health and Functioning

PubMed Central

Sexton, Minden B.; Hamilton, Lindsay; McGinnis, Ellen W.; Rosenblum, Katherine L.; Muzik, Maria

2015-01-01

Objective Recently postpartum women participated to investigate main and moderating influences of resilience and childhood history of maltreatment on posttraumatic stress disorder (PTSD), major depressive disorder (MDD), parental sense of mastery, and family functioning. Method At 4-months postpartum, 214 mothers (145 with a history of childhood abuse or neglect) completed interviews assessing mental health symptoms, positive functioning, resilience and trauma history. Multiple and moderated linear regression with the Connor- Davidson Resilience Scale (CD-RISC) and Childhood Trauma Questionnaires (CTQ) were conducted to assess for main and moderating effects. Results Resilience, childhood trauma severity, and their interaction predicted postpartum PTSD and MDD. In mothers without childhood maltreatment, PTSD was absent irrespective of CD-RISC scores. However, for those with the highest quartile of CTQ severity, 8% of those with highest resilience in contrast with 58% of those with lowest CD-RISC scores met PTSD diagnostic criteria. Similar, in those with highest resilience, no mothers met criteria for postpartum MDD, irrespective of childhood trauma, while for those with lowest quartile of resilience, 25% with lowest CTQ severity and 68% of those with highest CTQ severity were depressed. The CD-RISC, but not the CTQ, was predictive of postpartum sense of competence. The CD-RISC and the CTQ were predictive of postpartum family functioning, though no moderating influence of resilience on childhood trauma was found. Conclusions Resilience is associated with reduced psychopathology and improved wellbeing in all mothers. It further serves as a buffer against psychiatric symptoms following childhood trauma. Such findings may assist in identification of those at greatest risk of adverse functioning postpartum, utilization of resilience-enhancing intervention may benefit perinatal wellness, and reduce intergenerational transmission of risk. PMID:25560192

The roles of resilience and childhood trauma history: main and moderating effects on postpartum maternal mental health and functioning.

PubMed

Sexton, Minden B; Hamilton, Lindsay; McGinnis, Ellen W; Rosenblum, Katherine L; Muzik, Maria

2015-03-15

Recently postpartum women participated to investigate main and moderating influences of resilience and childhood history of maltreatment on posttraumatic stress disorder (PTSD), major depressive disorder (MDD), parental sense of mastery, and family functioning. At 4-months postpartum, 214 mothers (145 with a history of childhood abuse or neglect) completed interviews assessing mental health symptoms, positive functioning, resilience and trauma history. Multiple and moderated linear regression with the Connor-Davidson Resilience Scale (CD-RISC) and Childhood Trauma Questionnaires (CTQ) were conducted to assess for main and moderating effects. Resilience, childhood trauma severity, and their interaction predicted postpartum PTSD and MDD. In mothers without childhood maltreatment, PTSD was absent irrespective of CD-RISC scores. However, for those with the highest quartile of CTQ severity, 8% of those with highest resilience in contrast with 58% of those with lowest CD-RISC scores met PTSD diagnostic criteria. Similar, in those with highest resilience, no mothers met criteria for postpartum MDD, irrespective of childhood trauma, while for those with lowest quartile of resilience, 25% with lowest CTQ severity and 68% of those with highest CTQ severity were depressed. The CD-RISC, but not the CTQ, was predictive of postpartum sense of competence. The CD-RISC and the CTQ were predictive of postpartum family functioning, though no moderating influence of resilience on childhood trauma was found. Resilience is associated with reduced psychopathology and improved wellbeing in all mothers. It further serves as a buffer against psychiatric symptoms following childhood trauma. Such findings may assist in identification of those at greatest risk of adverse functioning postpartum, utilization of resilience-enhancing intervention may benefit perinatal wellness, and reduce intergenerational transmission of risk. Copyright © 2015 Elsevier B.V. All rights reserved.

Parentification and Resilience among Students with Clinical and Nonclinical Aspirations: A Cross-Sectional Quantitative Study

ERIC Educational Resources Information Center

Yew, Wan Ping; Siau, Ching Sin; Kwong, Su Fong

2017-01-01

This study examined the relationship between level of parentification and resilience among students with clinical and nonclinical aspirations in Malaysia. A total of 419 college students were surveyed using the Parentification Questionnaire (Jurkovic & Thirkield, 1998) and Connor-Davidson Resilience Scale (Connor & Davidson, 2003). Results…

Depression and resilience in women with HIV and early life stress: does trauma play a mediating role? A cross-sectional study.

PubMed

Spies, Georgina; Seedat, Soraya

2014-02-24

The present study sought to assess the relationship between depressive symptomatology and resilience among women infected with HIV and to investigate whether trauma exposure (childhood trauma, other discrete lifetime traumatic events) or the presence of post-traumatic stress symptomatology mediated this relationship. Cross-sectional study. Western Cape, South Africa. A convenience sample of 95 women infected with HIV in peri-urban communities in the Western Cape, South Africa. All women had exposure to moderate-to-severe childhood trauma as determined by the Childhood Trauma Questionnaire. We examined the relationship between depressive symptomatology and resilience (the Connor-Davidson Resilience Scale) and investigated whether trauma exposure or the presence of post-traumatic stress symptomatology mediated this relationship through the Sobel test for mediation and PLS path analysis. There was a significant negative correlation between depressive symptomatology and resilience (p=<0.01). PLS path analysis revealed a significant direct effect between depression and resilience. On the Sobel test for mediation, distal (childhood trauma) and proximal traumatic events did not significantly mediate this association (p=> 0.05). However, post-traumatic stress symptomatology significantly mediated the relationship between depression and resilience in trauma-exposed women living with HIV. In the present study, higher levels of resilience were associated with lower levels of self-reported depression. Although causal inferences are not possible, this suggests that in this sample, resilience may act as protective factor against the development of clinical depression. The results also indicate that post-traumatic stress symptoms (PTSS), which are highly prevalent in HIV-infected and trauma exposed individuals and often comorbid with depression, may further explain and account for this relationship. Further investigation is required to determine whether early identification and treatment of PTSS in this population may ameliorate the onset and persistence of major depression.

Depression and resilience in women with HIV and early life stress: does trauma play a mediating role? A cross-sectional study

PubMed Central

Spies, Georgina; Seedat, Soraya

2014-01-01

Objectives The present study sought to assess the relationship between depressive symptomatology and resilience among women infected with HIV and to investigate whether trauma exposure (childhood trauma, other discrete lifetime traumatic events) or the presence of post-traumatic stress symptomatology mediated this relationship. Design Cross-sectional study. Setting Western Cape, South Africa. Participants A convenience sample of 95 women infected with HIV in peri-urban communities in the Western Cape, South Africa. All women had exposure to moderate-to-severe childhood trauma as determined by the Childhood Trauma Questionnaire. Primary and secondary outcome measures We examined the relationship between depressive symptomatology and resilience (the Connor-Davidson Resilience Scale) and investigated whether trauma exposure or the presence of post-traumatic stress symptomatology mediated this relationship through the Sobel test for mediation and PLS path analysis. Results There was a significant negative correlation between depressive symptomatology and resilience (p=<0.01). PLS path analysis revealed a significant direct effect between depression and resilience. On the Sobel test for mediation, distal (childhood trauma) and proximal traumatic events did not significantly mediate this association (p=> 0.05). However, post-traumatic stress symptomatology significantly mediated the relationship between depression and resilience in trauma-exposed women living with HIV. Conclusions In the present study, higher levels of resilience were associated with lower levels of self-reported depression. Although causal inferences are not possible, this suggests that in this sample, resilience may act as protective factor against the development of clinical depression. The results also indicate that post-traumatic stress symptoms (PTSS), which are highly prevalent in HIV-infected and trauma exposed individuals and often comorbid with depression, may further explain and account for this relationship. Further investigation is required to determine whether early identification and treatment of PTSS in this population may ameliorate the onset and persistence of major depression. PMID:24566532

Assessing and Promoting Resilience: An Additional Tool to Address the Increasing Number of College Students with Psychological Problems

ERIC Educational Resources Information Center

Hartley, Michael T.

2012-01-01

This study examined the assessment of resilience in undergraduate college students. Multigroup comparisons of the Connor-Davidson Resilience Scale (CD-RISC; Connor & Davidson, 2003) were performed on general population students and students recruited from campus mental health offices offering college counseling, psychiatric-support, and…

Resilience characteristics mitigate tendency for harmful alcohol and illicit drug use in adults with a history of childhood abuse: a cross-sectional study of 2024 inner-city men and women.

PubMed

Wingo, Aliza P; Ressler, Kerry J; Bradley, Bekh

2014-04-01

Resilience refers to abilities to cope adaptively with adversity or trauma. A common psychological sequella of childhood abuse or other traumatic experiences is substance use problems. There are, however, very limited data on relationships among resilience traits, childhood abuse, and alcohol or drug use problems. Hence, we aimed to examine associations between resilience characteristics and lifetime alcohol and illicit drug use in 2024 inner-city adults with high rates of childhood abuse and other trauma exposure. In this cross-sectional study, resilience was assessed with the Connor-Davidson Resilience Scale, childhood abuse with the Childhood Trauma Questionnaire, lifetime alcohol and illicit drug use with the Alcohol Use Disorder Identification Test and Drug Abuse Screening Test. Associations between resilience and substance use were examined with linear regression models, adjusting for trauma load, age, and sex. We found that resilience characteristics mitigated tendency for lifetime alcohol use problems both as a main effect (β = -0.11; p = 0.0014) and an interaction with severity of childhood abuse (β = -0.06; p = 0.0115) after trauma severity, age, and sex were controlled for. Similarly, resilience reduced lifetime illicit drug use both as a main effect (β = -0.03; p = 0.0008) and as an interaction with severity of childhood abuse (β = -0.01; p = 0.0256) after trauma load, age, and sex were adjusted for. Our findings add to a nascent body of literature suggesting that resilience characteristics mitigate risks not only for PTSD, major depression, and suicidality, but also for substance use problems in adults exposed to childhood abuse or other traumatic experiences. Published by Elsevier Ltd.

Self-Rated Mental Health: Screening for Depression and Posttraumatic Stress Disorder Among Women Exposed to Perinatal Intimate Partner Violence.

PubMed

Kastello, Jennifer C; Jacobsen, Kathryn H; Gaffney, Kathleen F; Kodadek, Marie P; Bullock, Linda C; Sharps, Phyllis W

2015-11-01

The purpose of the current study was to evaluate the validity of a single-item, self-rated mental health (SRMH) measure in the identification of women at risk for depression and posttraumatic stress disorder (PTSD). Baseline data of 239 low-income women participating in an intimate partner violence (IPV) intervention study were analyzed. PTSD was measured with the Davidson Trauma Scale. Risk for depression was determined using the Edinburgh Postnatal Depression Scale. SRMH was assessed with a single item asking participants to rate their mental health at the time of the baseline interview. Single-item measures can be an efficient way to increase the proportion of patients screened for mental health disorders. Although SRMH is not a strong indicator of PTSD, it may be useful in identifying pregnant women who are at increased risk for depression and need further comprehensive assessment in the clinical setting. Future research examining the use of SRMH among high-risk populations is needed. Copyright 2015, SLACK Incorporated.

Countertransference in the initial visit of women victims of sexual violence.

PubMed

Eizirik, Mariana; Schestatsky, Sidnei; Kruel, Letícia; Ceitlin, Lúcia Helena Freitas

2011-03-01

To identify demographic and clinical correlates associated with therapists' countertransference feelings on the first visit of women victims of sexual violence. Forty patients were seen by 26 therapists, during 2 consecutive years, at the Center for the Study and Treatment of Psychological Trauma, Hospital de Clínicas de Porto Alegre , Brazil. After the first visit with the patient, the therapist completed the Assessment of Countertransference Scale and the patient was evaluated with the Davidson Trauma Scale, the Standardized Assessment of Personality - Abbreviated Scale, the Beck Depression Inventory, and the Defense Style Questionnaire. The therapists showed a predominance of feelings of closeness (Mean = 5.42, SD = 1.25) in relation to the feelings of indifference (Mean = 1.82, SD = 1.22) and distance (Mean = 1.57, SD = 1.08) [p < 0.001]. Multivariate analyses did not present significant associations between countertransference feelings and clinical characteristics of patients. The gender of the therapists did not influence the pattern of countertransference feelings. In the subgroup of female therapists, we detected an inverse correlation between a higher probability of patients' personality disorders and feelings of closeness in the therapists. We did not detect a differential pattern of countertransference feelings associated with specific clinical characteristics. Therapists of both genders presented a similar pattern of feelings of empathy towards women victims of sexual violence, although the gender of the therapist may moderate the feelings evoked by patients with increased likelihood of personality disorders.

Exploration of the resilience construct in posttraumatic stress disorder severity and functional correlates in military combat veterans who have served since September 11, 2001.

PubMed

Green, Kimberly T; Calhoun, Patrick S; Dennis, Michelle F; Beckham, Jean C

2010-07-01

This study evaluated the relationship between resilience and psychological functioning in military veterans deployed to a region of military conflict in support of Operation Enduring Freedom or Operation Iraqi Freedom. 497 military veterans completed a structured psychiatric interview and questionnaires measuring psychological symptoms, resiliency, and trauma exposure. The study had 2 primary aims: (1) to examine whether the association between trauma exposure and PTSD was moderated by resilience and (2) to examine whether resilience was uniquely associated with functional outcomes after accounting for PTSD. Measures included the Structured Clinical Interview for DSM-IV-TR Axis I Disorders (for PTSD diagnosis), the Connor-Davidson Resilience Scale, and the Traumatic Life Events Questionnaire. Data were collected between June 2005 and February 2009. Evaluating the association of resilience and trauma exposure with PTSD revealed main effects for combat exposure, lifetime trauma exposure, and resilience. Additionally, there was a significant (P < .05) interaction between combat exposure and resilience such that higher levels of resilience were particularly protective among individuals with high combat exposure. After controlling for age, gender, minority status, trauma exposure, and PTSD diagnosis, resilience was uniquely associated with decreased suicidality, reduced alcohol problems, lower depressive symptom severity, and fewer current health complaints and lifetime and past-year medical problems. These results suggest that resilience is a construct that may play a unique role in the occurrence of PTSD and severity of other functional correlates among deployed veterans. Future studies in this area would benefit from a prospective design, the evaluation of other possible protective processes (e.g., social support), and specific examination of particular aspects of resilience and how resilience may be increased. (c) Copyright 2010 Physicians Postgraduate Press, Inc.

Factorial invariance of posttraumatic stress disorder symptoms across three veteran samples.

PubMed

McDonald, Scott D; Beckham, Jean C; Morey, Rajendra; Marx, Christine; Tupler, Larry A; Calhoun, Patrick S

2008-06-01

Research generally supports a 4-factor structure of posttraumatic stress disorder (PTSD) symptoms. However, few studies have established factor invariance by comparing multiple groups. This study examined PTSD symptom structure using the Davidson Trauma Scale (DTS) across three veteran samples: treatment-seeking Vietnam-era veterans, treatment-seeking post-Vietnam-era veterans, and Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veteran research participants. Confirmatory factor analyses of DTS items demonstrated that a 4-factor structural model of the DTS (reexperiencing, avoidance, numbing, and hyperarousal) was superior to five alternate models, including the conventional 3-factor model proposed by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; American Psychiatric Association, 1994). Results supported factor invariance across the three veteran cohorts, suggesting that cross-group comparisons are interpretable. Implications and applications for DSM-IV nosology and the validity of symptom measures are discussed.

Reliability and validity of the korean version of the connor-davidson resilience scale.

PubMed

Baek, Hyun-Sook; Lee, Kyoung-Uk; Joo, Eun-Jeong; Lee, Mi-Young; Choi, Kyeong-Sook

2010-06-01

The Connor-Davidson Resilience Scale (CD-RISC) measures various aspects of psychological resilience in patients with posttraumatic stress disorder (PTSD) and other psychiatric ailments. This study sought to assess the reliability and validity of the Korean version of the Connor-Davidson Resilience Scale (K-CD-RISC). In total, 576 participants were enrolled (497 females and 79 males), including hospital nurses, university students, and firefighters. Subjects were evaluated using the K-CD-RISC, the Beck Depression Inventory (BDI), the Impact of Event Scale-Revised (IES-R), the Rosenberg Self-Esteem Scale (RSES), and the Perceived Stress Scale (PSS). Test-retest reliability and internal consistency were examined as a measure of reliability, and convergent validity and factor analysis were also performed to evaluate validity. Cronbach's alpha coefficient and test-retest reliability were 0.93 and 0.93, respectively. The total score on the K-CD-RISC was positively correlated with the RSES (r=0.56, p<0.01). Conversely, BDI (r=-0.46, p<0.01), PSS (r=-0.32, p<0.01), and IES-R scores (r=-0.26, p<0.01) were negatively correlated with the K-CD-RISC. The K-CD-RISC showed a five-factor structure that explained 57.2% of the variance. The K-CD-RISC showed good reliability and validity for measurement of resilience among Korean subjects.

Is John Henryism a resilience factor in women experiencing intimate partner violence?

PubMed

Kramer, Nicole M; Johnson, Nicole L; Johnson, Dawn M

2015-01-01

Research suggests that posttraumatic stress disorder (PTSD) and depression are two common mental health problems in intimate partner violence (IPV) survivors. Research has found that while Black women consistently report higher rates of victimization than White women, they also report less severe PTSD and depressive symptoms, suggesting that Black IPV survivors might be more resilient to PTSD and depression than are White survivors. We implemented a correlational study with 81 Black and 100 White female survivors of IPV to determine if John Henryism (JH; i.e., a predisposed active coping mechanism) contributes to the resilience observed in Black IPV survivors. Participants completed the John Henryism Active Coping Scale, Center for Epidemiological Studies Depression Scale, Davidson Trauma Scale, and the Abusive Behavior Inventory. Results demonstrated that White woman endorsed more severe depressive symptoms as compared to Black women. Severity of PTSD symptoms and JH was not significantly different between races. JH did not moderate the relationship between race and depression; however, for PTSD, JH was found to be protective of PTSD in White women, while demonstrating little impact on Black women. The implications of these findings are discussed in terms of the minority stress model.

Trait-aggressiveness and impulsivity: role of psychological resilience and childhood trauma in a sample of male prisoners.

PubMed

Carli, Vladimir; Mandelli, Laura; Zaninotto, Leonardo; Alberti, Siegfried; Roy, Alec; Serretti, Alessandro; Sarchiapone, Marco

2014-01-01

One of the major challenges for research in the field of human aggression is the need to define the role of personality and trait-like dimensions, such as impulsivity and aggressiveness, in predisposing to violent behavior. 1) To determine whether trait- aggressiveness and impulsivity may be associated with socio-demographic, clinical and crime history variables in a sample of male prisoners; 2) to detect any association of those traits with measures of early traumatic experiences and current resilience traits. A sample of male prisoners (n = 1356) underwent the Brown-Goodwin Assessment for Lifetime History of Aggression (BGLHA) and the Barratt Impulsivity Scale (BIS). Axis I psychiatric disorders were also assessed. Early traumatic experiences and psychological resilience were detected respectively by the Childhood Trauma Questionnaire (CTQ) and the Connor-Davidson Resilience Scale (CD-RISC). Two non-linear logistic regression models were performed to test for the best predictors of trait-aggressiveness and impulsivity. Subjects with a history of substance use disorders and self-mutilation reported both higher BGLHA and BIS scores. Axis I disorders and suicide attempts were associated with aggressiveness, but not to impulsivity. A consistent correlation was found between BGLHA scores and early traumatic experiences. Resilience was positively correlated to impulsivity but not to aggressiveness scores. Our results support the view that aggressiveness and impulsivity are two different, albeit related trait-like dimensions of personality, having a different relationship with resilience, and, inferentially, a different impact over the development of psychiatric disorders.

The 10-Item Connor-Davidson Resilience Scale: Factorial Structure, Reliability, Validity, and Correlates Among Student Nurses in Southwestern Nigeria.

PubMed

Aloba, Olutayo; Olabisi, Oluseyi; Aloba, Tolulope

2016-01-01

The 10-item Connor-Davidson Resilience Scale (CD-RISC) has demonstrated satisfactory psychometric properties as a measure of resilience in all the previous studies conducted in developed countries. The objective of this study was to explore the psychometric characteristics of the 10-item CD-RISC among students nurses in southwestern Nigeria. This descriptive cross-sectional study involved a total of 449 student nurses who completed the 10-item CD-RISC in addition to measures of self-esteem, depression, religiosity, and psychological distress. The scale demonstrated adequate reliability (Cronbach's α = .81) and satisfactory validity with significant correlations with the measures of self-esteem, depression, religiosity, and psychological distress. Factor analyses revealed that resilience was best explained by a two-factor construct. The scale is a valid measure of resilience among Nigerian student nurses. © The Author(s) 2016.

Altered responsiveness in psychogenic nonepileptic seizures and its implication to underlying psychopathology.

PubMed

Baslet, Gaston; Tolchin, Benjamin; Dworetzky, Barbara A

2017-11-01

Altered responsiveness during psychogenic nonepileptic seizures (PNES) is a distinct semiological feature that may signal a psychological vulnerability. We hypothesized that altered responsiveness is related to difficulties with emotion tolerance, experiential avoidance, difficulty coping, dissociation and trauma and prior experiences of loss of awareness. 71 patients with video-EEG confirmed PNES were divided into two groups based on their responsiveness at the time of the captured event during long-term monitoring. Demographic information, clinical history and self-rated questionnaires highlighting psychopathology were compared between the groups. 47 patients (66%) had altered responsiveness during their captured event. Married or partnered subjects were more represented in the altered responsiveness group. Experiential avoidance, as measured by the Acceptance and Action Questionnaire-II, and affect intolerance, as measured by the Affective Style Questionnaire, were significantly higher in the altered responsiveness group. The Connor Davidson Resilience Scale was significantly higher among intact responsiveness subjects. Subjects with altered responsiveness were more likely to have a family history of seizures, comorbid headaches, and loss of consciousness (LOC) during traumatic brain injury. There were no differences in measures of dissociation, somatization, mood or anxiety, or presence of psychiatric comorbidities, including PTSD or history of trauma. Altered responsiveness during PNES is a marker of lower emotional resilience or ability to tolerate emotions among patients with PNES. Emotion management may be an important therapeutic target for these patients. Prior experiences with LOC also contribute to the presence of altered responsiveness. Trauma and dissociation did not differentiate responsiveness during PNES. Copyright © 2017 British Epilepsy Association. All rights reserved.

Explanatory Model of Resilience in Pediatric Burn Survivors.

PubMed

Quezada, Lucía; González, Mónica T; Mecott, Gabriel A

2016-01-01

Identifying factors of adjustment in pediatric burn patients may facilitate appropriate mental health interventions postinjury. The aim of this is study was to explore the roles of both the patient's and caregivers' resilience and posttraumatic stress in pediatric burn survivor adjustment. For the purposes of the study, "51 patient-parent/guardian" dyads participated. Patients answered the Resilience Questionnaire for Children and Adolescents, and caregivers answered the Mexican Resilience Scale and the Davidson Trauma Scale. The roles of patient age, time since the burn, and size of burn injury were also considered. Statistical analyses included Spearman's ρ for correlations and structural equation modeling. P less than .05 was considered significant. Patients and caregivers reported high levels of resilience, and the majority of caregivers reported low severity of posttraumatic stress disorder symptoms. Pediatric burn survivors' resilience was associated with being younger at the time of the burn and less severity of intrusive and avoidance symptoms in caregivers; it was also associated with a higher resilience in caregivers. It can be concluded that psychological responses of caregivers of pediatric burn survivors affect the well being and positive adjustment of patients; thus psychological services for caregivers would likely have a double benefit for both caregivers and patients.

An in-depth psychometric analysis of the Connor-Davidson Resilience Scale: calibration with Rasch-Andrich model.

PubMed

Arias González, Víctor B; Crespo Sierra, María Teresa; Arias Martínez, Benito; Martínez-Molina, Agustín; Ponce, Fernando P

2015-09-23

The Connor-Davidson Resilience Scale (CD-RISC) is inarguably one of the best-known instruments in the field of resilience assessment. However, the criteria for the psychometric quality of the instrument were based only on classical test theory. The aim of this paper has focused on the calibration of the CD-RISC with a nonclinical sample of 444 adults using the Rasch-Andrich Rating Scale Model, in order to clarify its structure and analyze its psychometric properties at the level of item. Two items showed misfit to the model and were eliminated. The remaining 22 items form basically a unidimensional scale. The CD-RISC has good psychometric properties. The fit of both the items and the persons to the Rasch model was good, and the response categories were functioning properly. Two of the items showed differential item functioning. The CD-RISC has an obvious ceiling effect, which suggests to include more difficult items in future versions of the scale.

Relationships among Trait Resilience, Virtues, Post-traumatic Stress Disorder, and Post-traumatic Growth

PubMed Central

Duan, Wenjie; Guo, Pengfei; Gan, Pei

2015-01-01

The present study aims to examine the relationship between trait resilience and virtues in the context of trauma. A total of 537 participants who attended the preliminary investigation and completed the Life Events Checklist were screened. Of these participants, 142 suffered from personal traumatic experiences in the past year; these individuals were qualified and invited to respond to online questionnaires to assess trait resilience, virtues (i.e., Conscientiousness, Vitality, and Relationship), post-traumatic stress disorder (PTSD) symptoms, and post-traumatic growth (PTG). The following questionnaires were used: Connor-Davidson Resilience Scale-Revised, Chinese Virtues Questionnaire, PTSD Checklist-Specific, and Post-traumatic Growth Inventory-Chinese. Only 95 participants who manifested self-reported PTSD symptoms and PTG were involved in the current analyses. Trauma was positively and significantly correlated with PTSD in the current sample. Results indicated that trait resilience was positively associated with virtues and PTG; by contrast, PTSD scores were negatively but not significantly related to most of these factors. The three virtues contributed to PTG to a greater extent than trait resilience in non-PTSD and PTSD groups. However, trait resilience remained a significant predictor in the PTSD group even when the three virtues were controlled. The relationship between trait resilience and PTG was moderated by PTSD type (non-PTSD group vs. PTSD group). Our results further suggested that trait resilience and virtues were conceptually related but functionally different constructs. Trait resilience and virtues are positively related; thus, these factors contributed variances to PTG in the context of trauma; however, trait resilience is only manifested when virtues are controlled and when individuals are diagnosed as PTSD. Furthermore, implications and limitations of this study are discussed. PMID:25932954

Using the Kannada version of the Connor Davidson Resilience Scale to assess resilience and its relationship with psychological distress among adolescent girls in Bangalore, India.

PubMed

Sidheek, K P Fasli; Satyanarayana, Veena A; Sowmya, H R; Chandra, Prabha S

2017-12-01

A widely used and accepted scale for assessing resilience is the Connor-Davidson Resilience Scale (CD-RISC). The aim of the present study was to establish the psychometric properties of the Kannada version of the scale and assess the relationship between resilience and psychological distress in a sample of adolescent girls living in low-income settings. Data was obtained from a sample of 606 adolescent girls studying in a college meant for women from a socio-economically disadvantaged setting. The CD- RISC (25 item) was used to assess resilience and Kessler Psychological Distress Scale (K10) was used to assess psychological distress. Exploratory factor analysis yielded four stable factors instead of the original five factors. Similar results have been obtained in other factor-analytic studies. A significant negative correlation was found between psychological distress and resilience. Our study shows that the CD-RISC is a valuable measure to assess resilience among adolescents in low-income settings. Copyright © 2017 Elsevier B.V. All rights reserved.

Using Multidimensional Scaling To Assess the Dimensionality of Dichotomous Item Data.

ERIC Educational Resources Information Center

Meara, Kevin; Robin, Frederic; Sireci, Stephen G.

2000-01-01

Investigated the usefulness of multidimensional scaling (MDS) for assessing the dimensionality of dichotomous test data. Focused on two MDS proximity measures, one based on the PC statistic (T. Chen and M. Davidson, 1996) and other, on interitem Euclidean distances. Simulation results show that both MDS procedures correctly identify…

A Pilot Study of Neurofeedback for Chronic PTSD.

PubMed

Gapen, Mark; van der Kolk, Bessel A; Hamlin, Ed; Hirshberg, Laurence; Suvak, Michael; Spinazzola, Joseph

2016-09-01

EEG Biofeedback (also known as neurofeedback) has been in use as a clinical intervention for well over 30 years; however, it has made very little impact on clinical care. One reason for this has been the difficulty in designing research to measure clinical change in the real world. While substantial evidence exists for its efficacy in treating attention deficit/hyperactivity disorder, relatively little evidence exists for its utility in other disorders including posttraumatic stress disorder (PTSD). The current study represents a "proof-of-concept" pilot for the use of neurofeedback with multiply-traumatized individuals with treatment-resistant PTSD. Participants completed 40 sessions of neurofeedback training two times per week with sensors randomly assigned (by the study coordinator, who was not blind to condition) to sensor placements of either T4-P4 or T3-T4. We found that neurofeedback significantly reduced PTSD symptoms (Davidson Trauma Scale scores averaged 69.14 at baseline to 49.26 at termination), and preceded gains in affect regulation (Inventory of Altered Self-Capacities-Affect Dysregulation scores averaged 23.63 at baseline to 17.20 at termination). We discuss a roadmap for future research.

[Post-traumatic condition and psychological distress/well-being in a sample of inmates: a cluster analytic approach].

PubMed

Gremigni, Paola; Del Bene, Serena; Tossani, Eliana

2010-01-01

Researchers addressing the mental health needs of inmates reported that post-traumatic stress disorder (PTSD) was one of the most common disorders. This study examined the patterns of PTSD symptoms and their relation to the self-reported level of distress and psychological wellbeing in a sample of Italian inmates. Fifty inmates, 90% male, 54% aged 31-50 years, 70% awaiting trial, completed a battery of tests including the Davidson Trauma Scale (DTS), the Symptom Questionnaire (SQ), and the Psychological Well-Being Scales (PWBS). Cluster analysis revealed three distinct clusters of respondents, which presents varying combination of PTSD symptoms, as measured with the three subscales of the DTS. Accordingly, these clusters were labeled Cluster 1--Traumatized (n = 18), Cluster 2--Non-traumatized (n = 18), and Cluster 3--Seriously traumatized (n = 14). Findings indicated that the three groups differed consistently across all the domains of the SQ and on the environmental mastery scale of the PWBS. Those in the Traumatized clusters, as compared to the Nontraumatized, demonstrated higher overall psychological distress and lower perceived environmental mastery. Moreover, independent of posttraumatic level, inmates showed poorer psychological wellbeing and higher distress than the normative population. The patterns manifested in clusters 1 and 3 could become the focus of attention to deliver specific intervention aimed at reducing inmates' distress and encouraging their adjustment to prison life.

The role of impulsivity in self-mutilators, suicide ideators and suicide attempters - a study of 1265 male incarcerated individuals.

PubMed

Carli, Vladimir; Jovanović, Nikolina; Podlesek, Anja; Roy, Alec; Rihmer, Zoltan; Maggi, Stefania; Marusic, Dragan; Cesaro, Caterina; Marusic, Andrej; Sarchiapone, Marco

2010-06-01

We explored differences between high and low-impulsive incarcerated individuals in the context of lifetime self-mutilation, suicide ideation and suicide attempt. A total of 1265 males detained in Italian penitentiary institutions were studied between January 2006 and December 2008. The study raters were specifically trained to discriminate between suicide attempters, ideators and self-mutilators. Participants completed the Barratt Impulsivity Scale, Childhood Trauma Questionnaire (CTQ), Eysenck Personality Questionnaire (EPQ), Connor-Davidson Resilience Scale (CD-RISC), Brown-Goodwin Assessment for Lifetime History of Aggression (BGLHA) and Buss and Durkee Hostility Inventory (BDHI). Based on BIS 7 total score distribution, two extreme quarters - high-impulsive group (n=306) and low-impulsive group (n=285) - were compared. Over 42% of participants had lifetime suicide ideation, 13% attempted suicide and 17% were self-mutilators. High-impulsive subjects were younger, more often single and with more prominent psychoticism, extraversion, aggression, hostility and resilience capacity. They were more frequently diagnosed with substance use disorders and engaged in self-mutilating behaviour. There was no difference in the rate of suicide attempts between the two groups. Although high-impulsive subjects were more prone to suicidal behaviour, it was not predicted by higher impulsivity when other psychological variables were accounted for. Copyright 2010 Elsevier B.V. All rights reserved.

Identification of post traumatic stress disorder and risk factors in military first responders 6 months after Wen Chuan earthquake in China.

PubMed

Wang, Huanlin; Jin, Hua; Nunnink, Sarah E; Guo, Wei; Sun, Jian; Shi, Jianan; Zhao, Bin; Bi, Yinhau; Yan, Tongjun; Yu, Haiying; Wang, Guangjian; Gao, Zhiqing; Zhao, Hanqing; Ou, Yanghui; Song, Zixiagn; Chen, Fangbin; Lohr, James B; Baker, Dewleen G

2011-04-01

Military personnel commonly serve as first responders to natural disasters. Our aim is to identify Post-Traumatic Stress Disorder (PTSD) and determine risk in military responders to the Wen Chuan earthquake. Analyses were carried out on 1056 of the 1125 soldiers enrolled. In addition to social demographic characteristics, the Davidson Trauma Scale (DTS) and an Earthquake exposure screening scale were administered. PTSD prevalence was 6.53% (69 cases). Logistic regression indicated that intensity of traumatic exposure (odds ratio 6.46, 95% CI 4.47-9.32, p<0.001), not having received psychological counseling (odds ratio 3.28, 95% CI 1.31-8.20, p<0.02) and regular drinking (odds ratio 2.42, 95% CI 1.04-5.62, p<0.05) were significant predictors of PTSD. Being a single-child, not being raised by both parents and regular smoking also independently predicted PTSD if intensity of earthquake traumatic exposure was not included in the model. The self-rated DTS was used to classify PTSD in this study and psychiatric co-morbidity outside of PTSD was not assessed in this sample. PTSD is a concern for Military disaster responders; to identify those with high risk of developing PTSD would be important and beneficial. Published by Elsevier B.V.

The Psychometric Evaluation of the Connor-Davidson Resilience Scale Using a Chinese Military Sample

PubMed Central

Xie, Yuanjun; Peng, Li; Zuo, Xin; Li, Min

2016-01-01

This study examined the psychometric properties of the Connor-Davidson Resilience Scale (CD-RISC) with a Chinese military population with the aim of finding a suitable instrument to quantify resilience in Chinese military service members. The confirmatory factor analysis results did not support the factorial structure of the original or the Chinese community version of the CD-RISC, but the exploratory factor analysis results revealed a three-factor model (composed of Competency, Toughness, and Adaptability) that seemed to fit. Moreover, the repeat confirmatory factory analysis replicated the three-factor model. Additionally, the CD-RISC with a Chinese military sample exhibited appropriate psychometric properties, including internal consistency, test-retest reliability, and structural and concurrent validity. The revised CD-RISC with a Chinese military sample provides insight into the resilience measurement framework and could be a reliable and valid measurement for evaluating resilience in a Chinese military population. PMID:26859484

4. Close view of the logs joining of the north ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

4. Close view of the logs joining of the north and south rooms, with scale (Note: hole with remains of peg SITU as seen in the east cabin) - The Hermitage, Alfred's Cabin, 4580 Rachel's Lane, Hermitage, Davidson County, TN

Individual-level factors associated with mental health in Rwandan youth affected by HIV/AIDS.

PubMed

Scorza, Pamela; Duarte, Cristiane S; Stevenson, Anne; Mushashi, Christine; Kanyanganzi, Fredrick; Munyana, Morris; Betancourt, Theresa S

2017-07-01

Prevention of mental disorders worldwide requires a greater understanding of protective processes associated with lower levels of mental health problems in children who face pervasive life stressors. This study aimed to identify culturally appropriate indicators of individual-level protective factors in Rwandan adolescents where risk factors, namely poverty and a history of trauma, have dramatically shaped youth mental health. The sample included 367 youth aged 10-17 in rural Rwanda. An earlier qualitative study of the same population identified the constructs "kwihangana" (patience/perseverance) and "kwigirira ikizere" (self-esteem) as capturing local perceptions of individual-level characteristics that helped reduce risks of mental health problems in youth. Nine items from the locally derived constructs were combined with 25 items from an existing scale that aligned well with local constructs-the Connor-Davidson Resilience Scale (CD-RISC). We assessed the factor structure of the CD-RISC expanded scale using exploratory factor analysis and determined the correlation of the expanded CD-RISC with depression and functional impairment. The CD-RISC expanded scale displayed high internal consistency (α = 0.93). Six factors emerged, which we labeled: perseverance, adaptability, strength/sociability, active engagement, self-assuredness, and sense of self-worth. Protective factor scale scores were significantly and inversely correlated with depression and functional impairment (r = -0.49 and r = - 0.38, respectively). An adapted scale displayed solid psychometric properties for measuring protective factors in Rwandan youth. Identifying culturally appropriate protective factors is a key component of research associated with the prevention of mental health problems and critical to the development of cross-cultural strength-based interventions for children and families.

The Structure and Temporal Stability of the Child and Adolescent Perfectionism Scale

ERIC Educational Resources Information Center

O'Connor, Rory C.; Dixon, Diane; Rasmussen, Susan

2009-01-01

In this study, the authors examined the factor structure and temporal stability of the Child and Adolescent Perfectionism Scale (CAPS; G. L. Flett, P. L. Hewitt, D. J. Boucher, L. A. Davidson, & Y. Munro, 1997) in 2 samples of adolescents (15-16 years old). In Sample 1 (n = 624), confirmatory factor analysis did not support a 2-factor structure…

Mediating Effect of Resilience on the Association between Emotional Neglect and Depressive Symptoms

PubMed Central

Lee, Sang Won; Bae, Geum Ye; Rim, Hyo-Deog; Lee, Seung Jae; Chang, Sung Man; Kim, Byung-Soo

2018-01-01

Objective Previous studies have reported that childhood maltreatment experiences could induce biological and psychological vulnerability in depressive disorders. However, it is still unclear that type-specific effects of childhood maltreatment on psychological resilience, depressive symptoms and interactions among childhood maltreatment experiences, resilience, and depressive symptoms. Methods A total of 438 medical students were included in the study. The Childhood Trauma Questionnaire-Short Form, the Conner-Davidson Resilience Scale, and the Beck Depression Inventory were used for measuring childhood maltreatment experiences, psychological resilience, and depressive symptoms, respectively. We investigated the effects of childhood maltreatment experiences on resilience and depressive symptoms using correlation analysis. In addition, we analyzed the mediating effect of resilience on the association between childhood maltreatment and symptoms of depression. Results Among childhood maltreatment, emotional neglect was a significant predictor of the scores of low resilience and high depressive symptoms in both gender groups (all ps<0.05). Furthermore, resilience was found to be a mediator connecting emotional neglect experiences with depressive symptoms. Conclusion Our results suggest that emotional neglect has detrimental effects on mood and resilience, and clinicians need to focus on the recovery of resilience when they deal with depressive symptoms in victims of childhood maltreatment. PMID:29422927

Mediating Effect of Resilience on the Association between Emotional Neglect and Depressive Symptoms.

PubMed

Lee, Sang Won; Bae, Geum Ye; Rim, Hyo-Deog; Lee, Seung Jae; Chang, Sung Man; Kim, Byung-Soo; Won, Seunghee

2018-01-01

Previous studies have reported that childhood maltreatment experiences could induce biological and psychological vulnerability in depressive disorders. However, it is still unclear that type-specific effects of childhood maltreatment on psychological resilience, depressive symptoms and interactions among childhood maltreatment experiences, resilience, and depressive symptoms. A total of 438 medical students were included in the study. The Childhood Trauma Questionnaire-Short Form, the Conner-Davidson Resilience Scale, and the Beck Depression Inventory were used for measuring childhood maltreatment experiences, psychological resilience, and depressive symptoms, respectively. We investigated the effects of childhood maltreatment experiences on resilience and depressive symptoms using correlation analysis. In addition, we analyzed the mediating effect of resilience on the association between childhood maltreatment and symptoms of depression. Among childhood maltreatment, emotional neglect was a significant predictor of the scores of low resilience and high depressive symptoms in both gender groups (all ps<0.05). Furthermore, resilience was found to be a mediator connecting emotional neglect experiences with depressive symptoms. Our results suggest that emotional neglect has detrimental effects on mood and resilience, and clinicians need to focus on the recovery of resilience when they deal with depressive symptoms in victims of childhood maltreatment.

Alterations in the neural circuitry for emotion and attention associated with posttraumatic stress symptomatology

PubMed Central

Hayes, Jasmeet Pannu; LaBar, Kevin S.; Petty, Christopher M.; McCarthy, Gregory; Morey, Rajendra A.

2009-01-01

Information processing models of posttraumatic stress disorder (PTSD) suggest that PTSD is characterized by preferential allocation of attentional resources to potentially threatening stimuli. However, few studies have examined the neural pattern underlying attention and emotion in association with PTSD symptomatology. In the present study, combat veterans with PTSD symptomatology engaged in an emotional oddball task while undergoing functional magnetic resonance imaging (fMRI). Veterans were classified into a high or low symptomatology group based on their scores on the Davidson Trauma Scale (DTS). Participants discriminated infrequent target stimuli (circles) from frequent standards (squares) while emotional and neutral distractors were presented infrequently and irregularly. Results revealed that participants with greater PTSD symptomatology showed enhanced neural activity in ventral-limbic and dorsal regions for emotional stimuli and attenuated activity in dorsolateral prefrontal and parietal regions for attention targets. In the anterior cingulate gyrus, participants with fewer PTSD symptoms showed equivalent responses to attentional and emotional stimuli while the high symptom group showed greater activation for negative emotional stimuli. Taken together, the results suggest that hyperresponsive ventral-limbic activity coupled with altered dorsal-attention and anterior cingulate function may be a neural marker of attention bias in PTSD. PMID:19237269

Collective motion in prolate γ-rigid nuclei within minimal length concept via a quantum perturbation method

NASA Astrophysics Data System (ADS)

Chabab, M.; El Batoul, A.; Lahbas, A.; Oulne, M.

2018-05-01

Based on the minimal length concept, inspired by Heisenberg algebra, a closed analytical formula is derived for the energy spectrum of the prolate γ-rigid Bohr-Mottelson Hamiltonian of nuclei, within a quantum perturbation method (QPM), by considering a scaled Davidson potential in β shape variable. In the resulting solution, called X(3)-D-ML, the ground state and the first β-band are all studied as a function of the free parameters. The fact of introducing the minimal length concept with a QPM makes the model very flexible and a powerful approach to describe nuclear collective excitations of a variety of vibrational-like nuclei. The introduction of scaling parameters in the Davidson potential enables us to get a physical minimum of this latter in comparison with previous works. The analysis of the corrected wave function, as well as the probability density distribution, shows that the minimal length parameter has a physical upper bound limit.

2. PHOTOGRAPH TAKEN FROM NORTH SIDE OF DAVIDSON DITCH LOOKING ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

2. PHOTOGRAPH TAKEN FROM NORTH SIDE OF DAVIDSON DITCH LOOKING SOUTH ALONG LENGTH OF FLUME--VEGETATION NOT REMOVED AS PER ALASKA DEPARTMENT OF TRANSPORTATION PERSONNEL. - Davidson Ditch Waste Water Weir, Mile 63 of Alaska's Steese Highway, Chatanika, Fairbanks North Star Borough, AK

Development of a screening measure of stress for parents of children hospitalised in a Paediatric Intensive Care Unit.

PubMed

Rodríguez-Rey, Rocío; Alonso-Tapia, Jesús

2016-08-01

Having a child admitted to intensive care is a highly stressful experience for parents; however there is a lack of screening instruments of parental stress in that context, which would be useful for both, research and clinical purposes. (1) To validate a brief measure of parental stress based on the Parental Stressor Scale: Paediatric Intensive Care Unit (PSS:PICU), (2) to study which environmental factors of the PICU are more stressful in a sample of Spanish parents, and (3) to study which variables are related to higher levels of stress among this group. 196 Spanish parents completed the Abbreviated PSS: PICU (A-PSS:PICU) and a general stress scale (the Perceived Stress Scale) upon their child's discharge to test the convergent validity of the tool. Three months later, they were assessed anxiety and depression using the Hospital Anxiety and Depression Scale, and posttraumatic stress with the Davidson Trauma Scale in order to test the predictive validity of the A-PSS:PICU. Two factors emerged from Confirmatory Factor Analyses, (1) stress due to child's condition and (2) stress related to PICU's staff. The A-PSS:PICU showed adequate reliability and convergent and predictive validity. The most stressful aspects were the behaviours and emotional responses of their child and the loss of their parental role. Age, gender, child's condition, length of admission, spiritual beliefs, and mechanical ventilation were associated to parental stress scores. The A-PSS:PICU is a reliable and valid measure. Parental stress should be screened during a child's PICU admission to identify parents at risk of post-discharge distress. Copyright © 2016 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

40 CFR 81.343 - Tennessee.

Code of Federal Regulations, 2011 CFR

2011-07-01

... X Coffee County X Crockett County X Cumberland County X Those portions of Davidson County within a... Clay County X Cocke County X Coffee County X Crockett County X Cumberland County X Davidson County X... County Claiborne County Clay County Cocke County Coffee County Crockett County Cumberland County Davidson...

40 CFR 81.343 - Tennessee.

Code of Federal Regulations, 2010 CFR

2010-07-01

... X Coffee County X Crockett County X Cumberland County X Those portions of Davidson County within a... Clay County X Cocke County X Coffee County X Crockett County X Cumberland County X Davidson County X... County Claiborne County Clay County Cocke County Coffee County Crockett County Cumberland County Davidson...

"All Things Flow."

ERIC Educational Resources Information Center

Mohan, John M.

1999-01-01

Presents a tribute to Dan Davidson, American Department of Foreign Language's (ADFL) 1997 honoree as an outstanding educator, focusing on Davidson's work to expand Russian studies nationwide and forge ties between U.S. Russianists and Russia itself over the past decades, beginning with the post-Sputnik era. Davidson was able to go beyond the Iron…

The Structure and Correlates of Perfectionism in African American Children

ERIC Educational Resources Information Center

McCreary, Beth T.; Joiner, Thomas E.; Schmidt, Norman B.; Ialongo, Nicholas S.

2004-01-01

This study examined the structure and symptom correlates of perfectionism in a sample of 6th-grade, urban, African American children using the Child and Adolescent Perfectionism Scale (CAPS; Flett, Hewitt, Boucher, Davidson, & Munro, 2000). Confirmatory factor analysis showed inadequate fit of the original subscales. Exploratory factor analysis…

75 FR 34524 - Decision That Certain Nonconforming Motor Vehicles Are Eligible for Importation

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-17

... Harley Davidson FX, FL, XL and VR Series Motorcycles. Substantially Similar U.S. Certified Vehicles: 2009 Harley Davidson FX, FL, XL and VR Series Motorcycles. Notice of Petition Published at: 74 FR 51943... and VR Series Motorcycles. Substantially Similar U.S. Certified Vehicles: 2008 Harley Davidson FX, FL...

Language Learning in Wittgenstein and Davidson

ERIC Educational Resources Information Center

Kotzee, Ben

2014-01-01

In this paper, I discuss language learning in Wittgenstein and Davidson. Starting from a remark by Bakhurst, I hold that both Wittgenstein and Davidson's philosophies of language contain responses to the problem of language learning, albeit of a different form. Following Williams, I hold that the concept of language learning can explain…

Spanish validation of the 10-item Connor-Davidson Resilience Scale (CD-RISC 10) with non-professional caregivers.

PubMed

Blanco, Vanessa; Guisande, María Adelina; Sánchez, María Teresa; Otero, Patricia; Vázquez, Fernando L

2017-11-08

Despite the importance of resilience in populations under stress, and the fact that the 10-item version Connor-Davidson Resilience Scale (CD-RISC 10) is the shortest instrument for reliable and valid evaluation of resilience, there are no data on their psychometric properties in non-professional caregivers. The aim of this study was to analyze the psychometric properties and factorial structure of the spanish version of the CD-RISC 10 in non-professional caregivers. Independently trained assessors evaluated resilience, self-esteem, social support, emotional distress and depression in a sample of 294 caregivers (89.8% women, mean age 55.3 years). The internal consistency of CD-RISC 10 was α = .86. A single factor was found that accounted for 44.7% of the total variance. Confirmatory factor analysis corroborated this unifactorial model. The CD-RISC 10 was significantly correlated with the self-esteem (r = .416, p < .001) and social support (r = .228, p < .001) scales, and the emotional distress scale (r = -.311, p < .001), though this was an inverse relationship. A score ≤ 23 was a suitable cut-off point for discriminating caregivers with depression (sensitivity = 70.0%, specificity = 68.2%). The CD-RISC 10 is a reliable and valid instrument to evaluate resilience in the caregiver population.

The End of Monterey Submarine Canyon Incision and Potential River Source Areas-Os, Nd, and Pb Isotope Constraints from Hydrogenetic Fe-Mn Crusts

NASA Astrophysics Data System (ADS)

Conrad, T. A.; Nielsen, S.; Ehrenbrink, B. P. E.; Blusztajn, J.; Hein, J. R.; Paytan, A.

2015-12-01

The Monterey Canyon off central California is the largest submarine canyon off North America and is comparable in scale to the Grand Canyon. The age and history of the Monterey Canyon are poorly constrained due to thick sediment cover and sediment disruption from turbidity currents. To address this deficit we analyzed isotopic proxies (Os, Pb, Nd) from hydrogenetic ferromanganese (Fe-Mn) crusts, which grow over millions of years on elevated rock surfaces by precipitation of metals from seawater. Fe-Mn crusts were studied from Davidson Seamount near the base of the Monterey submarine fan, the Taney Seamount Chain, and from Hoss Seamount, which serves as a regional control (Fig.). Fe-Mn crusts were dated using Os isotope ratios compared to those that define the Cenozoic Os isotope seawater curve. Four Fe-Mn crust samples from Davidson and Taney Seamounts deviate from the Os isotopic seawater curve towards radiogenic values after 4.5±1 Ma. Osmium is well mixed in the global ocean and is not subject to significant diffusive reequilibration in Fe-Mn crusts. We therefore attribute deviations from the Os isotope seawater curve to large-scale terrestrial input that ended about 4.5±1 Ma. The two Davidson samples also show more radiogenic Nd isotope values from about 4.5±1 Ma. Lead isotopes in one Davidson Seamount crust, measured by LA-ICPMS, deviate from regional values after 4.5±1 Ma for about 500 ka towards terrestrial sources. The Taney Seamount Fe-Mn crust does not deviate from regional Nd nor Pb isotope values due to its greater distance from Monterey Canyon and the shorter marine residence times of Nd and Pb. Isotope plots of our crust data and compiled data for potential source rocks indicate that the river that carved Monterey Canyon carried sediment with values closer to the Sierra Nevada than to a Colorado Plateau source, with cessation of major riverine input occurring approximately 4.5±1 Ma, an age that we interpret as the end of the Monterey Canyon incision.

The impact of witnessing other people's trauma: The resilience and coping strategies of members of the Faculty of Forensic and Legal Medicine.

PubMed

Horvath, Miranda A H; Massey, Kristina

2018-04-01

The coping strategies, resilience and psychological distress of members of the Faculty of Forensic and Legal Medicine (FFLM) were measured in an attempt to establish how they are affected by, and accommodate potentially traumatic encounters with patients. Belief in a just world was also measured as it was deemed to be a mediating factor in the psychological distress exhibited in the medical practitioners who participated in this study. 120 members of the FFLM (65 females, 54 males and 1 undisclosed) volunteered to complete an online survey. Data was collected using Survey Monkey. Participants filled out the Personal Belief in a Just World Scale and General Belief in a Just World Scale, as well as the Connor-Davidson Resilience Scale 25, the COPE and the Brief Symptom Inventory. A multiple regression with stepwise entry was carried out. Personal belief in a just world, coping strategies and resilience were all identified as having a significant relationship with psychological distress. Although this is only a preliminary study into this phenomenon, findings suggest the personal belief in a just world, coping strategies and resilience are useful predictors of psychological distress amongst forensic medical practitioners. However they did not predict the majority of the variance and as such, more detailed investigations are needed to identify which other factors are important in order to design interventions and support for members of the Faculty of Forensic and Legal Medicine and other forensic medical practitioners. Copyright © 2018 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

A perspective on the contributions of Ronald C. Davidson to plasma physics

NASA Astrophysics Data System (ADS)

Wurtele, Jonathan S.

2016-10-01

Starting in the 1960s and continuing for half a century, Ronald C. Davidson made fundamental theoretical contributions to a wide range of areas of pure and applied plasma physics. Davidson was one of the founders of nonneutral plasma physics and a pioneer in developing and applying kinetic theory and nonlinear stability theorems to collective interaction processes and nonlinear dynamics of nonneutral plasmas and intense charged particle beams. His textbooks on nonneutral plasmas are the classic references for the field and educated generations of graduate students. Davidson was a strong advocate for applying the ideas of plasma theory to develop techniques that benefit other branches of science. For example, one of the major derivative fields enabled by nonneutral plasmas is the study of antimatter plasmas and the synthesis of antihydrogen. This talk will review a few highlights of Ronald Davidson's impact on plasma physics and related fields of science.

15 CFR Appendix F to Subpart M of... - Davidson Seamount Management Zone

Code of Federal Regulations, 2011 CFR

2011-01-01

... 15 Commerce and Foreign Trade 3 2011-01-01 2011-01-01 false Davidson Seamount Management Zone F Appendix F to Subpart M of Part 922 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign... Sanctuary Pt. 922, Subpt. M, App. F Appendix F to Subpart M of Part 922—Davidson Seamount Management Zone...

Paired Comparisons.

DTIC Science & Technology

1982-05-01

including multidimensional scaling. Applications have arisen in many areas, but most notably in food technolog, marketing research, and sports ... competition .- An extensive bibliography on paired comparisons by Davidson and Farquhar (1976) contains some 400 references. - Paired comparisons have been...consideration of chess competition . Ford (1957) pro- posed the model independently. Both Zermelo and Ford concentrated on solution of normal equations for

Resiliency and the Ability to Detect Cartoon Humor

ERIC Educational Resources Information Center

Killlon, Jessica B.; Torres, Aurora

2017-01-01

The Connor Davidson Resilience Scale was developed to measure resiliency, an individual's ability to positively adapt to stressful or adverse situations. Resilient individuals have close and secure relationships, have a strong sense of purpose, know when to turn to others for help, and find humor in situations. The focus of this study was on the…

Psychometric properties of Connor-Davidson Resilience Scale in a Spanish sample of entrepreneurs.

PubMed

Manzano-García, Guadalupe; Ayala Calvo, Juan Carlos

2013-01-01

The literature regarding entrepreneurship suggests that the resilience of entrepreneurs may help to explain entrepreneurial success, but there is no resilience measure widely accepted by researchers. This study analyzes the psychometric properties of the Connor and Davidson Resilience Scale (CD-RISC) in a sample of Spanish entrepreneurs. A telephone survey research method was used. The participants were entrepreneurs operating in the business services sector. Interviewers telephoned a total of 900 entrepreneurs of whom 783 produced usable questionnaires. The CD-RISC was used as data collection instrument. We used principal component analysis factor and confirmatory factor analysis to determine the factor structure of the CD-RISC. Confirmatory factor analysis failed to verify the original five-factor structure of the CD-RISC, whereas principal component analysis factor yielded a 3-factor structure of resilience (hardiness, resourcefulness and optimism). In this research, 47.48% of the total variance was accounted for by three factors, and the obtained factor structure was verified through confirmatory factor analysis. The CD-RISC has been shown to be a reliable and valid tool for measuring entrepreneurs' resilience.

Specific pain complaints in Iraq and Afghanistan veterans screening positive for post-traumatic stress disorder.

PubMed

Moeller-Bertram, Tobias; Afari, Niloofar; Mostoufi, Sheeva; Fink, David S; Johnson Wright, Lisa; Baker, Dewleen G

2014-01-01

Post-traumatic stress disorder (PTSD) and pain are highly comorbid. The purpose of this study was to examine the association of PTSD with specific pain complaints in veterans of Operations Enduring and Iraqi Freedom (OEF/OIF). A total of 381 primarily male (88.5%) veterans with a mean age of 30 years completed a battery of self-report questionnaires. A positive PTSD screen was defined as a score of ≥40 on the Davidson Trauma Scale. Logistic regression was used to examine the association of positive PTSD screen with specific pain complaints. There were no significant demographic or physical and mental health differences between veterans who screened positive for PTSD only and those with PTSD and at least one pain complaint, although differences on rates of combat injury and depression approached significance. Veterans who screened positive for PTSD were 2 to 3 times more likely to report abdominal pain, muscle aches or cramps, and joint aches, even after controlling for age, gender, combat injury, and depression. Similar to findings in other populations, there is a relationship between PTSD and pain complaints in OEF/OIF veterans. Future research should examine the mechanisms that link PTSD with specific pain complaints, especially abdominal pain. Published by Elsevier Inc.

Cole-Davidson dynamics of simple chain models.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dotson, Taylor C.; McCoy, John Dwane; Adolf, Douglas Brian

2008-10-01

Rotational relaxation functions of the end-to-end vector of short, freely jointed and freely rotating chains were determined from molecular dynamics simulations. The associated response functions were obtained from the one-sided Fourier transform of the relaxation functions. The Cole-Davidson function was used to fit the response functions with extensive use being made of Cole-Cole plots in the fitting procedure. For the systems studied, the Cole-Davidson function provided remarkably accurate fits [as compared to the transform of the Kohlrausch-Williams-Watts (KWW) function]. The only appreciable deviations from the simulation results were in the high frequency limit and were due to ballistic or freemore » rotation effects. The accuracy of the Cole-Davidson function appears to be the result of the transition in the time domain from stretched exponential behavior at intermediate time to single exponential behavior at long time. Such a transition can be explained in terms of a distribution of relaxation times with a well-defined longest relaxation time. Since the Cole-Davidson distribution has a sharp cutoff in relaxation time (while the KWW function does not), it makes sense that the Cole-Davidson would provide a better frequency-domain description of the associated response function than the KWW function does.« less

Adaptation of Individual and Team Character in Sport Questionnaire to Turkish

ERIC Educational Resources Information Center

Görgüt, Ilyas; Tutkun, Erkut

2017-01-01

The aim of this study was to make validity and reliability of Turkish form of the individual and team character in sport questionnaire (ITCSQ) which was developed by Davidson et al., (2000). Scale was designed to measure outcomes related with character in the sport environment. 438 participants were voluntarily included into the study in two…

Sex differences in traumatic events and psychiatric morbidity associated to probable posttraumatic stress disorder among Latino prisoners.

PubMed

Pérez-Pedrogo, Coralee; Martínez-Taboas, Alfonso; González, Rafael A; Caraballo, José N; Albizu-García, Carmen E

2018-04-14

Latinos comprised 17.1% of the U.S. population and 33.1% of US prisoners, yet they are underrepresented in the psychopathology literature. Despite higher rates of trauma among incarcerated individuals than in the general population, most of the previous research in this area focused primarily on women samples, and very few studies examined sex differences in PTSD and traumatic experiences. In addition, there is a need for research assessing traumatic experiences and probable PTSD in men and women Latino inmates to inform culturally competent care and sex sensitive care for this vulnerable and underserved population. Our study examined whether men and women Latino inmates with probable Posttraumatic Stress Disorder (PTSD), based on the cut off 40 or more symptoms on the Davidson Trauma Scale (DTS), differed significantly by the number of event types experienced, the type of potentially traumatizing event, and in co-occurring psychiatric conditions. A multi-stage sample design was used to select a probabilistic sample of 1,331 inmates from 26 penal institutions in PR of which 1179 participated in the study. Bivariate associations were calculated for each type of traumatic event and probable PTSD. Mean number of types of potentially traumatizing event experienced was comparable for both sexes (F = 3.83, M = 3.74) yet sex differences were found in the nature of the event. Women with probable PTSD had higher rates of experiencing rape and sexual abuse. Men had higher rates of experiencing combat in war, a life-threatening accident, of witnessing violence, and being threatened with a weapon. Men with significant ADHD symptoms in childhood and with Generalized Anxiety Disorder (GAD) during adulthood were almost 5 and 7 times as likely to score above threshold on the DTS whereas women were >3 times as likely in the presence of ADHD symptoms in childhood or depression during adulthood. This study underscores the need to improve understanding of the clinical manifestations of trauma and co-occurring psychiatric conditions for appropriate sex sensitive interventions targeting Latinos living in prisons. Copyright © 2018 Elsevier B.V. All rights reserved.

Trauma, depression, and resilience of earthquake/tsunami/nuclear disaster survivors of Hirono, Fukushima, Japan.

PubMed

Kukihara, Hiroko; Yamawaki, Niwako; Uchiyama, Kumi; Arai, Shoichi; Horikawa, Etsuo

2014-07-01

A mega-earthquake and tsunami struck the northeastern coast of Japan, and many survivors were forced to evacuate to temporary housing due to rising radiation levels. The aims of this study were to investigate the prevalence of symptoms of post-traumatic stress disorder (PTSD), depression, and poor general health among survivors, to test the predictive roles of resilience on mental and physical health, and to examine the predictive sociodemographic factors on resilience. Two hundred and forty-one evacuees (men/women: 116/125) from Hirono, Fukushima participated in the study. They were asked to complete the Connor-Davidson Resilience Scale, the Zung Self-Rating Depression Scale, the Impact of Events Scale-Revised, and a demographic questionnaire. Among all participants, 53.5% exhibited the clinically concerning symptoms of PTSD, and among them 33.2% indicated clinical PTSD symptoms. Additionally, 66.8% reported symptoms of depression, and among them 33.2% showed mildly depressive symptoms, while 19.1% and 14.5% demonstrated moderate and severe depressive symptoms, respectively. Resilience was a significant buffer for depression, PTSD, and general health. Additionally, employment status, eating/exercise habits, and drinking habits predicted resilience. The results indicated that depression and PTSD are prevalent among the survivors of massive earthquakes, tsunamis, and accidents from nuclear power plants. However, the results also showed that some survivors managed to endure the traumatic events relatively well, and resilience was a significant protective factor in dealing with such events. Therefore, it is crucial to assist survivors in improving their resilience by providing job opportunities and encouraging a healthy lifestyle. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

Reliability and validity of the Khmer version of the 10-item Connor-Davidson Resilience Scale (Kh-CD-RISC10) in Cambodian adolescents.

PubMed

Duong, Chanmettachampavieng; Hurst, Cameron P

2016-06-08

Resilience has been characterized as a defensive factor against the refinement of mental health problems. This study adapted the Connor-Davidson Resilience Scale (Kh-CD-RISC10) for use in Khmer adolescents and subsequently investigates its psychometric properties. Using stratified random sampling, this cross-sectional study sampled Cambodian adolescents from high schools selected randomly within three provinces (Phnom Penh, Battambang and Mondulkiri)-location (rural, urban) combinations. Parallel analysis was used to identify the number of component(s), and the structure of the single factor was subsequently explored using principal axis factoring. A confirmatory factor analysis was then performed to establish the fit of the Kh-CD-RISC10 to another sample. To assess convergent validity, the factor scores of the Khmer version of Connor-Davidson Resilience Scale were categorized into three levels, and then the general negative affectivity (GNA) and physiological hyperarousal (PH) scales (derived from the DASS 21) were compared among the three resilience groups. Of the 798 participants who responded (responded rate = 82.26 %), 440 (41.23 %) were female and the age ranged from 14 to 24 years old (mean = 17.36, SD = 1.325). The internal consistency of the Khmer 10-item CD-RISC was also shown to be high in Cambodian adolescents (Cronbach's alpha = 0. 82). Confirmatory factor analysis revealed the single factor model fit data adequately (χ(2) = 100.103, df = 35, p < 0.001, CFI = 0.9484, RMSEA = 0.0384). We found that there were significant differences in both General Negative affectivity and Physiological Hyperarousal among the three resilience groups (FGNA = 12. 84, df = 2, p < 0.001; FPH = 13. 01, df = 2, p < 0.001). The results from the present study indicate that the Khmer version of CD-RISC shows good psychometric properties in Cambodian adolescents. Our result confirms that a single dimension underlay the 10 items on the CD-RISC scale of this population, and can be used to assess the resilience comparing to the level of PTSD symptoms in general Khmer adolescent.

Eric Davidson and deep time.

PubMed

Erwin, Douglas H

2017-10-13

Eric Davidson had a deep and abiding interest in the role developmental mechanisms played in generating evolutionary patterns documented in deep time, from the origin of the euechinoids to the processes responsible for the morphological architectures of major animal clades. Although not an evolutionary biologist, Davidson's interests long preceded the current excitement over comparative evolutionary developmental biology. Here I discuss three aspects at the intersection between his research and evolutionary patterns in deep time: First, understanding the mechanisms of body plan formation, particularly those associated with the early diversification of major metazoan clades. Second, a critique of early claims about ancestral metazoans based on the discoveries of highly conserved genes across bilaterian animals. Third, Davidson's own involvement in paleontology through a collaborative study of the fossil embryos from the Ediacaran Doushantuo Formation in south China.

Eric Davidson, his philosophy, and the history of science.

PubMed

Deichmann, Ute

2017-10-16

Eric Davidson, a passionate molecular developmental biologist and intellectual, believed that conceptual advances in the sciences should be based on knowledge of conceptual history. Convinced of the superiority of a causal-analytical approach over other methods, he succeeded in successfully applying this approach to the complex feature of organismal development by introducing the far-reaching concept of developmental Gene Regulatory Networks. This essay reviews Davidson's philosophy, his support for the history of science, and some aspects of his scientific personality.

Psychometric validation of the French version of the Connor-Davidson Resilience Scale.

PubMed

Guihard, G; Deumier, L; Alliot-Licht, B; Bouton-Kelly, L; Michaut, C; Quilliot, F

2018-02-01

Resilience defines the ability to face adversity with positive outcomes. Different scales, including the 25-item Connor-Davidson Resilience Scale (CDRISC), have been elaborated in order to evaluate resilience among various populations. The evaluation of resilience in French populations was impossible until CDRISC was translated into French. In the present work, we aim to validate a French version of CDRISC (f-CDRISC). The survey was conducted at Nantes University. Both dental and medical students were eligible. The factor structure of f-CDRISC was determined and its replicability was tested on two sub-samples by exploratory factor analysis (EFA) and parallel analysis (PA). A third student sample was used for confirmatory factorial analysis (CFA). We collected 1210 responses. Four items did not reach acceptance thresholds for reliability and were discarded from the f-CDRISC. EFA and PA of the remaining 21 items highlighted a replicable 3-factor structure that was further confirmed by CFA. Resilience factors included "tolerance to negative affects", "tenacity" and "self-confidence". All factors displayed acceptable to good internal consistency. They were characterized by positive medium to strong correlations with the overall f-CDRISC Scale. Significant positive correlations were also observed between the resilience factors. The present work constitutes the first study devoted to a French adaptation of the CDRISC questionnaire. We present evidence showing that the f-CDRISC is a reliable tool for resilience evaluation in French speaking populations. Copyright © 2017 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Consent Decree for Harley-Davidson

EPA Pesticide Factsheets

Harley-Davidson will also pay a $12 million civil penalty and spend $3 million on a project to mitigate air pollution through a project to replace conventional woodstoves with cleaner-burning stoves in local communities.

Large-Scale Physical Separation of Depleted Uranium from Soil

DTIC Science & Technology

2012-09-01

Earth and Environment 285 Davidson Avenue, Suite 100 Somerset, NJ 08873 Catherine Nestler Applied Research Associates, Inc. 119 Monument Place...square meters square miles 2.589998 E+06 square meters square yards 0.8361274 square meters yards 0.9144 meters ERDC/EL TR-12-25 viii...depleted uranium EL Environmental Laboratory ERDC Engineer Research and Development Center ICP-MS Inductively coupled plasma - mass spectroscopy

From Lyme Disease to Art and Advocacy | NIH MedlinePlus the Magazine

MedlinePlus

... Tick Bites Follow us From Lyme Disease to Art and Advocacy Bruce Davidson always enjoyed the outdoors. ... his recovery, Davidson has become "hyper-focused" on art and uses these talents to help others. "I ...

Normative data and psychometric properties of the Connor-Davidson Resilience Scale (CD-RISC) and the abbreviated version (CD-RISC2) among the general population in Hong Kong.

PubMed

Ni, Michael Y; Li, Tom K; Yu, Nancy X; Pang, Herbert; Chan, Brandford H Y; Leung, Gabriel M; Stewart, Sunita M

2016-01-01

To examine whether the two-item version (CD-RISC2) of the Connor-Davidson Resilience Scale (CD-RISC) has adequate internal consistency and construct validity, as well as significant correlation with the full scale, and to provide normative data for the CD-RISC and the CD-RISC2 in a Chinese general population in Hong Kong. In total, 10,997 randomly selected participants aged ≥20 years completed the Chinese version of the CD-RISC (including the 2 items of the CD-RISC2), the Patient Health Questionnaire, Family Harmony Scale, Family APGAR, and CAGE Questionnaire. Internal consistency and convergent and discriminant validity of the CD-RISC and CD-RISC2 were assessed. Cronbach's α for CD-RISC and CD-RISC2 was 0.97 and 0.79, respectively. CD-RISC2 was associated with the 25-item version of the CD-RISC (r = 0.88), depressive symptoms (r s = -0.18), family harmony (r = 0.20), family functioning (r = 0.27) and was not associated with alcohol consumption (r = 0.05). The mean score for the CD-RISC and CD-RISC2 was 59.99 (SD = 13.92) and 5.03 (SD = 1.37), respectively. Men, younger individuals, and those with higher education or higher household income reported higher resilience levels. The Chinese version of the CD-RISC2 was demonstrated to be a reliable and valid measure in assessing resilience among the general population in Hong Kong.

Dissociative disorders and dissociative symptoms among veterans of the Iraq-Iran war suffering from chronic post-traumatic disorder.

PubMed

Nejad, Alireza G; Farahati, Hamid

2007-10-01

To evaluate any dissociative disorders in patients with post traumatic stress disorder (PTSD), and find any relationship between dissociation and related variables in these patients. A case controlled study carried out among 130 male patients with PTSD, and 130 matched individuals from the normal population. The study was carried out between January and September 2005, at Beheshti Psychiatric Hospital, Kerman, Iran, Demographic data and history of childhood physical abuse and self-harm in both groups were recorded. The severity of PTSD was measured by Davidson PTSD scale in the study group. Dissociative symptoms were evaluated with the dissociative experience scale (DES). For evaluating dissociative disorders, the dissociative disorder interview schedule (DDIS) was used. Data were analyzed by SPSS software. The mean age (+/- SD) of veterans was 41.46 (+/-5.09) years, and the mean age of going to the combat area was 29.4 (+/-5.015). The mean duration of involvement in combat was 27.8 (+/-23.44) months. The mean DES score in the study group was 26.01 (+/-12.31) and was 9.58 (+/-7.23) in the control group (F=1.171, p<0.0001). The mean score (+/-SD) of Davidson PTSD scale was 54+/-96 in the study group. The most prevalent dissociative disorder in the study group was psychogenic amnesia. Many veterans with the impression of chronic PTSD may have an additional diagnosis of dissociative disorders.

Resilience of internal medicine house staff and its association with distress and empathy in an oncology setting.

PubMed

McFarland, Daniel C; Roth, Andrew

2017-10-01

Resilience is a beneficial trait for resident physicians who are exposed to adversity through their work with patients. Inpatient hematology-oncology produces vicarious trauma for physicians in training. Physician distress and empathy influence patient care and may be associated with respectively lower and greater levels of resilience. We collected measures of resilience (Connor-Davidson Resilience Scale), distress (Impact of Events Scale - Revised), and rotation-specific information (e.g., number of death encounters, death stress, and meaning) at the end of a routine hematology-oncology ward rotation. Empathy (Interpersonal Reactivity Index) was measured both before and after the rotation. Fifty-six out of 96 residents completed the study with an overall response rate of 58%. Resilience was negatively correlated with distress (r = -0.306, p = 0.023) but not with empathy (r = 0.172, p = 0.204) and nor with change in empathy over the course of the rotation (r = -0.122, p = 0.374). When separated by sex, male resilience was negatively correlated with distress (r = -0.389, p = 0.04), but female resilience was not. Resident distress levels were in a clinically significant (76%) or posttraumatic stress disorder range (17%), and resident empathy decreased during the rotation (p = 0.018). Resilience levels were similar in those who reported that death events were the most stressful experiences of the rotation and those who derived a sense of meaning from working with dying patients. Resident physicians experienced clinically relevant distress and a decrease in empathy. Resilient resident physicians were less likely to experience distress. This study provides evidence for the salutary effects of resilience on physician distress. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Resilience and Associated Factors among Mainland Chinese Women Newly Diagnosed with Breast Cancer.

PubMed

Wu, Zijing; Liu, Ye; Li, Xuelian; Li, Xiaohan

2016-01-01

Resilience is the individual's ability to bounce back from trauma. It has been studied for some time in the U.S., but few studies in China have addressed this important construct. In mainland China, relatively little is known about the resilience of patients in clinical settings, especially among patients with breast cancer. In this study, we aimed to evaluate the level of resilience and identify predictors of resilience among mainland Chinese women newly diagnosed with breast cancer. A cross-sectional descriptive study was conducted with 213 mainland Chinese women newly diagnosed with breast cancer between November 2014 and June 2015. Participants were assessed with the Connor-Davidson Resilience Scale (CD-RISC), Social Support Rating Scale (SSRS), Medical Coping Modes Questionnaire (MCMQ, including 3 subscales: confrontation, avoidance, and acceptance-resignation), Herth Hope Index (HHI), and demographic and disease-related information. Descriptive statistics, bivariate analyses and multiple stepwise regression were conducted to explore predictors for resilience. The average score for CD-RISC was 60.97, ranging from 37 to 69. Resilience was positively associated with educational level, family income, time span after diagnosis, social support, confrontation, avoidance, and hope. However, resilience was negatively associated with age, body mass index (BMI), and acceptance-resignation. Multiple stepwise regression analysis indicated that hope (β = 0.343, P<0.001), educational level of junior college or above (β = 0.272, P<0.001), educational level of high school (β = 0.235, P<0.001), avoidance (β = 0.220, P<0.001), confrontation (β = 0.187, P = 0.001), and age (β = -0.108, P = 0.037) significantly affected resilience and explained 50.1% of the total variance in resilience. Women with newly diagnosed breast cancer from mainland China demonstrated particularly low resilience level, which was predicted by hope educational level, avoidance, confrontation, and age.

77 FR 59829 - List of Nonconforming Vehicles Decided To Be Eligible for Importation

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-01

..., the environment, public health or safety, or State, local, or Tribal governments or communities; (2... concern an environmental, health, or safety risk that NHTSA has reason to believe may have a... ..... ..... Harley Davidson (MC)......... FX, FL, XL & VR 2004 422 ..... ..... Series. Harley Davidson (MC...

Advanced Diagnostics for Reacting Flows

DTIC Science & Technology

1991-11-20

Ingeniera Mecanica , 17-19 Dec. 1990, Zaragosa, Spain; published in Congress Proceedings. 19. D. F. Davidson, A. Y. Chang, M. D. DiRosa and R. K. Hanson... Mecanica , 17-19 Dec. 1990, Zaragosa, Spain; published in Congress Proceedings. 14. D. F. Davidson, A. Y. Chang, M. D. DiRosa and R. K. Hanson

77 FR 24382 - Approval and Promulgation of Air Quality Implementation Plans; North Carolina; Annual Emissions...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-24

..., Lincoln, Rowan, and Union Counties in their entireties and Davidson Township and Coddle Creek Township in..., Durham, Forsyth, Gaston, Guilford, Mecklenburg, and Wake County, the Dutchville Township in Granville... entireties and Davidson Township and Coddle Creek Township in Iredell County to the annual emissions...

PTSD, combat injury, and headache in Veterans Returning from Iraq/Afghanistan.

PubMed

Afari, Niloofar; Harder, Laura H; Madra, Naju J; Heppner, Pia S; Moeller-Bertram, Tobias; King, Clay; Baker, Dewleen G

2009-10-01

To examine the relationship between posttraumatic stress disorder, combat injury, and headache in Operation Iraqi Freedom and Operation Enduring Freedom veterans at the VA San Diego Healthcare System. Previous investigations suggest that a relationship between posttraumatic stress disorder and primary headache disorders exists and could be complicated by the contribution of physical injury, especially one that results in loss of consciousness. These associations have not been systematically examined in Operation Iraqi Freedom and Operation Enduring Freedom veterans. In this observational cross-sectional study, a battery of self-report, standardized questionnaires was completed by 308 newly registered veterans between March and October 2006. The Davidson Trauma Scale was used to determine the degree of posttraumatic stress disorder symptoms and combat-related physical injury was assessed by self-report. The presence of headache was based on a symptom checklist measure and self-reported doctor diagnoses. Logistic regression analysis was performed to predict presence of headache and determine odds ratios and 95% confidence intervals associated with demographic, military, in-theatre, and mental health characteristics. About 40% of the veterans met the criteria for posttraumatic stress disorder; 40% self-reported current headache, 10% reported a physician diagnosis of migraine, 12% a physician diagnosis of tension-type headache, and 6% reported both types of headache. Results from the logistic regression model indicated that combat-related physical injury (odds ratio: 2.25; 95% confidence interval: 1.17-4.33) and posttraumatic stress disorder (odds ratio: 4.13; 95% confidence interval: 2.44-6.99) were independent predictors of self-reported headache. Additional analyses found that veterans with both tension and migraine headache had higher rates of posttraumatic stress disorder (chi-square [d.f. = 3] = 15.89; P = .001) whereas veterans with migraine headache alone had higher rates of combat-related physical injury (chi-square [d.f. = 9] = 22.00; P = .009). Posttraumatic stress disorder and combat-related physical injury were related to higher rates of self-reported headache in newly returning veterans. Our finding that posttraumatic stress disorder and injury during combat are differentially related to migraine and tension-type headache, point to a complex relationship between physical and psychological trauma and headache. These findings have implications for a comprehensive approach to interventions for headache and the physical and psychological sequelae of trauma.

The Cedar Project: resilience in the face of HIV vulnerability within a cohort study involving young Indigenous people who use drugs in three Canadian cities.

PubMed

Pearce, Margo E; Jongbloed, Kate A; Richardson, Chris G; Henderson, Earl W; Pooyak, Sherri D; Oviedo-Joekes, Eugenia; Christian, Wunuxtsin M; Schechter, Martin T; Spittal, Patricia M

2015-10-29

Indigenous scholars have long argued that it is critical for researchers to identify factors related to cultural connectedness that may protect against HIV and hepatitis C infection and buffer the effects of historical and lifetime trauma among young Indigenous peoples. To our knowledge, no previous epidemiological studies have explored the effect of historical and lifetime traumas, cultural connectedness, and risk factors on resilience among young, urban Indigenous people who use drugs. This study explored risk and protective factors associated with resilience among participants of the Cedar Project, a cohort study involving young Indigenous peoples who use illicit drugs in three cities in British Columbia, Canada. We utilized the Connor-Davidson Resilience Scale to measure resilience, the Childhood Trauma Questionnaire to measure childhood maltreatment, and the Symptom-Checklist 90-Revised to measure psychological distress among study participants. Multivariate linear mixed effects models (LME) estimated the effect of study variables on mean change in resilience scores between 2011-2012. Among 191 participants, 92 % had experienced any form of childhood maltreatment, 48 % had a parent who attended residential school, and 71 % had been in foster care. The overall mean resilience score was 62.04, with no differences between the young men and women (p = 0.871). Adjusted factors associated with higher mean resilience scores included having grown up in a family that often/always lived by traditional culture (B = 7.70, p = 0.004) and had often/always spoken their traditional language at home (B = 10.52, p < 0.001). Currently knowing how to speak a traditional language (B = 13.06, p = 0.001), currently often or always living by traditional culture (B = 6.50, p = 0.025), and having recently sought drug/alcohol treatment (B = 4.84, p = 0.036) were also significantly associated with higher mean resilience scores. Adjusted factors associated with diminished mean resilience scores included severe childhood emotional neglect (B = -13.34, p = 0.001), smoking crack daily (B = -5.42, p = 0.044), having been sexual assaulted (B =  14.42, p = 0.041), and blackout drinking (B = -6.19, p = 0.027). Young people in this study have faced multiple complex challenges to their strength. However, cultural foundations continue to function as buffers that protect young Indigenous people from severe health outcomes, including vulnerability to HIV and HCV infection.

78 FR 54182 - List of Nonconforming Vehicles Decided To Be Eligible for Importation

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-03

... health or safety, or State, local, or Tribal governments or communities; (2) Create a serious... concern an environmental, health, or safety risk that NHTSA has reason to believe may have a...) FL Series 2010 528 Harley Davidson (MC) FX, FL, XL & VR Series......... 2004 422 Harley Davidson (MC...

Gatekeeper Training in Campus Suicide Prevention

ERIC Educational Resources Information Center

Wallack, Cory; Servaty-Seib, Heather L.; Taub, Deborah J.

2013-01-01

Gatekeeper training is one of the most commonly employed methods for identifying and intervening with at-risk students (Davidson and Locke, 2010). Within the context of campus suicide prevention, a gatekeeper is broadly defined as any individual who has the potential to come into contact with at-risk students (Davidson and Locke, 2010). Although…

The Secret Life of Slurs from the Perspective of Reported Speech

ERIC Educational Resources Information Center

Salmani Nodoushan, Mohammad Ali

2015-01-01

Research on reported speech is old, but scholars working in this field are inclined to see its roots in Davidson's (1968) paratactic account of indirect reports. Although Davidson aimed at a "truth-conditional" theory of indirect reports which could challenge ideational, use, and psychological theories, his paratactic view--of which the…

15 CFR Appendix F to Subpart M of... - Davidson Seamount Management Zone

Code of Federal Regulations, 2010 CFR

2010-01-01

... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Davidson Seamount Management Zone F Appendix F to Subpart M of Part 922 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE OCEAN AND...

EFFECT OF THE APOE ε4 ALLELE AND COMBAT EXPOSURE ON PTSD AMONG IRAQ/AFGHANISTAN-ERA VETERANS.

PubMed

Kimbrel, Nathan A; Hauser, Michael A; Garrett, Melanie; Ashley-Koch, Allison; Liu, Yutao; Dennis, Michelle F; Klein, Rebecca C; Beckham, Jean C

2015-05-01

The apolipoprotein E (APOE) ε4 allele has been implicated in a range of neuropsychiatric conditions. The present research examined if the ε4 allele of the APOE gene moderated the effect of combat exposure on posttraumatic stress disorder (PTSD) among Iraq/Afghanistan-era veterans. Participants included 765 non-Hispanic White (NHW) and 859 non-Hispanic Black (NHB) Iraq/Afghanistan-era veterans. A structured interview established psychiatric diagnoses. Combat exposure and PTSD symptom severity were assessed via self-report. The most common lifetime diagnoses were depression (39.2%), PTSD (38.4%), and alcohol dependence (24.38%). After correcting for multiple comparisons, no significant effects were observed on any of the outcomes among the NHW sample; however, within the NHB sample, significant gene × environment (G × E) interactions were observed for lifetime PTSD (P = .0029) and PTSD symptom severity (P = .0009). In each case, the APOE ε4 allele had no effect on the outcomes when combat exposure was low; however, when combat exposure was high, an additive effect was observed such that ε4 homozygotes exposed to high levels of combat reported the highest rates of PTSD (92%) and the worst symptom severity scores on the Davidson Trauma Scale (M = 79.5). Although preliminary, these findings suggest that the APOE ε4 allele, in conjunction with exposure to high levels of combat exposure, may increase veterans' risk for developing PTSD. © 2015 Wiley Periodicals, Inc.

Psychopathological consequences after a terrorist attack: an epidemiological study among victims, the general population, and police officers.

PubMed

Gabriel, Rafael; Ferrando, Laura; Cortón, Enrique Sainz; Mingote, Carlos; García-Camba, Eduardo; Liria, Alberto Fernández; Galea, Sandro

2007-09-01

To assess the prevalence and correlates of post-traumatic stress disorder (PTSD), major depression and anxiety disorders other than PTSD, among three samples with different level of exposure to the March 11, 2004 terrorist attacks in Madrid. We sampled three groups of persons-those injured in the attacks, the residents of Alcala de Henares, and police officers involved with the rescue effort-with different exposure to the March 11, 2004 terrorist attacks, using random sampling from comprehensive censuses of all three groups. In person interviews were conducted with all three groups between 5 and 12 weeks after March 11, 2004. Questionnaire included assessment of socio-demographic characteristics, of PTSD using the Davidson trauma scale, and of a range of psychiatric illnesses using the mini international neuropsychiatric interview (MINI). The overall sample included 127 persons injured in the attack, 485 residents of Alcalá de Henares, and 153 policemen involved in rescue. Of all three groups 57.5%, 25.9% and 3.9% of persons, respectively, reported symptoms consistent with any assessed psychiatric disorder. The use of psychoactive medication before March 11, 2004 was consistently the main predictor of PTSD and major depression among those injured and of major depression and anxiety disorders others than PTSD among residents of Alcala. There was a substantial burden of psychological consequences of the March 11, 2004 terrorist attacks two months after the event. Persons with prior mental illness are at higher risk of post-event psychopathology, across groups of exposure.

76 FR 59578 - List of Nonconforming Vehicles Decided To Be Eligible for Importation

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-27

... health or safety, or State, local, or Tribal governments or communities; (2) Create a serious... does not concern an environmental, health, or safety risk that NHTSA has reason to believe may have a.......... 1987-1997 202 Harley Davidson (MC) FL Series 2010 528 Harley Davidson (MC) FX, FL, XL & VR Series...

Selected List of Materials. Sarah K. Davidson Family-Patient Library.

ERIC Educational Resources Information Center

Sanders, Susan, Comp.; Satterwhite, Betty, Comp.

Designed as an aid for those wishing to establish pediatric health education resource centers for use by patients and their families, this bibliography lists selected holdings of the Sarah K. Davidson Family-Patient Library, which is located in the Strong Memorial Hospital of the University of Rochester, New York. It is noted that all…

Wiki Use That Increases Communication and Collaboration Motivation: A Reflection Several Semesters Later

ERIC Educational Resources Information Center

Davidson, Robyn

2015-01-01

The article "Wiki use that increases communication and collaboration motivation" (Davidson, 2012) appeared in the "Journal of Learning Design," Volume 5, Issue 2 in 2012. Three years on, Robyn Davidson reflects upon her original article. This article gave an account of how wikis were used as a platform to provide an opportunity…

A finite difference Davidson procedure to sidestep full ab initio hessian calculation: Application to characterization of stationary points and transition state searches

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sharada, Shaama Mallikarjun; Bell, Alexis T., E-mail: mhg@bastille.cchem.berkeley.edu, E-mail: bell@cchem.berkeley.edu; Head-Gordon, Martin, E-mail: mhg@bastille.cchem.berkeley.edu, E-mail: bell@cchem.berkeley.edu

2014-04-28

The cost of calculating nuclear hessians, either analytically or by finite difference methods, during the course of quantum chemical analyses can be prohibitive for systems containing hundreds of atoms. In many applications, though, only a few eigenvalues and eigenvectors, and not the full hessian, are required. For instance, the lowest one or two eigenvalues of the full hessian are sufficient to characterize a stationary point as a minimum or a transition state (TS), respectively. We describe here a method that can eliminate the need for hessian calculations for both the characterization of stationary points as well as searches for saddlemore » points. A finite differences implementation of the Davidson method that uses only first derivatives of the energy to calculate the lowest eigenvalues and eigenvectors of the hessian is discussed. This method can be implemented in conjunction with geometry optimization methods such as partitioned-rational function optimization (P-RFO) to characterize stationary points on the potential energy surface. With equal ease, it can be combined with interpolation methods that determine TS guess structures, such as the freezing string method, to generate approximate hessian matrices in lieu of full hessians as input to P-RFO for TS optimization. This approach is shown to achieve significant cost savings relative to exact hessian calculation when applied to both stationary point characterization as well as TS optimization. The basic reason is that the present approach scales one power of system size lower since the rate of convergence is approximately independent of the size of the system. Therefore, the finite-difference Davidson method is a viable alternative to full hessian calculation for stationary point characterization and TS search particularly when analytical hessians are not available or require substantial computational effort.« less

Health and Economic Outcomes in the Alumni of the Wounded Warrior Project: 2010-2012

DTIC Science & Technology

2014-01-01

design a web-based survey that would help the organization evaluate how well it is meeting its three primary strategic goals: • Ensure that wounded...the Primary Care PTSD Screen (PC-PTSD). When responses to all three surveys were pooled into one analysis, they show that the percentage of...relied on a metric in the data, the two-item Connor- Davidson Resilience Scale (CD- RISC  2), a measure specifically designed to quantify an indi

Resilience Among Naval Recruits: A Quantitative and Qualitative Analysis of Interventions at Recruit Training Command and Implications on Fleet Readiness

DTIC Science & Technology

2016-03-01

associated with higher levels of resilience (Connor & Davidson, 2003). The CD-RISC offers a validated quantitative scale to researchers , allowing for the...a total of 35 recruits and 12 RDCs were interviewed. Four focus groups and 30 personal interviews were conducted. The interviews included recruits...two to four individuals. The interviews and focus groups were semi-structured. A set of questions were identified prior to the interviews as a

Joyce McLaren | NREL

Science.gov Websites

. Golden, CO: National Renewable Energy Laboratory. NREL/TP-6A20-64852. McLaren, J. 2015. Reaching 100 Laboratory. NREL/BR-6A20-62490. McLaren J., C. Davidson, J. Miller, and L. Bird. "Impact of Rate Design . Davidson, J. McLaren, and J. Miller. 2015. Impact of Rate Design Alternatives on Residential Solar Customer

State of Utopia v. Jamie Davidson. 2002-2003 Oklahoma High School Mock Trial Program.

ERIC Educational Resources Information Center

Benischek, Sandra; Davis, Courtney; Horton, Johnathan; Longwell, Nicole; Williams, Keri

In the spring of 2001, illegal drug use had risen by 40% among teens in the town of Springdale, Utopia. School administrators and the Springdale Police Department decided to implement a crackdown on teen drug use in all high schools in Springdale. A high school principal received a tip on a hotline that Jamie Davidson, a senior, had been seen…

Sound Propagation in Gas-Vapor-Droplet Suspensions with Evaporation and Nonlinear Particle Relaxation

NASA Technical Reports Server (NTRS)

Kandula, Max

2012-01-01

The Sound attenuation and dispersion in saturated gas-vapor-droplet mixture in the presence of evaporation has been investigated theoretically. The theory is based on an extension of the work of Davidson to accommodate the effects of nonlinear particle relaxation processes of mass, momentum and energy transfer on sound attenuation and dispersion. The results indicate the existence of a spectral broadening effect in the attenuation coefficient (scaled with respect to the peak value) with a decrease in droplet mass concentration. It is further shown that for large values of the droplet concentration the scaled attenuation coefficient is characterized by a universal spectrum independent of droplet mass concentration.

Adversity and Resilience Are Associated with Outcome after Mild Traumatic Brain Injury in Military Service Members.

PubMed

Reid, Matthew W; Cooper, Douglas B; Lu, Lisa H; Iverson, Grant L; Kennedy, Jan E

2018-05-15

The objective of this study was to assess the associations between resilience, adversity, post-concussion symptoms, and post-traumatic stress symptom reporting after mild traumatic brain injury (mTBI). We hypothesized that resilience would be associated with less symptom reporting, and adversity would be associated with greater symptom reporting. This was a cross-sectional study of retrospective data collected for an ongoing TBI repository. United States military service members who screened positive for mTBI during a primary care visit completed the Trauma History Screen (THS), Connor-Davidson Resilience Scale (CD-RISC), Neurobehavioral Symptom Inventory (NSI), and post-traumatic stress disorder (PTSD) Checklist-Civilian Version (PCL-C). Data collected from February 2015 to August 2016 were used for the present study. Only participants with complete data for the above measures were included, yielding a sample size of 165 participants. Adversity (THS) and resilience (CD-RISC) scores were each correlated significantly with post-concussion (NSI) and traumatic stress (PCL-C) total and subscale scores in the hypothesized direction. Interactions between adversity and resilience were absent for all measures except the NSI sensory subscale. Four traumatic event types were significantly associated positively with most NSI and PCL-C total and subscale scores, but the age at which traumatic events were first experienced showed few and mixed significant associations. In conclusion, resilience and adversity were significantly associated with symptom endorsement after mTBI. Screening for cumulative adversity may identify individuals at greater risk of developing persistent post-concussion symptoms and/or PTSD, and interventions that increase resilience may reduce symptom severity.

A classical twin study of PTSD symptoms and resilience: Evidence for a single spectrum of vulnerability to traumatic stress.

PubMed

Wolf, Erika J; Miller, Mark W; Sullivan, Danielle R; Amstadter, Ananda B; Mitchell, Karen S; Goldberg, Jack; Magruder, Kathryn M

2018-02-01

To examine shared genetic and environmental risk factors across PTSD symptoms and resilience. Classical twin study of 2010-2012 survey data conducted among 3,318 male twin pairs in the Vietnam Era Twin Registry. Analyses included: (a) estimates of genetic and environmental influences on PTSD symptom severity (as measured by the PTSD Checklist) and resilience (assessed with the Connor-Davidson Resilience Scale-10); (b) development of a latent model of traumatic stress, spanning both PTSD and resilience; and (c) estimates of genetic and environmental influences on this spectrum. The heritability of PTSD was 49% and of resilience was 25%. PTSD and resilience were correlated at r = -.59, and 59% of this correlation was attributable to a single genetic factor, whereas the remainder was due to a single non-shared environment factor. Resilience was also influenced by common and unique environmental factors not shared with PTSD, but there was no genetic factor specific to resilience. Confirmatory factor analysis supported the Development of a revised phenotype reflecting the broader dimension of traumatic stress, with biometric models suggesting increased heritability (66%) of this spectrum compared to PTSD or resilience individually. Genetic factors contribute to a single spectrum of traumatic stress reflecting resilience at one end and high symptom severity at the other. This carries implications for phenotype refinement in the search for molecular genetic markers of trauma-related psychopathology. Rather than focusing only on genetic risk for PTSD, molecular genetics research may benefit from evaluation of the broader spectrum of traumatic stress. © 2017 Wiley Periodicals, Inc.

Algorithm-Eigenvalue Estimation of Hyperspectral Wishart Covariance Matrices from a Limited Number of Samples

DTIC Science & Technology

2015-03-01

ALGORITHM—EIGENVALUE ESTIMATION OF HYPERSPECTRAL WISHART COVARIANCE MATRICES FROM A LIMITED NUMBER OF SAMPLES ECBC-TN-067 Avishai Ben- David ...NUMBER 6. AUTHOR(S) Ben- David , Avishai (ECBC) and Davidson, Charles E. (STC) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7...and published by Avishai Ben- David and Charles E. Davidson (Eigenvalue Estimation of Hyperspectral WishartCovariance Matrices from Limited Number of

The relationship of trauma severity and mortality with cardiac enzymes and cytokines at multiple trauma patients.

PubMed

Karakuş, Ali; Kekeç, Zeynep; Akçan, Ramazan; Seydaoğlu, Gülşah

2012-07-01

In this study, we aimed to determine the effects of trauma severity on cardiac involvement through evaluating the trauma severity score together with diagnostic tests in multiple trauma patients. A trauma score was determined using various trauma severity scales. After obtaining the approval of the ethics committee of the faculty, this prospective study was performed through evaluating 100 multiple trauma patients, aged over 15 years, who applied to our Emergency Department (ED). After determining the trauma severity score using instruments such as the Injury Severity Score (ISS), Glasgow Coma Scale (GCS), and Revised Trauma Score (RTS), the cardiac condition was evaluated using biochemical and radiological diagnostic tests. During the study period, 100 patients were evaluated (78 male, 22 female; mean age: 33.2±15.4; range 15 to 70 years). It was determined that 92 (92%) were blunt trauma cases, and 77 (77%) of them were due to traffic accidents. The majority of cases showed electrocardiogram (ECG) abnormalities (63%) and sinus tachycardia (36%). Abnormal echocardiogram (ECHO) findings, mostly accompanied by ventricular defects (n=24), were determined in 31 of the cases. Nineteen cases with high trauma severity score resulted in death, and 14 of all deaths were secondary to traffic accidents. Trauma scores were found to show a significant difference between the two groups. The ISS trauma scale was determined to be the most effective in terms of indicating heart involvement in patients with multiple traumas. Close follow-up and cardiac monitoring should be applied to patients with high trauma severity scores considering possible cardiac rhythm changes and hemodynamic disturbances due to cardiac involvement.

An Analysis of the Metrics Used in the United States Navy’s Enlisted Supply Chain As They Apply to the Royal Australian Navy

DTIC Science & Technology

2012-12-01

and Hill, 1988; Williamson, 1981), enhances socialization (Edwards, 1979), and lowers transaction costs ( Mahoney , 1992; Williamson, 1975). It does...much information as possible about its workforce to ensure it is managed effectively and efficiently (Davidson & Newman , 2006). Data measurement of...112 Cappelli, P. (2009b). A Supply Chain Approach to Workforce Planning. Organizational Dynamics, 38(1), 8–15. Davidson, G., & Newman , E

A Randomized Controlled Study of Neurofeedback for Chronic PTSD

PubMed Central

van der Kolk, Bessel A.; Hodgdon, Hilary; Gapen, Mark; Musicaro, Regina; Suvak, Michael K.; Hamlin, Ed; Spinazzola, Joseph

2016-01-01

Introduction Brain/Computer Interaction (BCI) devices are designed to alter neural signals and, thereby, mental activity. This study was a randomized, waitlist (TAU) controlled trial of a BCI, EEG neurofeedback training (NF), in patients with chronic PTSD to explore the capacity of NF to reduce PTSD symptoms and increase affect regulation capacities. Study Design 52 individuals with chronic PTSD were randomized to either NF (n = 28) or waitlist (WL) (n = 24). They completed four evaluations, at baseline (T1), after week 6 (T2), at post-treatment (T3), and at one month follow up (T4). Assessment measures were:1. Traumatic Events Screening Inventory (T1); 2. the Clinician Administered PTSD Scale (CAPS; T1, T3, T4); 3. the Davidson Trauma Scale (DTS; T1-T4) and 4. the Inventory of Altered Self-Capacities (IASC; T1-T4). NF training occurred two times per week for 12 weeks and involved a sequential placement with T4 as the active site, P4 as the reference site. Results Participants had experienced an average of 9.29 (SD = 2.90) different traumatic events. Post-treatment a significantly smaller proportion of NF (6/22, 27.3%) met criteria for PTSD than the WL condition (15/22, 68.2%), χ2 (n = 44, df = 1) = 7.38, p = .007. There was a significant treatment condition x time interaction (b = -10.45, t = -5.10, p< .001). Measures of tension reduction activities, affect dysregulation, and affect instability exhibited a significant Time x Condition interaction. The effect sizes of NF (d = -2.33 within, d = - 1.71 between groups) are comparable to those reported for the most effective evidence based treatments for PTSD. Discussion Compared with the control group NF produced significant PTSD symptom improvement in individuals with chronic PTSD, as well as in affect regulation capacities. NF deserves further investigation for its potential to ameliorate PTSD and to improve affect regulation, and to clarify its mechanisms of action. PMID:27992435

Yoga as an adjunctive treatment for posttraumatic stress disorder: a randomized controlled trial.

PubMed

van der Kolk, Bessel A; Stone, Laura; West, Jennifer; Rhodes, Alison; Emerson, David; Suvak, Michael; Spinazzola, Joseph

2014-06-01

More than a third of the approximately 10 million women with histories of interpersonal violence in the United States develop posttraumatic stress disorder (PTSD). Currently available treatments for this population have a high rate of incomplete response, in part because problems in affect and impulse regulation are major obstacles to resolving PTSD. This study explored the efficacy of yoga to increase affect tolerance and to decrease PTSD symptomatology. Sixty-four women with chronic, treatment-resistant PTSD were randomly assigned to either trauma-informed yoga or supportive women's health education, each as a weekly 1-hour class for 10 weeks. Assessments were conducted at pretreatment, midtreatment, and posttreatment and included measures of DSM-IV PTSD, affect regulation, and depression. The study ran from 2008 through 2011. The primary outcome measure was the Clinician-Administered PTSD Scale (CAPS). At the end of the study, 16 of 31 participants (52%) in the yoga group no longer met criteria for PTSD compared to 6 of 29 (21%) in the control group (n = 60, χ²₁ = 6.17, P = .013). Both groups exhibited significant decreases on the CAPS, with the decrease falling in the large effect size range for the yoga group (d = 1.07) and the medium to large effect size decrease for the control group (d = 0.66). Both the yoga (b = -9.21, t = -2.34, P = .02, d = -0.37) and control (b = -22.12, t = -3.39, P = .001, d = -0.54) groups exhibited significant decreases from pretreatment to the midtreatment assessment. However, a significant group × quadratic trend interaction (d = -0.34) showed that the pattern of change in Davidson Trauma Scale significantly differed across groups. The yoga group exhibited a significant medium effect size linear (d = -0.52) trend. In contrast, the control group exhibited only a significant medium effect size quadratic trend (d = 0.46) but did not exhibit a significant linear trend (d = -0.29). Thus, both groups exhibited significant decreases in PTSD symptoms during the first half of treatment, but these improvements were maintained in the yoga group, while the control group relapsed after its initial improvement. Yoga significantly reduced PTSD symptomatology, with effect sizes comparable to well-researched psychotherapeutic and psychopharmacologic approaches. Yoga may improve the functioning of traumatized individuals by helping them to tolerate physical and sensory experiences associated with fear and helplessness and to increase emotional awareness and affect tolerance. ClinicalTrials.gov identifier: NCT00839813. © Copyright 2014 Physicians Postgraduate Press, Inc.

Mindfulness goes to work: impact of an online workplace intervention.

PubMed

Aikens, Kimberly A; Astin, John; Pelletier, Kenneth R; Levanovich, Kristin; Baase, Catherine M; Park, Yeo Yung; Bodnar, Catherine M

2014-07-01

The objective of this study was to determine whether a mindfulness program, created for the workplace, was both practical and efficacious in decreasing employee stress while enhancing resiliency and well-being. Participants (89) recruited from The Dow Chemical Company were selected and randomly assigned to an online mindfulness intervention (n = 44) or wait-list control (n = 45). Participants completed the Perceived Stress Scale, the Five Facets of Mindfulness Questionnaire, the Connor-Davidson Resiliency Scale, and the Shirom Vigor Scale at pre- and postintervention and 6-month follow-up. The results indicated that the mindfulness intervention group had significant decreases in perceived stress as well as increased mindfulness, resiliency, and vigor. This online mindfulness intervention seems to be both practical and effective in decreasing employee stress, while improving resiliency, vigor, and work engagement, thereby enhancing overall employee well-being.

Cumulative trauma and partner conflict predict post-traumatic stress disorder in postpartum African-American women.

PubMed

Hauff, Nancy J; Fry-McComish, Judith; Chiodo, Lisa M

2017-08-01

To describe relationships between cumulative trauma, partner conflict and post-traumatic stress in African-American postpartum women. Cumulative trauma exposure estimates for women in the USA range from 51-69%. During pregnancy, most trauma research has focused on physical injury to the mother. Post-traumatic stress disorder (PTSD) is associated with trauma and more prevalent in African-American women than women of other groups. Knowledge about both the rate and impact of cumulative trauma on pregnancy may contribute to our understanding of women seeking prenatal care, and disparities in infant morbidity and mortality. This retrospective, correlational, cross-sectional study took place on postpartum units of two Detroit hospitals. Participants were 150 African-American women aged between 18-45 who had given birth. Mothers completed the Cumulative Trauma Scale, Conflict Tactics Scale, Clinician Administered Post-traumatic Stress Scale, Edinburgh Postnatal Depression Scale and a Demographic Data form. Descriptive statistics, correlations and multiple regressions were used for data analysis. All participants reported at least one traumatic event in their lifetime. Cumulative trauma and partner conflict predicted PTSD, with the trauma of a life-threatening event for a loved one reported by 60% of the sample. Nearly, one-fourth of the women screened were at risk for PTSD. Increased cumulative trauma, increased partner conflict and lower level of education were related to higher rates of PTSD symptoms. Both cumulative trauma and partner conflict in the past year predict PTSD. Reasoning was used most often for partner conflict resolution. The results of this study offer additional knowledge regarding relationships between cumulative trauma, partner conflict and PTSD in African-American women. Healthcare providers need to be sensitive to patient life-threatening events, personal failures, abuse and other types of trauma. Current evidence supports the need to assess for post-traumatic stress symptoms during pregnancy. © 2016 John Wiley & Sons Ltd.

Validity of CBCL-derived PTSD and dissociation scales: further evidence in a sample of neglected children and adolescents.

PubMed

Milot, Tristan; Plamondon, André; Ethier, Louise S; Lemelin, Jean-Pascal; St-Laurent, Diane; Rousseau, Michel

2013-05-01

There is growing evidence that child neglect is an important risk factor for posttraumatic stress disorder (PTSD) and dissociation. Considering that the Child Behavior Checklist (CBCL) is a widely used measure, the possibility of using validated CBCL-derived trauma symptoms scales could be particularly useful to better understand how trauma symptoms develop among neglected children and adolescents. This study examined the factor structure of three CBCL-derived measures of PTSD and dissociation (namely, PTSD scale, Dissociation scale, and PTSD/Dissociation scale) in a sample of 239 neglected children and adolescents aged 6 to 18 years using the latest version of CBCL (CBCL 6-18). Evidence of convergent validity of these scales was also examined for participants aged 12 and under using two well-validated measures of PTSD and Dissociation: the Trauma Symptoms Checklist for Young Children and the Child Dissociation Checklist. Findings suggest that CBCL-derived measures of trauma symptoms, especially PTSD and Dissociations scales, may be of heuristic value in the study of trauma symptomatology in neglected samples. Factor structure and evidence of convergent validity were supported for these two scales. Results also provide further support to the well-established assumption that PTSD and dissociation are two related but different constructs.

1985 Update of Materials in the Sarah K. Davidson Family-Patient Health Education Library with Addresses of Publishers of All Listings, and Addresses of Resources from Which Pamphlets and Fact Sheets Are Available.

ERIC Educational Resources Information Center

Stevenson, Betty Satterwhite, Ed.

This update of a bibliography published in 1981 lists selected holdings of the Sarah K. Davidson Family-Patient Library, which is located in the Strong Memorial Hospital of the University of Rochester (New York); it is intended for use with the original bibliography. To aid in ordering books and seeking further information on various topics, this…

The role of certification in the buyer/planner position: a case study at Harley-Davidson Motor Company.

PubMed

Orange, V J; Robinson, D E

1999-02-01

The use of buyer/planners may becoming more popular. If they are, the reason is probably that many companies are integrating materiel management skill sets as a way of increasing the effectiveness of their supply chains. Harley-Davidson recently created a supply management function composed of buyer/planners. This article describes the method it used to achieve the transition, the training plan it implemented to support the process, and the role management played in achieving success.

Targeting histone abnormality in triple negative breast cancer

DTIC Science & Technology

2017-08-01

ELEMENT NUMBER N/A 6. AUTHOR(S) 5d. PROJECT NUMBER N/A Yi Huang, M.D., Ph.D. 5e. TASK NUMBER N/A E -Mail:huangy2@upmc.edu 5f. WORK UNIT NUMBER...prevention. This funded Breast Cancer Breakthrough Award is initially a partnership between Dr. Yi Huang (initiating PI) and Dr. Nancy E . Davidson...partner PI). During the current funding period, Dr. Nancy E . Davidson moved to University of Washington at Seattle and transferred the Partnering PI to

Measuring symptoms of post-traumatic stress disorder in people with intellectual disabilities: the development and psychometric properties of the Impact of Event Scale-Intellectual Disabilities (IES-IDs).

PubMed

Hall, James C; Jobson, Laura; Langdon, Peter E

2014-09-01

The aims of the study were to (1) revise the Impact of Event Scale-Revised for use with people with intellectual disabilities (IDs), creating the Impact of Event Scale-Intellectual Disabilities (IES-IDs), (2) assess the reliability of the IES-IDs, and (3) compare the IES-IDs to an existing measure trauma-related symptomatology, namely the Lancaster and Northgate Trauma Scale (LANTS), along with measures of anxiety and depression. Forty adults with IDs who had experienced at least one traumatic event were recruited and completed the IES-IDs and the LANTS on two occasions, separated by 2 weeks. Participants also completed the Glasgow Depression Scale and the Glasgow Anxiety Scale, along with the Trauma Information Form which was used to collect information about trauma history. Fifteen per cent of the sample had encountered five or more traumatic events. The IES-IDs and the LANTS had good to excellent internal consistency and test-retest reliability. Both measures correlated with self-report measures of depression and anxiety, although the strength of this correlation was greater with the LANTS. There was a significant positive correlation between trauma frequency and the IES-IDs, while trauma frequency did not correlate with the LANTS. Both the IES-IDs and the LANTS appear to have good reliability. There is a lack of well-developed questionnaires that can be used to assess symptoms of post-traumatic stress disorder (PTSD) in people with intellectual disabilities. The Impact of Event Scale-Revised was augmented creating the Impact of Event Scale-Intellectual Disabilities (IES-IDs). The IES-IDs was shown to have good psychometric properties. The IES-IDs was compared to the Lancaster and Northgate Trauma Scale (LANTS), but the LANTS did not correlate with trauma frequency. However, this study had a small sample size, and a much larger study is needed to examine the factor structure of both the IES-IDs and the LANTS. Future studies should attempt to recruit people with IDs who have a diagnosis of PTSD. © 2014 The British Psychological Society.

Simulated Trauma and Resuscitation Team Training course-evolution of a multidisciplinary trauma crisis resource management simulation course.

PubMed

Gillman, Lawrence M; Brindley, Peter; Paton-Gay, John Damian; Engels, Paul T; Park, Jason; Vergis, Ashley; Widder, Sandy

2016-07-01

We previously reported on a pilot trauma multidisciplinary crisis resource course titled S.T.A.R.T.T. (Simulated Trauma and Resuscitative Team Training). Here, we study the course's evolution. Satisfaction was evaluated by postcourse survey. Trauma teams were evaluated using the Ottawa global rating scale and an Advanced Trauma Life Support primary survey checklist. Eleven "trauma teams," consisting of physicians, nurses, and respiratory therapists, each completed 4 crisis simulations over 3 courses. Satisfaction remained high among participants with overall mean satisfaction being 4.39 on a 5-point Likert scale. As participants progressed through scenarios, improvements in global rating scale scores were seen between the 1st and 4th (29.8 vs 36.1 of 42, P = .022), 2nd and 3rd (28.2 vs 34.6, P = .017), and 2nd and 4th (28.2 vs 36.1, P = .003) scenarios. There were no differences in Advanced Trauma Life Support checklist with mean scores for each scenario ranging 11.3 to 13.2 of 17. The evolved Simulated Trauma and Resuscitative Team Training curriculum has maintained high participant satisfaction and is associated with improvement in team crisis resource management skills over the duration of the course. Copyright © 2015 Elsevier Inc. All rights reserved.

Neurotrauma pediatric scales

PubMed Central

Alexandru, Vlad Ciurea; Aurelia, Mihaela Sandu; Mihai, Popescu; Stefan, Mircea Iencean; Bogdan, Davidescu

2008-01-01

Cranial traumas have different particularities in infants, toddlers, preschool child, school child and teenagers. The assessment of these cases must be individualized according to age. It is completely different in children that in adults. Trauma scales, very useful in grading the severity and predicting outcome in traumatic brain injury, used in adults must be adapted in children. Children have age-related specificity and anatomic particularities, for each of this period of development. Neurotrauma scales, specific for infants and children, such as Pediatric Coma Scale, Children’s Coma Score, Trauma Infant Neurological Score, Glasgow Coma Scale, Liege Scale are reviewed, as well as neurotrauma outcome scales, like Glasgow Outcome Scale, modified Rankin score, KOSCHI score and Barthel Index. The authors present these scales in an exhaustive manner for thoroughgoing pediatric neurotrauma standards. PMID:20108520

Resilience in Patients With Recent Diagnosis of a Schizophrenia Spectrum Disorder.

PubMed

Bozikas, Vasilis P; Parlapani, Eleni; Holeva, Vasiliki; Skemperi, Eleni; Bargiota, Stavroula I; Kirla, Danai; Rera, Eirini; Garyfallos, Georgios

2016-08-01

This study focused on resilience in patients who recently received a diagnosis of schizophrenia spectrum disorder (SSD). Psychopathological symptoms, depressive symptoms, and hopelessness were considered as sources of stress in the context of psychosis. Forty-eight SSD patients (mean period between diagnosis and recruitment, 20.79 months) were enrolled. Psychopathological symptoms were assessed by the Positive and Negative Syndrome Scale, depression by the Calgary Depression Scale for Schizophrenia, hopelessness by the Beck Hopelessness Scale, and functioning by the Social and Occupational Functioning Scale. Resilience was evaluated by the Connor-Davidson Resilience Scale, which was additionally completed by 81 healthy controls. Patients demonstrated less resilience than did healthy participants. Female patients showed higher resilience levels and functioning than did males. High resilience levels were associated with less severe positive symptoms, general psychopathological symptoms, depression, and hopelessness. Apart from negative symptoms, results indicated that resilience may be a potential moderator of functioning. Thus, resilience-oriented interventions might constitute an additional therapeutic approach for SSD patients.

Multitasking the Davidson algorithm for the large, sparse eigenvalue problem

DOE Office of Scientific and Technical Information (OSTI.GOV)

Umar, V.M.; Fischer, C.F.

1989-01-01

The authors report how the Davidson algorithm, developed for handling the eigenvalue problem for large and sparse matrices arising in quantum chemistry, was modified for use in atomic structure calculations. To date these calculations have used traditional eigenvalue methods, which limit the range of feasible calculations because of their excessive memory requirements and unsatisfactory performance attributed to time-consuming and costly processing of zero valued elements. The replacement of a traditional matrix eigenvalue method by the Davidson algorithm reduced these limitations. Significant speedup was found, which varied with the size of the underlying problem and its sparsity. Furthermore, the range ofmore » matrix sizes that can be manipulated efficiently was expended by more than one order or magnitude. On the CRAY X-MP the code was vectorized and the importance of gather/scatter analyzed. A parallelized version of the algorithm obtained an additional 35% reduction in execution time. Speedup due to vectorization and concurrency was also measured on the Alliant FX/8.« less

Scoring systems of severity in patients with multiple trauma.

PubMed

Rapsang, Amy Grace; Shyam, Devajit Chowlek

2015-04-01

Trauma is a major cause of morbidity and mortality; hence severity scales are important adjuncts to trauma care in order to characterize the nature and extent of injury. Trauma scoring models can assist with triage and help in evaluation and prediction of prognosis in order to organise and improve trauma systems. Given the wide variety of scoring instruments available to assess the injured patient, it is imperative that the choice of the severity score accurately match the application. Even though trauma scores are not the key elements of trauma treatment, they are however, an essential part of improvement in triage decisions and in identifying patients with unexpected outcomes. This article provides the reader with a compendium of trauma severity scales along with their predicted death rate calculation, which can be adopted in order to improve decision making, trauma care, research and in comparative analyses in quality assessment. Copyright © 2013 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Classifying and Standardizing Panfacial Trauma With a New Bony Facial Trauma Score.

PubMed

Casale, Garrett G A; Fishero, Brian A; Park, Stephen S; Sochor, Mark; Heltzel, Sara B; Christophel, J Jared

2017-01-01

The practice of facial trauma surgery would benefit from a useful quantitative scale that measures the extent of injury. To develop a facial trauma scale that incorporates only reducible fractures and is able to be reliably communicated to health care professionals. A cadaveric tissue study was conducted from October 1 to 3, 2014. Ten cadaveric heads were subjected to various degrees of facial trauma by dropping a fixed mass onto each head. The heads were then imaged with fine-cut computed tomography. A Bony Facial Trauma Scale (BFTS) for grading facial trauma was developed based only on clinically relevant (reducible) fractures. The traumatized cadaveric heads were then scored using this scale as well as 3 existing scoring systems. Regression analysis was used to determine correlation between degree of incursion of the fixed mass on the cadaveric heads and trauma severity as rated by the scoring systems. Statistical analysis was performed to determine correlation of the scores obtained using the BFTS with those of the 3 existing scoring systems. Scores obtained using the BFTS were not correlated with dentition (95% CI, -0.087 to 1.053; P = .08; measured as absolute number of teeth) or age of the cadaveric donor (95% CI, -0.068 to 0.944; P = .08). Facial trauma scores. Among all 10 cadaveric specimens (9 male donors and 1 female donor; age range, 41-87 years; mean age, 57.2 years), the facial trauma scores obtained using the BFTS correlated with depth of penetration of the mass into the face (odds ratio, 4.071; 95% CI, 1.676-6.448) P = .007) when controlling for presence of dentition and age. The BFTS scores also correlated with scores obtained using 3 existing facial trauma models (Facial Fracture Severity Scale, rs = 0.920; Craniofacial Disruption Score, rs = 0.945; and ZS Score, rs = 0.902; P < .001 for all 3 models). In addition, the BFTS was found to have excellent interrater reliability (0.908; P = .001), which was similar to the interrater reliability of the other 3 tested trauma scales. Scores obtained using the BFTS were not correlated with dentition (odds ratio, .482; 95% CI, -0.087 to 1.053; P = .08; measured as absolute number of teeth) or age of the cadaveric donor (odds ratio, .436; 95% CI, -0.068 to 0.944; P = .08). Facial trauma severity as measured by the BFTS correlated with depth of penetration of the fixed mass into the face. In this study, the BFTS was clinically relevant, had high fidelity in communicating the fractures sustained in facial trauma, and correlated well with previously validated models. NA.

Measuring the Quality of Care for Psychological Health Conditions in the Military Health System: Candidate Quality Measures for Posttraumatic Stress Disorder and Major Depressive Disorder

DTIC Science & Technology

2015-01-01

therapy CDC Centers for Disease Control and Prevention CESD Center for Epidemiologic Studies Depression Scale CGI-BP Clinical Global Impressions Scale for...dimensions GDS Geriatric Depression Scale HEDIS Healthcare Effectiveness Data and Information Set HOS Health Outcomes Survey HRQOL health-related quality of...TBI traumatic brain injury TF-CBT Trauma-Focused Cognitive–Behavioral Therapy TSC-40 Trauma Symptom Checklist—40 TSI Trauma Symptom Inventory VA U.S

Post-traumatic Stress and Growth Among Medical Student Volunteers After the March 2011 Disaster in Fukushima, Japan: Implications for Student Involvement with Future Disasters.

PubMed

Anderson, David; Prioleau, Phoebe; Taku, Kanako; Naruse, Yu; Sekine, Hideharu; Maeda, Masaharu; Yabe, Hirooki; Katz, Craig; Yanagisawa, Robert

2016-06-01

The March 2011 "triple disaster" (earthquake, tsunami, and nuclear accident) had a profound effect on northern Japan. Many medical students at Fukushima Medical University volunteered in the relief effort. We aimed to investigate the nature of students' post-disaster involvement and examine the psychological impact of their experiences using a survey containing elements from the Davidson Trauma Scale and Posttraumatic Growth Inventory. We collected 494 surveys (70 % response rate), of which 132 students (26.7 %) had volunteered. Volunteers were more likely to be older, have witnessed the disaster in person, had their hometowns affected, and had a family member or close friend injured. In the month after 3/11, volunteers were more likely to want to help, feel capable of helping, and report an increased desire to become a physician. Both in the month after 3/11 and the most recent month before the survey, there were no significant differences in distressing symptoms, such as confusion, anger, or sadness, between volunteers and non-volunteers. Volunteers reported a significantly higher level of posttraumatic growth than non-volunteers. Participating in a greater variety of volunteer activities was associated with a higher level of posttraumatic growth, particularly in the Personal Strength domain. There may be self-selection in some criteria, since students who were likely to be resistant to confusion/anxiety/sadness may have felt more capable of helping and been predisposed to volunteer. However, participation in post-disaster relief efforts did not appear to have a harmful effect on medical students, an important consideration for mobilizing volunteers after future disasters.

Relation between psychotic symptoms, parental care and childhood trauma in severe mental disorders.

PubMed

Catalan, Ana; Angosto, Virxina; Díaz, Aida; Valverde, Cristina; de Artaza, Maider Gonzalez; Sesma, Eva; Maruottolo, Claudio; Galletero, Iñaki; Bustamante, Sonia; Bilbao, Amaia; van Os, Jim; Gonzalez-Torres, Miguel Angel

2017-05-01

A relation between different types of parental care, trauma in childhood and psychotic symptoms in adulthood has been proposed. The nature of this association is not clear and if it is more related to psychotic disorders per se or to a cluster of symptoms such as positive psychotic symptoms remains undefined. We have analysed the presence of childhood trauma using the CTQ scale and types of parental care using the PBI scale in three groups of subjects: borderline personality disorder patients (n=36), first psychotic episode patients (n=61) and healthy controls (n=173). Positive psychotic symptomatology was assessed with the CAPE scale. General linear models were used to study the relation between positive psychotic symptomatology and variables of interest. BPD patients had the highest rate of any kind of trauma, followed by FEP patients. We found a positive relationship between psychotic symptomatology and the existence of trauma in childhood in all groups. Moreover, an affectionless control rearing style was directly associated with the existence of trauma. Furthermore, subjects with trauma presented less probability of having an optimal parenting style in childhood. The relation between psychotic symptoms and trauma remained statistically significant after adjusting for other variables including parental rearing style. There seems to be a link between trauma in childhood and psychotic symptomatology across different populations independently of psychiatric diagnosis. Taking into account that there is an association between trauma and psychosis and that trauma is a modifiable factor, clinicians should pay special attention to these facts. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Religious Moral Beliefs Inversely Related to Trauma Experiences Severity and Presented Posttraumatic Stress Disorder Among Bosnia and Herzegovina War Veterans.

PubMed

Hasanović, Mevludin; Pajević, Izet

2015-08-01

The aim of this study was to determine the correlation of the level of religious moral beliefs (RMB) with trauma experiences and posttraumatic stress disorder (PTSD) severity in war veterans of Bosnia and Herzegovina. The sample consists of 120 Bosnian war veterans divided into two equal groups-one with and one without PTSD. We used the Harvard Trauma Questionnaire and the RMB belief scale. We then correlated the severity of trauma experiences and PTSD symptoms with veterans' scores on the RMB scale. The score on the RMB scale was negatively correlated to severity of trauma experiences and PTSD symptoms (Pearson's r = -0.509, P = 0.004; Pearson's r = -0.325, P < 0.001, respectively). The RMB may have protective role in the mental health stability of severely traumatized war veterans.

Posttraumatic Stress Among Syrian Refugees: Trauma Exposure Characteristics, Trauma Centrality, and Emotional Suppression.

PubMed

Chung, Man Cheung; Shakra, Mudar; AlQarni, Nowf; AlMazrouei, Mariam; Al Mazrouei, Sara; Al Hashimi, Shurooq

2018-01-01

This study revisited the prevalence of posttraumatic stress disorder (PTSD) and examined a hypothesized model describing the interrelationship between trauma exposure characteristics, trauma centrality, emotional suppression, PTSD, and psychiatric comorbidity among Syrian refugees. A total of 564 Syrian refugees participated in the study and completed the Harvard Trauma Questionnaire, General Health Questionnaire (GHQ-28), Centrality of Event Scale, and Courtauld Emotional Control Scale. Of the participants, 30% met the cutoff for PTSD. Trauma exposure characteristics (experiencing or witnessing horror and murder, kidnapping or disappearance of family members or friends) were associated with trauma centrality, which was associated with emotional suppression. Emotional suppression was associated with PTSD and psychiatric comorbid symptom severities. Suppression mediated the path between trauma centrality and distress outcomes. Almost one-third of refugees can develop PTSD and other psychiatric problems following exposure to traumatic events during war. A traumatized identity can develop, of which life-threatening experiences is a dominant feature, leading to suppression of depression with associated psychological distress.

Intentional Forgetting of Emotional Words after Trauma: A Study with Victims of Sexual Assault

PubMed Central

Blix, Ines; Brennen, Tim

2011-01-01

Following exposure to a trauma, people tend to experience intrusive thoughts and memories about the event. In order to investigate whether intrusive memories in the aftermath of trauma might be accounted for by an impaired ability to intentionally forget disturbing material, the present study used a modified Directed Forgetting task to examine intentional forgetting and intrusive recall of words in sexual assault victims and controls. By including words related to the trauma in addition to neutral, positive, and threat-related stimuli it was possible to test for trauma-specific effects. No difference between the Trauma and the Control group was found for correct recall of to-be-forgotten (F) words or to-be-remembered (R) words. However, when recalling words from R-list, the Trauma group mistakenly recalled significantly more trauma-specific words from F-list. “Intrusive“ recall of F-trauma words when asked to recall R-words was related to symptoms of post-traumatic stress disorder reported on the Impact of Event Scale and the Post-traumatic Diagnostic Scale. The results are discussed in term of a source-monitoring account. PMID:21994497

Posttraumatic maladaptive beliefs scale: evolution of the personal beliefs and reactions scale.

PubMed

Vogt, Dawne S; Shipherd, Jillian C; Resick, Patricia A

2012-09-01

The posttraumatic maladaptive beliefs scale (PMBS) was developed to measure maladaptive beliefs about current life circumstances that may occur following trauma exposure. This scale assesses maladaptive beliefs within three domains: (a) threat of harm, (b) self-worth and judgment, and (c) reliability and trustworthiness of others. Items for the PMBS were drawn from a larger preexisting measure that assesses a wide range of personal beliefs and reactions associated with trauma exposure. The construct validity of the PMBS was assessed in two independent samples of interpersonal trauma survivors. This article provides data to support the reliability and validity of the PMBS as an instrument to assess general, rather than trauma-specific, maladaptive beliefs that have relevance for functioning in the aftermath of a traumatic event. Moreover, the measure is sensitive to changes that occur in treatment, and the length of the measure (15 items) is practical for use in clinical settings.

Mental health of Somali adolescent refugees: the role of trauma, stress, and perceived discrimination.

PubMed

Ellis, B Heidi; MacDonald, Helen Z; Lincoln, Alisa K; Cabral, Howard J

2008-04-01

The primary purpose of this study was to examine relations between trauma exposure, post-resettlement stressors, perceived discrimination, and mental health symptoms in Somali adolescent refugees resettled in the U.S. Participants were English-speaking Somali adolescent refugees between the ages of 11 and 20 (N = 135) who had resettled in the U.S. Participants were administered an interview battery comprising self-report instruments that included the UCLA Posttraumatic Stress Disorder (PTSD) Index, the War Trauma Screening Scale, the Every Day Discrimination scale, the Adolescent Post-War Adversities Scale, and the Acculturative Hassles Inventory. Results indicated that cumulative trauma was related to PTSD and depression symptoms. Further, post-resettlement stressors, acculturative stressors, and perceived discrimination were also associated with greater PTSD symptoms after accounting for trauma, demographic, and immigration variables. Number of years since resettlement in the US and perceived discrimination were significantly related to depressive symptoms, after accounting for trauma, demographic, and immigration variables. Further research elucidating the relations between post-resettlement stressors, discrimination, and mental health of refugee adolescents may inform intervention development. PsycINFO Database Record (c) 2008 APA, all rights reserved.

The Utility and Comparative Incremental Validity of the MMPI-2 and Trauma Symptom Inventory Validity Scales in the Detection of Feigned PTSD

ERIC Educational Resources Information Center

Efendov, Adele A.; Sellbom, Martin; Bagby, R. Michael

2008-01-01

The authors examined the comparative predictive capacity of the Trauma Symptom Inventory (TSI) Atypical Response Scale (ATR) and the standard set of Minnesota Multiphasic Personality Inventory-2 (MMPI-2) fake-bad validity scales (i.e., F, F[subscript B[prime

Utility of the Trauma Symptom Inventory's Atypical Response Scale in Detecting Malingered Post-Traumatic Stress Disorder

ERIC Educational Resources Information Center

Elhai, Jon D.; Gray, Matthew J.; Naifeh, James A.; Butcher, Jimmie J.; Davis, Joanne L.; Falsetti, Sherry A.; Best, Connie L.

2005-01-01

The authors examined the Trauma Symptom Inventorys (TSI) ability to discriminate 88 student post-traumatic stress disorder (PTSD) simulators screened for genuine PTSD from 48 clinical PTSD-diagnosed outpatients. Results demonstrated between-group differences on several TSI clinical scales and the Atypical Response (ATR) validity scale.…

Mortality factors in geriatric blunt trauma patients.

PubMed

Knudson, M M; Lieberman, J; Morris, J A; Cushing, B M; Stubbs, H A

1994-04-01

To examine various clinical factors for their ability to predict mortality in geriatric patients following blunt trauma. In this retrospective study, trauma registries and medical records from three trauma centers were reviewed for patients 65 years and older who had sustained blunt trauma. The following variables were extracted and examined independently and in combination for their ability to predict death: age, gender, mechanism of injury, admission blood pressure, and Glasgow Coma Scale score, respiratory status, Trauma Score, Revised Trauma Score, and Injury Severity Score. Three urban trauma centers. Geriatric trauma patients entering three trauma centers (Stanford [Calif] University Hospital, Vanderbilt University Medical Center, Nashville, Tenn, and Maryland Institute for Emergency Medical Services Systems, Baltimore) following blunt trauma during a 7-year period (1982 to 1989). The Injury Severity Score was the single variable that correlated most significantly with mortality. Mortality rates were higher for men than for women and were significantly higher in patients 75 years and older. Admission variables associated with the highest relative risks of death included a Trauma Score less than 7; hypotension (systolic blood pressure, < 90 mm Hg); hypoventilation (respiratory rate, < 10 breaths per minute); or a Glasgow Coma Scale score equal to 3. Admission variables in geriatric trauma patients can be used to predict outcome and may also be useful in making decisions about triage, quality assurance, and use of intensive care unit beds.

Two decades later: The resilience and post-traumatic responses of Indigenous Quechua girls and adolescents in the aftermath of the Peruvian armed conflict.

PubMed

Suarez, Eliana Barrios

2013-01-01

In comparison to other traumatic events, the impact of a childhood during war on resilience later in life has been seldom examined. The aim of this study was therefore to examine the long term outcomes of post-traumatic responses and resilience of a sample of adult Indigenous Quechua women, who were girls or adolescents during the Peruvian armed conflict (1980-1995). The study instruments (Harvard trauma questionnaire part I and IV; Connor-Davidson resilience scale; life stress questionnaire) were translated to Quechua and cross-culturally validated. A cross sectional survey design was used in 2010 to collect data from a convenience sample of 75 participants (25-45 years old) in Ayacucho, Peru, the region most affected by the conflict. Data was examined using hierarchical regression analyses. Participants reported extreme exposure to violence (e.g., sexual violence, torture, combat, death of family members, and forced displacement) during the armed conflict, but surprisingly, only 5.3% reported a current level of symptoms that may indicate a possible post-traumatic stress disorder (PTSD). Resilience scores and number of years exposed to conflict as a child were not associated with PTSD symptoms; instead only the degree of exposure to violence, and current level of stress contributed to the variance of PTSD-related symptoms. Conversely, resilience and current stress contributed to the variance of trauma symptoms when measured by local idioms of distress. Findings should be interpreted with caution, due to limitations in the content validity of instruments, risk of inaccurate recall, use of individual explanations of distress (such as PTSD) for collective experiences of violence, use of non-indigenous frameworks to examine Indigenous resilience, and other methodological concerns. The study however highlights the high degree of traumatic exposure of these former war children. While the prevalence of potential PTSD was astonishingly low in this sample, a number of women still suffer from significant distress two decades after the traumatic events. Therefore, post-conflict interventions should renew efforts to foster the resilience of marginalized populations disproportionately targeted by violence and advocate for enhanced protection of women and children in current armed conflicts. Copyright © 2012 Elsevier Ltd. All rights reserved.

Validation of trauma scales: ISS, NISS, RTS and TRISS for predicting mortality in a Colombian population.

PubMed

Valderrama-Molina, Carlos Oliver; Giraldo, Nelson; Constain, Alfredo; Puerta, Andres; Restrepo, Camilo; León, Alba; Jaimes, Fabián

2017-02-01

Our purpose was to validate the performance of the ISS, NISS, RTS and TRISS scales as predictors of mortality in a population of trauma patients in a Latin American setting. Subjects older than 15 years with diagnosis of trauma, lesions in two or more body areas according to the AIS and whose initial attention was at the hospital in the first 24 h were included. The main outcome was inpatient mortality. Secondary outcomes were admission to the intensive care unit, requirement of mechanical ventilation and length of stay. A logistic regression model for hospital mortality was fitted with each of the scales as an independent variable, and its predictive accuracy was evaluated through discrimination and calibration statistics. Between January 2007 and July 2015, 4085 subjects were enrolled in the study. 84.2% (n = 3442) were male, the mean age was 36 years (SD = 16), and the most common trauma mechanism was blunt type (80.1%; n = 3273). The medians of ISS, NISS, TRISS and RTS were: 14 (IQR = 10-21), 17 (IQR = 11-27), 4.21 (IQR = 2.95-5.05) and 7.84 (IQR = 6.90-7.84), respectively. Mortality was 9.3%, and the discrimination for ISS, NISS, TRISS and RTS was: AUC 0.85, 0.89, 0.86 and 0.92, respectively. No one scale had appropriate calibration. Determining the severity of trauma is an essential tool to guide treatment and establish the necessary resources for attention. In a Colombian population from a capital city, trauma scales have adequate performance for the prediction of mortality in patients with trauma.

Resilience, age, and perceived symptoms in persons with long-term physical disabilities.

PubMed

Terrill, Alexandra L; Molton, Ivan R; Ehde, Dawn M; Amtmann, Dagmar; Bombardier, Charles H; Smith, Amanda E; Jensen, Mark P

2016-05-01

Resilience may mitigate impact of secondary symptoms such as pain and fatigue on quality of life in persons aging with disability. This study examined resilience in a large sample of individuals with disabling medical conditions by validating the Connor-Davidson Resilience Scale, obtaining descriptive information about resilience and evaluating resilience as a mediator among key secondary symptoms and quality of life using structural equation modeling. Results indicated that the measure's psychometric properties were adequate in this sample. Resilience was lowest among participants who were middle-aged or younger, and participants with depression. Resilience mediated associations between secondary symptoms and quality of life. © The Author(s) 2014.

[Objective assessment of trauma severity in patients with spleen injuries].

PubMed

Alekseev, V S; Ivanov, V A; Alekseev, S V; Vaniukov, V P

2013-01-01

The work presents an analysis of condition severity of 139 casualties with isolated and combined spleen injuries on admission to a surgical hospital. The assessment of condition severity was made using the traditional gradation and score scale VPH-SP. The degree of the severity of combined trauma of the spleen was determined by the scales ISS. The investigation showed that the scale ISS and VPH-SP allowed objective measurement of the condition severity of patients with spleen trauma. The score assessment facilitated early detection of the severe category of the patients, determined the diagnostic algorithm and the well-timed medical aid.

Trauma Coping Self-Efficacy: A Context Specific Self-Efficacy Measure for Traumatic Stress

PubMed Central

Benight, Charles C.; Shoji, Kotaro; James, Lori E.; Waldrep, Edward E.; Delahanty, Douglas L.; Cieslak, Roman

2015-01-01

The psychometric properties of a Trauma Coping Self-Efficacy (CSE-T) scale that assesses general trauma-related coping self-efficacy perceptions were assessed. Measurement equivalence was assessed using several different samples: hospitalized trauma patients (n1 = 74, n2 = 69, n3 = 60), three samples of disaster survivors (n1 = 273, n2 = 227, n3 = 138), and trauma exposed college students (N = 242). This is the first multi-sample evaluation of the psychometric properties for a general trauma-related CSE measure. Results showed that a brief and parsimonious 9-item version of the CSE performed well across the samples with a robust factor structure; factor structure and factor loadings were similar across study samples. The 9-item scale CSE-T demonstrated measurement equivalence across samples indicating that the underlying concept of general post-traumatic CSE is organized in a similar manner in the different trauma-exposed groups. These results offer strong support for cross-event construct validity of the CSE-T scale. Associations of the CSE-T with important expected covariates showed significant evidence for convergent validity. Finally, discriminant validity was also supported. Replication of the factor structure, internal reliability, and other evidence for construct validity is a critical next step for future research. PMID:26524542

Proceedings of Biological Actions of Extracellular ATP Conference Held in Philadelphia, Pennsylvania on 27-19 November 1990. (Annals of the New York Academy of Sciences. Volume 603)

DTIC Science & Technology

1990-12-16

Uncomplexed with Divalent Cations Activate a Receptor Coupled to Phosphoinositidase C in iitar Cells. By J. S. DAVIDsoN, 1. WAKEFIEL, P. A. VAN DER ...selective antagonist, at least over a limited concentration range)." ’ Studies of the pharma - cological actions of isopolar phosphonate analogues of...139 VAN DER MERWE, F A, 1. K WAKEFIELD, I FINE, R, P. MILLAR & 3. S. DAVIDSON, 1989 FEltS Lell 243: 333-336. 140 HARDEN, T K, J L BOYER, It A BROWN

The Measurement of Psychological Maltreatment: Early Data on the Child Abuse and Trauma Scale.

ERIC Educational Resources Information Center

Sanders, Barbara; Becker-Lausen, Evvie

1995-01-01

The Child Abuse and Trauma Scale, a self-report measure yielding a quantitative index of the frequency and extent of negative experiences in childhood and adolescence, was administered to 1,198 college students and 17 subjects with Multiple Personality Disorder. Results revealed the scale's strong internal consistency, test-retest reliability, and…

The contributions of interpersonal trauma exposure and world assumptions to predicting dissociation in undergraduates.

PubMed

Lilly, Michelle M

2011-01-01

This study examines the relationship between world assumptions and trauma history in predicting symptoms of dissociation. It was proposed that cognitions related to the safety and benevolence of the world, as well as self-worth, would be related to the presence of dissociative symptoms, the latter of which were theorized to defend against threats to one's sense of safety, meaningfulness, and self-worth. Undergraduates from a midwestern university completed the Multiscale Dissociation Inventory, World Assumptions Scale, and Traumatic Life Events Questionnaire. Consistent with the hypotheses, world assumptions were related to the extent of trauma exposure and interpersonal trauma exposure in the sample but were not significantly related to non-interpersonal trauma exposure. World assumptions acted as a significant partial mediator of the relationship between trauma exposure and dissociation, and this relationship held when interpersonal trauma exposure specifically was considered. The factor structures of dissociation and world assumptions were also examined using principal component analysis, with the benevolence and self-worth factors of the World Assumptions Scale showing the strongest relationships with trauma exposure and dissociation. Clinical implications are discussed.

[Resilience and the burnout-engagement model in formal caregivers of the elderly].

PubMed

Menezes de Lucena Carvalho, Virginia A; Fernández Calvo, Bernardino; Hernández Martín, Lorenzo; Ramos Campos, Francisco; Contador Castillo, Israel

2006-11-01

This paper investigates the relationship between resilience and positive/negative mental aspects of psychological well-being in formal caregivers for the elderly. The sample consisted of 265 caregivers who work in different residential homes in Extremadura and Castilla y León (Spain). The instruments used included the Connor-Davidson Resilience Scale , the Maslach Burnout Inventory-General Survey and the Utrecht Work Engagement Scale. The most significant findings show that caregivers with higher levels of resilience also have higher levels of professional efficacy and job engagement (vigor, dedication and absorption) and appear to be less emotionally exhausted or cynical than caregivers with lower levels of resilience. It cannot be concluded that more resilient caregivers will not get burned out, but they develop better engagement skills. As they strengthen these personal attributes, they become less vulnerable to burnout.

Differential effects of childhood abuse and neglect: mediation by posttraumatic distress in neurotic disorder and negative symptoms in schizophrenia?

PubMed

Vogel, Matthias; Meier, Johanna; Grönke, Stephanie; Waage, Marco; Schneider, Wolfgang; Freyberger, Harald Jürgen; Klauer, Thomas

2011-08-30

Dissociation, though understood as a response to trauma, lacks a proven etiology. The assumption of a dose-response relationship between trauma, dissociation and Schneiderian symptoms led to the proposal of a dissociative subtype of schizophrenia characterized by severe child maltreatment, dissociation and psychosis. Child maltreatment and dissociation are common features of neurotic disorders as well, and the link between trauma, dissociation, and hallucinations is not specific for schizophrenia. This study compares childhood abuse and neglect, posttraumatic distress and adult dissociation in patients with psychotic vs. non-psychotic disorder. Thirty-five participants with non-psychotic disorder and twenty-five with schizophrenia were analyzed using the Scale for the Assessment of Positive Symptoms (SAPS), the Scale for the Assessment of Negative Symptoms (SANS), the Montgomery-Åsberg Depression Rating Scale (MADRS), the Posttraumatic Stress Diagnostic Scale PDS (PDS), the Childhood Trauma Questionnaire (CTO) and the Arbeitsgemeinschaft Methodik und Dokumentation in der Psychiatrie (AMDP)-module on dissociation. Trauma and clinical syndromes were compared by means of T-testing and logistic regression between 1) the diagnoses and 2) groups with and without post-traumatic stress disorder (PTSD), marked dissociation and psychotic symptoms. While non-psychotic disorder was related to abuse, schizophrenia showed an association with neglect. Childhood trauma predicted posttraumatic symptomatology and negative symptoms. Childhood abuse and neglect may effectuate different outcomes in neurotic and psychotic disorder. The underlying mechanisms, including dissociation, dovetail with cognitive, emotional and behavioural changes involved in depression, posttraumatic distress and chronic schizophrenia symptoms rather than being directly linked to trauma. Copyright © 2011 Elsevier Ltd. All rights reserved.

Five million years of compositionally diverse, episodic volcanism: Construction of Davidson Seamount atop an abandoned spreading center

NASA Astrophysics Data System (ADS)

Clague, D. A.; Paduan, J. B.; Duncan, R. A.; Huard, J. J.; Davis, A. S.; Castillo, P. R.; Lonsdale, P.; Devogelaere, A.

2009-12-01

Davidson Seamount, a volcano located about 80 km off the central California coast, has a volume of ˜320 km3 and consists of a series of parallel ridges serrated with steep cones. Davidson was sampled and its morphology observed during 27 ROV Tiburon dives. During those dives, 286 samples of lava, volcaniclastite, and erratics from the continental margin were collected, with additional samples from one ROV-collected push core and four gravity cores. We report glass compositions for 99 samples and 40Ar-39Ar incremental heating age data for 20 of the samples. The glass analyses are of hawaiite (62%), mugearite (13%), alkalic basalt (9%), and tephrite (8%), with minor transitional basalt (2%), benmoreite (2%), and trachyandesite (2%). The lithologies are irregularly distributed in space and time. The volcano erupted onto crust inferred to be 20 Ma from seafloor magnetic anomalies. Ages of the lavas range from 9.8 to 14.8 Ma. The oldest rocks are from the central ridge, and the youngest are from the flanks and southern end of the edifice. The compositions of the 18 reliably dated volcanic cones vary with age such that the oldest lavas are the most fractionated. The melts lost 65% to nearly 95% of their initial S because of bubble loss during vesiculation, and the shallowest samples have S contents similar to lava erupted subaerially in Hawaii. Despite this similarity in S contents, there is scant other evidence to suggest that Davidson was ever an island. The numerous small cones of disparate chemistry and the long eruptive period suggest episodic growth of the volcano over at least 5 Myr and perhaps as long as 10 Myr if it began to grow when the spreading ridge was abandoned.

2012 Photosynthesis Gordon Research Conference and Seminar, JUL 7-13, 2012

DOE Office of Scientific and Technical Information (OSTI.GOV)

Debus, Richard

2012-07-13

The Gordon Research Conference on PHOTOSYNTHESIS was held at Davidson College, Davidson, North Carolina, July 8-13, 2012. The Conference was well-attended with 150 participants (attendees list attached). The attendees represented the spectrum of endeavor in this field coming from academia, industry, and government laboratories, both U.S. and foreign scientists, senior researchers, young investigators, and students. Of the 150 attendees, 65 voluntarily responded to a general inquiry regarding ethnicity which appears on our registration forms. Of the 65 respondents, 20% were Minorities$-$ 5% Hispanic, 15% Asian and 0% African American. Approximately 28% of the participants at the 2012 meeting were women.more » The Gordon Research Seminar on PHOTOSYNTHESIS held at Davidson College, Davidson, North Carolina, July 7-8, 2012.. The Conference was well-attended with 51 participants (attendees list attached). The attendees represented the spectrum of endeavor in this field coming from academia, industry, and government laboratories, both U.S. and foreign scientists, senior researchers, young investigators, and students. Of the 51 attendees, 22 voluntarily responded to a general inquiry regarding ethnicity which appears on our registration forms. Of the 22 respondents, 14% were Minorities $-$0% Hispanic, 14% Asian and 0% African American. Approximately 35% of the participants at the 2012 meeting were women. Focal points for talks and discussions will include: Artificial photosynthesis and solar energy conversion strategies; Engineering organisms for biofuels and hydrogen production; Electron transport, proton transport, and energy coupling; Photoprotection mechanisms; Photosynthetic reaction center structure and function, including rewiring reaction centers for artificial photosynthesis; Energy capture and light harvesting solutions, including quantum coherence; Structure of the oxygen evolving complex and the mechanism of oxygen production.« less

Role of Islamic appraisals, trauma-related appraisals, and religious coping in the posttraumatic adjustment of Muslim trauma survivors.

PubMed

Berzengi, Azi; Berzenji, Latef; Kadim, Aladdin; Mustafa, Falah; Jobson, Laura

2017-03-01

This research investigated the role of Islamic appraisals, trauma-related appraisals, and religious coping in Muslim trauma survivors. We report 2 studies of Muslim trauma survivors with and without posttraumatic stress disorder (PTSD) living in the United Kingdom (Study 1) and a sample of Muslim trauma survivors living in Northern Iraq (Study 2). In both studies participants completed the Posttraumatic Stress Diagnostic Scale, Brief Religious Coping Scale, Islamic Appraisal Questionnaire, and Posttraumatic Cognitions Inventory in Arabic. First, it was found that negative religious coping differentiated between trauma survivors with and without PTSD (Study 1) and was significantly correlated with PTSD symptoms (Study 2). Second, negative Islamic appraisals were significantly associated with greater PTSD symptoms whereas positive Islamic appraisals were significantly associated with fewer PTSD symptoms (Study 2). Third, negative trauma-related appraisals correlated significantly with, and uniquely predicted, PTSD symptoms (Study 2). Finally, trauma-related appraisals were found to mediate the relationship between negative Islamic appraisals and negative religious coping and PTSD symptoms. These findings suggest that the theoretical emphasis on trauma-related cognitions may also be applicable to our understanding of PTSD in Muslim trauma survivors. However, for this population, trauma-related appraisals and subsequent coping strategies may be influenced by Islamic beliefs and values. Clinically, our findings suggest that addressing PTSD symptoms in Muslim trauma survivors may require clinicians to consider the impact of trauma on the survivor's religious appraisals and relationship with God. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Reliability, factor structure, and validity of the German version of the Trauma Symptom Checklist for Children in a sample of adolescents

PubMed Central

Matulis, Simone; Loos, Laura; Langguth, Nadine; Schreiber, Franziska; Gutermann, Jana; Gawrilow, Caterina; Steil, Regina

2015-01-01

Background The Trauma Symptom Checklist for Children (TSC-C) is the most widely used self-report scale to assess trauma-related symptoms in children and adolescents on six clinical scales. The purpose of the present study was to develop a German version of the TSC-C and to investigate its psychometric properties, such as factor structure, reliability, and validity, in a sample of German adolescents. Method A normative sample of N=583 and a clinical sample of N=41 adolescents with a history of physical or sexual abuse aged between 13 and 21 years participated in the study. Results The Confirmatory Factor Analysis on the six-factor model (anger, anxiety, depression, dissociation, posttraumatic stress, and sexual concerns with the subdimensions preoccupation and distress) revealed acceptable to good fit statistics in the normative sample. One item had to be excluded from the German version of the TSC-C because the factor loading was too low. All clinical scales presented acceptable to good reliability, with Cronbach's α's ranging from .80 to .86 in the normative sample and from .72 to .87 in the clinical sample. Concurrent validity was also demonstrated by the high correlations between the TSC-C scales and instruments measuring similar psychopathology. TSC-C scores reliably differentiated between adolescents with trauma history and those without trauma history, indicating discriminative validity. Conclusions In conclusion, the German version of the TSC-C is a reliable and valid instrument for assessing trauma-related symptoms on six different scales in adolescents aged between 13 and 21 years. PMID:26498182

Reliability, factor structure, and validity of the German version of the Trauma Symptom Checklist for Children in a sample of adolescents.

PubMed

Matulis, Simone; Loos, Laura; Langguth, Nadine; Schreiber, Franziska; Gutermann, Jana; Gawrilow, Caterina; Steil, Regina

2015-01-01

The Trauma Symptom Checklist for Children (TSC-C) is the most widely used self-report scale to assess trauma-related symptoms in children and adolescents on six clinical scales. The purpose of the present study was to develop a German version of the TSC-C and to investigate its psychometric properties, such as factor structure, reliability, and validity, in a sample of German adolescents. A normative sample of N=583 and a clinical sample of N=41 adolescents with a history of physical or sexual abuse aged between 13 and 21 years participated in the study. The Confirmatory Factor Analysis on the six-factor model (anger, anxiety, depression, dissociation, posttraumatic stress, and sexual concerns with the subdimensions preoccupation and distress) revealed acceptable to good fit statistics in the normative sample. One item had to be excluded from the German version of the TSC-C because the factor loading was too low. All clinical scales presented acceptable to good reliability, with Cronbach's α's ranging from .80 to .86 in the normative sample and from .72 to .87 in the clinical sample. Concurrent validity was also demonstrated by the high correlations between the TSC-C scales and instruments measuring similar psychopathology. TSC-C scores reliably differentiated between adolescents with trauma history and those without trauma history, indicating discriminative validity. In conclusion, the German version of the TSC-C is a reliable and valid instrument for assessing trauma-related symptoms on six different scales in adolescents aged between 13 and 21 years.

Going to Scale: Experiences Implementing a School-Based Trauma Intervention

ERIC Educational Resources Information Center

Nadeem, Erum; Jaycox, Lisa H.; Kataoka, Sheryl H.; Langley, Audra K.; Stein, Bradley D.

2011-01-01

This article describes implementation experiences "scaling up" the Cognitive Behavioral Intervention for Trauma in Schools (CBITS)--an intervention developed using a community partnered research framework. Case studies from two sites that have successfully implemented CBITS are used to examine macro- and school-level implementation…

Fatal torment--from psychosis-driven index offence to trauma: a case study in forensic psychotherapy, trauma therapy and matricide.

PubMed

Kayrouz, Rony; Vrklevski, Lila Petar

2015-02-01

This paper presents the case of a forensic inpatient who was found 'Not Guilty by Reason of Mental Illness' for the murder of his mother and illustrates how psychotic symptoms can mask trauma symptoms, leading to neglect in the treatment of trauma in psychotherapy with forensic inpatients. A case study of a forensic inpatient diagnosed with schizophrenia that as part of his rehabilitation program received 19 sessions of therapy (i.e. grief counselling, Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) and imagery rescripting). The following measures were administered pre- and post-treatment: (a) The Depression Anxiety Stress Scale (DASS), to measure symptoms of depression, anxiety and stress; (b) The Impact of Events Scale-Revised (IES-R), to measure post-traumatic stress symptoms; and (c) The Trauma Attachment and Beliefs Scale (TABS), to measure disruption in beliefs about self and others. At completion of therapy, he showed a reduction in Post-Traumatic Stress Disorder (PTSD), depression, anxiety and stress symptoms. Trauma and PTSD-related symptoms in the forensic inpatient population must be assessed and treated alongside psychotic symptoms, where relevant. TF-CBT was effective in reducing PTSD symptoms in this current case study and should be considered as an intervention in forensic inpatient populations. © The Royal Australian and New Zealand College of Psychiatrists 2014.

Impact of childhood trauma on functionality and quality of life in HIV-infected women.

PubMed

Troeman, Zyrhea C E; Spies, Georgina; Cherner, Mariana; Archibald, Sarah L; Fennema-Notestine, Christine; Theilmann, Rebecca J; Spottiswoode, Bruce; Stein, Dan J; Seedat, Soraya

2011-09-30

While there are many published studies on HIV and functional limitations, there are few in the context of early abuse and its impact on functionality and Quality of Life (QoL) in HIV. The present study focused on HIV in the context of childhood trauma and its impact on functionality and Quality of Life (QoL) by evaluating 85 HIV-positive (48 with childhood trauma and 37 without) and 52 HIV-negative (21 with childhood trauma and 31 without) South African women infected with Clade C HIV. QoL was assessed using the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), the Patient's Assessment of Own Functioning Inventory (PAOFI), the Activities of Daily Living (ADL) scale and the Sheehan Disability Scale (SDS). Furthermore, participants were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D) and the Childhood Trauma Questionnaire (CTQ). Subjects had a mean age of 30.1 years. After controlling for age, level of education and CES-D scores, analysis of covariance (ANCOVA) demonstrated significant individual effects of HIV status and childhood trauma on self-reported QoL. No significant interactional effects were evident. Functional limitation was, however, negatively correlated with CD4 lymphocyte count. In assessing QoL in HIV-infected women, we were able to demonstrate the impact of childhood trauma on functional limitations in HIV.

Variability in interhospital trauma data coding and scoring: A challenge to the accuracy of aggregated trauma registries.

PubMed

Arabian, Sandra S; Marcus, Michael; Captain, Kevin; Pomphrey, Michelle; Breeze, Janis; Wolfe, Jennefer; Bugaev, Nikolay; Rabinovici, Reuven

2015-09-01

Analyses of data aggregated in state and national trauma registries provide the platform for clinical, research, development, and quality improvement efforts in trauma systems. However, the interhospital variability and accuracy in data abstraction and coding have not yet been directly evaluated. This multi-institutional, Web-based, anonymous study examines interhospital variability and accuracy in data coding and scoring by registrars. Eighty-two American College of Surgeons (ACS)/state-verified Level I and II trauma centers were invited to determine different data elements including diagnostic, procedure, and Abbreviated Injury Scale (AIS) coding as well as selected National Trauma Data Bank definitions for the same fictitious case. Variability and accuracy in data entries were assessed by the maximal percent agreement among the registrars for the tested data elements, and 95% confidence intervals were computed to compare this level of agreement to the ideal value of 100%. Variability and accuracy in all elements were compared (χ testing) based on Trauma Quality Improvement Program (TQIP) membership, level of trauma center, ACS verification, and registrar's certifications. Fifty registrars (61%) completed the survey. The overall accuracy for all tested elements was 64%. Variability was noted in all examined parameters except for the place of occurrence code in all groups and the lower extremity AIS code in Level II trauma centers and in the Certified Specialist in Trauma Registry- and Certified Abbreviated Injury Scale Specialist-certified registrar groups. No differences in variability were noted when groups were compared based on TQIP membership, level of center, ACS verification, and registrar's certifications, except for prehospital Glasgow Coma Scale (GCS), where TQIP respondents agreed more than non-TQIP centers (p = 0.004). There is variability and inaccuracy in interhospital data coding and scoring of injury information. This finding casts doubt on the validity of registry data used in all aspects of trauma care and injury surveillance.

Amazonia Introduced to General Relativity: The May 29, 1919, Solar Eclipse from a North-Brazilian Point of View

NASA Astrophysics Data System (ADS)

Crispino, Luís C. B.; de Lima, Marcelo C.

2016-12-01

In 1919, A. C. D. Crommelin and C. R. Davidson, British astronomers from the Greenwich Observatory in England, passed by Amazonia on their Brazilian journey aiming to measure the bending of stars' light rays during the total solar eclipse of May 29, 1919, and thereby put the theory of general relativity to the test. In the context of Crommelin's and Davidson's visit, we discuss how Amazonia was introduced to Einstein's theory of gravitation, and also the observations and repercussions of the May 29, 1919, solar eclipse in Belém, capital city of the North-Brazilian Pará state.

Larval development of Brachiopod Coptothyris grayi (Davidson, 1852) (Brachiopoda, Rhynchonelliformea).

PubMed

Kuzmina, T V; Temereva, E N; Malakhov, V V

2016-11-01

The larval development of the Brachiopod Coptothyris grayi (Davidson, 1852) from the Sea of Japan is described for the first time. Ciliated blastula proved to represent the first free-swimming stage. The blastopore is initially formed as a rounded hole stretching later along the anteroposterior axis. The larva is first divided into two lobes (the apical lobe and the trunk); the mantle lobe is formed later as two lateral folds. Two pairs of seta bundles appear in the late stage larvae. The apical larval lobe in brachiopods is supposed to match the pre-oral lobe and anterior part of the trunk with tentacles in phoronids.

Efficient solution of the simplified P N equations

DOE PAGES

Hamilton, Steven P.; Evans, Thomas M.

2014-12-23

We show new solver strategies for the multigroup SPN equations for nuclear reactor analysis. By forming the complete matrix over space, moments, and energy a robust set of solution strategies may be applied. Moreover, power iteration, shifted power iteration, Rayleigh quotient iteration, Arnoldi's method, and a generalized Davidson method, each using algebraic and physics-based multigrid preconditioners, have been compared on C5G7 MOX test problem as well as an operational PWR model. These results show that the most ecient approach is the generalized Davidson method, that is 30-40 times faster than traditional power iteration and 6-10 times faster than Arnoldi's method.

Dow and Mary Davidson residence - A residence in a hot humid climate with major living spaces in rooms without walls

DOE Office of Scientific and Technical Information (OSTI.GOV)

Holder, L.M. III; Holder, L.M. IV

Dow Davidson works out of his home while his wife, Mary, home schools their three children. The entire family uses the house full time throughout the year. Dow and Mary Davidson stressed the importance of a home with minimal site disruption while providing for as many human needs as practical. Specific requirements were for harmony with the natural climate and adjacent bird sanctuary. The clients had a strong preference for a pole structural system reflecting buildings they were familiar with in Hawaii. The house was designed as a pole structure utilizing passive solar heating, natural ventilation, night flushing, daylighting, rainwatermore » harvesting, and an outdoor and indoor living area without walled separation from the climate. This type of open indoor/outdoor living is an extension of the Hawaiian experience. Use of the pole structure system provided compatibility between the residence and the neighboring bird habitat. The completed house easily blended with the surrounding vegetation due to the extensive use of natural materials. Exterior walks and drives, made from caliche and mulch (harvested from cedar cut on-site), helped further balance the structure with the terrain and vegetation.« less

Intra-abdominal solid organ injuries: an enhanced management algorithm.

PubMed

Kokabi, Nima; Shuaib, Waqas; Xing, Minzhi; Harmouche, Elie; Wilson, Kenneth; Johnson, Jamlik-Omari; Khosa, Faisal

2014-11-01

The organ injury scale grading system proposed by the American Association for the Surgery of Trauma provides guidelines for operative versus nonoperative management in solid organ injuries; however, major shortcomings of the American Association for the Surgery of Trauma injury scale may become apparent with low-grade injuries, in which conservative management may fail. Nonoperative management of common intra-abdominal solid organ injuries relies increasingly on computed tomographic findings and other clinical factors, including patient age, presence of concurrent injuries, and serial clinical assessments. Familiarity with characteristic imaging features is essential for the prompt diagnosis and appropriate treatment of blunt abdominal trauma. In this pictorial essay, the spectrum of the American Association for the Surgery of Trauma organ injury scale grading system is illustrated, and a multidisciplinary management algorithm for common intra-abdominal solid organ injuries is proposed. Copyright © 2014 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

Trauma Resilience Scale: Validation of Protective Factors Associated with Adaptation following Violence

ERIC Educational Resources Information Center

Madsen, Machelle D.; Abell, Neil

2010-01-01

Objectives: The Trauma Resilience Scale (TRS), assessing protective factors associated with positive adaptation following violence, was tested in three waves of data collection. Empirical and theoretical literature shaped subscale and item formation emphasizing resilience following physical abuse, sexual abuse, intimate partner violence, and/or a…

[Childhood Traumas and Attachment Style-Associated Depression Symptoms: The Mediator Role of Alexithymia].

PubMed

Şenkal, İpek; Işıklı, Sedat

2015-01-01

The aim of this study was to investigate the mediator role of alexithymia and its relationship with childhood traumas (sexual abuse, physical abuse, emotional abuse, emotional neglect, physical neglect) and attachment style (anxiety and avoidance dimensions of attachment) associated depression symptoms in adulthood. The sample of this study included 417 undergraduate university students from different departments that studied at Hacettepe University during the 2012-2013 school years with a final analysis done over 369 participants. The Demographic Information Form, Experiences in Close Relationship Inventory-II (ECR-R), Childhood Trauma Questionnaire (CTQ), Toronto Alexithymia Scale (TAS-20), and Beck Depression Inventory (BDI) were administered to the undergraduate students who participated in this study. Mediator analyses were applied to the data. The results revealed that the total score of the Toronto Alexithymia Scale had a partial mediating role in the relationship of childhood traumas (the total score of Childhood Trauma Questionnaire), childhood emotional abuse and emotional neglect with depressive symptom levels in university students. Besides, the total score of the Toronto Alexithymia Scale had a full mediating role in the relationship between childhood physical neglect and depressive symptom levels in adulthood. Additionally, it was found that the total score of the Toronto Alexithymia Scale had a partial mediating role between the anxiety dimension of the attachment and the depressive symptom levels. This study revealed that alexithymia should be considered as a significant variable in the relationship of childhood traumas and attachment patterns with depression symptoms in adulthood.

A Comparison of Sleep Difficulties among Iraq/Afghanistan Theater Veterans with and without Mental Health Diagnoses

PubMed Central

Ulmer, Christi S.; Van Voorhees, Elizabeth; Germain, Anne E.; Voils, Corrine I.; Beckham, Jean C.

2015-01-01

Study Objectives: Sleep disturbance is among the most common complaints of veterans and military personnel who deployed to the conflicts in Iraq and Afghanistan. A growing body of research has examined cross-sectional and longitudinal relationships between sleep disturbance and mental health symptoms and specific diagnoses in this population. However, prior research has not examined these relationships in terms of the presence or absence of any mental health diagnosis. The objective of the current study is to characterize the sleep complaints (sleep characteristics, sleep quality, insomnia symptoms, and distressing dreams and nightmares) of previously deployed military personnel in terms of the presence or absence of a mental health disorder, diagnosed using structured clinical diagnostic interviews. Methods: Participants (n = 1,238) were veterans and active duty military personnel serving in the military since September 11, 2001, and deployed at least once. Scale scores and item-level data from the Pittsburgh Sleep Quality Index (PSQI), the PSQI-Addendum, the Davidson Trauma Scale, and the Symptom Checklist-90 were used to compare sleep across mental health status (with/without mental health disorder). Results: As expected, self-reported sleep impairments were worse among those meeting criteria for a mental health disorder. However, findings also revealed very poor sleep among those without a mental health diagnosis as well. Mean values for both groups were suggestive of short sleep duration, low sleep efficiency, long sleep onset latencies, poor sleep quality, frequent insomnia symptoms, and nightmare frequencies that are well above norms for the general population. Conclusions: Given the evidence for adverse mental and physical health sequelae of untreated sleep disturbance, increased attention to sleep in this population may serve as a primary prevention strategy. Citation: Ulmer CS, Van Voorhees E, Germain AE, Voils CI, Beckham JC; VA Mid-Atlantic Mental Illness Research Education and Clinical Center Registry Workgroup. A comparison of sleep difficulties among Iraq/Afghanistan theater veterans with and without mental health diagnoses. J Clin Sleep Med 2015;11(9):995–1005. PMID:26094928

A Pragmatic Randomised, Controlled Trial of Intensive Care follow up programmes in improving Longer-term outcomes from critical illness. The PRACTICAL study

PubMed Central

Cuthbertson, Brian H; Rattray, Janice; Johnston, Marie; Wildsmith, J Anthony; Wilson, Edward; Hernendez, Rodolfo; Ramsey, Craig; Hull, Alastair M; Norrie, John; Campbell, Marion

2007-01-01

Background A number of intensive care (ICU) patients experience significant problems with physical, psychological, and social functioning for some time after discharge from ICU. These problems have implications not just for patients, but impose a continuing financial burden for the National Health Service. To support recovery, a number of hospitals across the UK have developed Intensive Care follow-up clinics. However, there is a lack of evidence base to support these, and this study aims to test the hypothesis that intensive care follow up programmes are effective and cost-effective at improving physical and psychological quality of life in the year after intensive care discharge. Methods/Design This is a multi-centre, pragmatic, randomised controlled trial. Patients (n = 270) will be recruited prior to hospital discharge from three intensive care units in the UK, and randomised to one of two groups. The control group will receive standard in-hospital follow-up and the intervention group will participate in an ICU follow-up programme with clinic appointments 2–3 and 9 months after ICU discharge. The primary outcome measure is Health-related Quality of Life (HRQoL) 12 months after ICU discharge as measured by the Short Form-36. Secondary measures include: HRQoL at six months; Quality-adjusted life years using EQ-5D; posttraumatic psychopathology as measured by Davidson Trauma Scale; and anxiety and depression using the Hospital Anxiety and Depression Scale at both six and twelve months after ICU discharge. Contacts with health services in the twelve months after ICU discharge will be measured as part of the economic analysis. Discussion The provision of intensive care follow-up clinics within the UK has developed in an ad hoc manner, is inconsistent in both the number of hospitals offering such a service or in the type of service offered. This study provides the opportunity to evaluate such services both in terms of patient benefit and cost-effectiveness. The results of this study therefore will inform clinical practice and policy with regard to the appropriate development of such services aimed at improving outcomes after intensive care. Trial Registration ISRCTN24294750. PMID:17645791

Reality versus fantasy: reply to Lynn et al. (2014).

PubMed

Dalenberg, Constance J; Brand, Bethany L; Loewenstein, Richard J; Gleaves, David H; Dorahy, Martin J; Cardeña, Etzel; Frewen, Paul A; Carlson, Eve B; Spiegel, David

2014-05-01

We respond to Lynn et al.'s (2014) comments on our review (Dalenberg et al., 2012) demonstrating the superiority of the trauma model (TM) over the fantasy model (FM) in explaining the trauma-dissociation relationship. Lynn et al. conceded that our meta-analytic results support the TM hypothesis that trauma exposure is a causal risk factor for the development of dissociation. Although Lynn et al. suggested that our meta-analyses were selective, we respond that each omitted study failed to meet inclusion criteria; our meta-analyses thus reflect a balanced view of the predominant trauma-dissociation findings. In contrast, Lynn et al. were hypercritical of studies that supported the TM while ignoring methodological problems in studies presented as supportive of the FM. We clarify Lynn et al.'s misunderstandings of the TM and demonstrate consistent superiority in prediction of time course of dissociative symptoms, response to psychotherapy of dissociative patients, and pattern of relationships of trauma to dissociation. We defend our decision not to include studies using the Dissociative Experiences Scale-Comparison, a rarely used revision of the Dissociative Experiences Scale that shares less than 10% of the variance with the original scale. We highlight several areas of agreement: (a) Trauma plays a complex role in dissociation, involving indirect and direct paths; (b) dissociation-suggestibility relationships are small; and (c) controls and measurement issues should be addressed in future suggestibility and dissociation research. Considering the lack of evidence that dissociative individuals simply fantasize trauma, future researchers should examine more complex models of trauma and valid measures of dissociation.

Cross-cultural validation of the Resilience Scale for Adults (RSA) in Iran.

PubMed

Jowkar, Bahram; Friborg, Oddgeir; Hjemdal, Odin

2010-10-01

Resilience, as an ability to withstand and rebound from crisis and adversity, is becoming an increasingly popular concept in research on intervention and prevention of mental health. The present study examined psychometric properties of a Persian version of the Resilience Scale for Adults (RSA), a scale intended to measure protective factors presumed to enhance resilience. The participants were 373 university undergraduate students, as well as 30 pairs of run-away girls and a matched control group. A confirmatory factor analysis verified the Norwegian five-factor structure. All subscale scores, personal competence, social competence, family cohesion, social resources and structured style, had good reliability. The convergent validity of the RSA was supported by showing positive associations with another resilience scale, i.e., a Persian version of the Connor-Davidson Resilience Scale (CD-RISC). Predictive validity of the RSA was supported, as well, by significantly differentiating between girls who had run away from home and a matched control group. The results indicate that the RSA may be a valid and reliable scale for the assessment of resilience protective resources in an Iranian population. © 2010 The Authors. Scandinavian Journal of Psychology © 2010 The Scandinavian Psychological Associations.

Computed tomographic findings in dogs with head trauma and development of a novel prognostic computed tomography-based scoring system.

PubMed

Chai, Orit; Peery, Dana; Bdolah-Abram, Tali; Moscovich, Efrat; Kelmer, Efrat; Klainbart, Sigal; Milgram, Joshua; Shamir, Merav H

2017-09-01

OBJECTIVE To characterize CT findings and outcomes in dogs with head trauma and design a prognostic scale. ANIMALS 27 dogs admitted to the Koret School Veterinary Teaching Hospital within 72 hours after traumatic head injury that underwent CT imaging of the head. PROCEDURES Data were extracted from medical records regarding dog signalment, history, physical and neurologic examination findings, and modified Glasgow coma scale scores. All CT images were retrospectively evaluated by a radiologist unaware of dog status. Short-term (10 days after trauma) and long-term (≥ 6 months after trauma) outcomes were determined, and CT findings and other variables were analyzed for associations with outcome. A prognostic CT-based scale was developed on the basis of the results. RESULTS Cranial vault fractures, parenchymal abnormalities, or both were identified via CT in 24 of 27 (89%) dogs. Three (11%) dogs had only facial bone fractures. Intracranial hemorrhage was identified in 16 (59%) dogs, cranial vault fractures in 15 (56%), midline shift in 14 (52%), lateral ventricle asymmetry in 12 (44%), and hydrocephalus in 7 (26%). Hemorrhage and ventricular asymmetry were significantly and negatively associated with short- and long-term survival, respectively. The developed 7-point prognostic scale included points for hemorrhage, midline shift or lateral ventricle asymmetry, cranial vault fracture, and depressed fracture (1 point each) and infratentorial lesion (3 points). CONCLUSIONS AND CLINICAL RELEVANCE The findings reported here may assist in determining prognoses for other dogs with head trauma. The developed scale may be useful for outcome assessment of dogs with head trauma; however, it must be validated before clinical application.

Efficient exact-exchange time-dependent density-functional theory methods and their relation to time-dependent Hartree-Fock.

PubMed

Hesselmann, Andreas; Görling, Andreas

2011-01-21

A recently introduced time-dependent exact-exchange (TDEXX) method, i.e., a response method based on time-dependent density-functional theory that treats the frequency-dependent exchange kernel exactly, is reformulated. In the reformulated version of the TDEXX method electronic excitation energies can be calculated by solving a linear generalized eigenvalue problem while in the original version of the TDEXX method a laborious frequency iteration is required in the calculation of each excitation energy. The lowest eigenvalues of the new TDEXX eigenvalue equation corresponding to the lowest excitation energies can be efficiently obtained by, e.g., a version of the Davidson algorithm appropriate for generalized eigenvalue problems. Alternatively, with the help of a series expansion of the new TDEXX eigenvalue equation, standard eigensolvers for large regular eigenvalue problems, e.g., the standard Davidson algorithm, can be used to efficiently calculate the lowest excitation energies. With the help of the series expansion as well, the relation between the TDEXX method and time-dependent Hartree-Fock is analyzed. Several ways to take into account correlation in addition to the exact treatment of exchange in the TDEXX method are discussed, e.g., a scaling of the Kohn-Sham eigenvalues, the inclusion of (semi)local approximate correlation potentials, or hybrids of the exact-exchange kernel with kernels within the adiabatic local density approximation. The lowest lying excitations of the molecules ethylene, acetaldehyde, and pyridine are considered as examples.

A cubic scaling algorithm for excited states calculations in particle-particle random phase approximation

NASA Astrophysics Data System (ADS)

Lu, Jianfeng; Yang, Haizhao

2017-07-01

The particle-particle random phase approximation (pp-RPA) has been shown to be capable of describing double, Rydberg, and charge transfer excitations, for which the conventional time-dependent density functional theory (TDDFT) might not be suitable. It is thus desirable to reduce the computational cost of pp-RPA so that it can be efficiently applied to larger molecules and even solids. This paper introduces an O (N3) algorithm, where N is the number of orbitals, based on an interpolative separable density fitting technique and the Jacobi-Davidson eigensolver to calculate a few low-lying excitations in the pp-RPA framework. The size of the pp-RPA matrix can also be reduced by keeping only a small portion of orbitals with orbital energy close to the Fermi energy. This reduced system leads to a smaller prefactor of the cubic scaling algorithm, while keeping the accuracy for the low-lying excitation energies.

Extrasensory Perception Experiences and Childhood Trauma: A Rorschach Investigation.

PubMed

Scimeca, Giuseppe; Bruno, Antonio; Pandolfo, Gianluca; La Ciura, Giulia; Zoccali, Rocco A; Muscatello, Maria R A

2015-11-01

This study investigated whether people who report recurrent extrasensory perception (ESP) experiences (telepathy, clairvoyance, and precognition) have suffered more traumatic experiences and traumatic intrusions. Thirty-one nonclinical participants reporting recurrent ESP experiences were compared with a nonclinical sample of 31 individuals who did not report recurrent ESP phenomena. Past traumatic experiences were assessed via a self-report measure of trauma history (Childhood Trauma Questionnaire); traumatic intrusions were assessed via a performance-based personality measure (Rorschach Traumatic Content Index). Participants also completed the Anomalous Experience Inventory, the Minnesota Multiphasic Personality Inventory-2, the Dissociative Experience Scale, and the Revised Paranormal Belief Scale. The ESP group reported higher levels of emotional abuse, sexual abuse, emotional neglect, physical neglect, and traumatic intrusions. The association between ESP experiences and trauma was partly mediated by the effects of dissociation and emotional distress. Implications for health professionals are discussed. Results also showed the reliability of the twofold method of assessment of trauma.

Prognostic scales ISS-RTS-TRISS, PRISM, APACHE II and PTS in decision support of treatment children with severe mechanical trauma.

PubMed

Vasilyeva, I V; Shvirev, S L; Arseniev, S B; Zarubina, T V

2013-01-01

The aim of the present study is to assess a possibility and validity of prognostic scales ISS-RTS-TRISS, PRISM, APACHE II and PTS to be used for the automated calculation in decision support when treating children with severe mechanical traumas. The mentioned scales are used in the Hospital Information System (HIS) MEDIALOG. The retrospective study was conducted using clinical and physiological data collected at the admission and during the first 24 hours of hospitalization in 166 patients. Scales PRISM, APACHE II, ISS-RTS-TRISS were used for calculating the severity of injury and for prognosis in death outcomes. Scale PTS was used for evaluating the severity index only. Our research has shown that ISS-RTS-TRISS has excellent discrimination ability, PRISM and APACHE II prognostic scales have acceptable discrimination ability; moreover, they all have significant calibration ability. PTS scale has acceptable discrimination ability. It has been showed that automated calculation scales ISS-RTS-TRISS, PRISM, APACHE II and PTS are useful for assessing outcomes in children with severe mechanical trauma.

Family Trauma and Dysfunction in Sexually Abused Female Adolescent Psychiatric Control Groups.

ERIC Educational Resources Information Center

Wherry, Jeffrey N.; And Others

1994-01-01

Differences in family trauma, stressors, and dysfunction among adolescent psychiatric inpatients grouped by sexual abuse self-reports were investigated. Family trauma/dysfunction was determined from a composite score derived from the Traumatic Antecedents Scale. The results indicated that sexually abused adolescents reported more family…

Establishing inter-rater reliability scoring in a state trauma system.

PubMed

Read-Allsopp, Christine

2004-01-01

Trauma systems rely on accurate Injury Severity Scoring (ISS) to describe trauma patient populations. Twenty-seven (27) Trauma Nurse Coordinators and Data Managers across the state of New South Wales, Australia trauma network were instructed in the uses and techniques of the Abbreviated Injury Scale (AIS) from the Association for the Advancement of Automotive Medicine. The aim is to provide accurate, reliable and valid data for the state trauma network. Four (4) months after the course a coding exercise was conducted to assess inter-rater reliability. The results show that inter-rater reliability is with accepted international standards.

Attachment insecurity as a mediator of the relationship between childhood trauma and adult dissociation.

PubMed

Kong, Seong Sook; Kang, Dae Ryong; Oh, Min Jung; Kim, Nam Hee

2018-01-01

This study aimed to investigate whether attachment insecurity mediates the relationship between childhood trauma and adult dissociation, specifically with regard to individual forms of childhood maltreatment. Psychiatric outpatients who visited a specialized trauma clinic (n = 115) participated in the study. Data were collected via the Childhood Trauma Questionnaire, Revised Adult Attachment Scale, and Dissociative Experience Scale. Structural equation modeling and path analysis were performed to analyze the mediating effects of attachment insecurity on the relationship between childhood trauma and adult dissociation. Greater childhood trauma was associated with higher dissociation, and the relationship between them was fully mediated by attachment anxiety. In path analysis of trauma subtypes, the effects of emotional abuse, physical abuse, and physical neglect as a child on adult dissociation were found to be fully mediated by attachment anxiety. The effect of sexual abuse on dissociation was mediated by a synergistic effect from both attachment anxiety and attachment avoidance. Regarding emotional neglect, a countervailing interaction was discovered between the direct and indirect effects thereof on dissociation; the indirect effect of emotional neglect on dissociation was partially mediated by attachment insecurity. Specific aspects of attachment insecurity may help explain the relationships between individual forms of childhood trauma and adult dissociative symptoms. Tailored treatments based on affected areas of attachment insecurity may improve outcomes among patients with dissociative symptoms and a history of childhood trauma.

Bohr Hamiltonian for γ = 30° with Davidson potential

NASA Astrophysics Data System (ADS)

Yigitoglu, Ibrahim; Gokbulut, Melek

2018-03-01

A γ-rigid solution of the Bohr Hamiltonian for γ = 30° is constructed with the Davidson potential in the β part. This solution is going to be called Z(4)-D. The energy eigenvalues and wave functions are obtained by using the analytic method developed by Nikiforov and Uvarov. The calculated intraband and interband B(E2) transitions rates are presented and compared with the Z(4) model predictions. The staggering behavior in γ-bands is considered to search Z(4) -D candidate nuclei. A variational procedure is applied to demonstrate that the Z(4) model is a solution of the critical point at the shape phase transition from spherical to rigid triaxial rotor.

Rumination as a Mediator between Childhood Trauma and Adulthood Depression/Anxiety in Non-clinical Participants.

PubMed

Kim, Ji S; Jin, Min J; Jung, Wookyoung; Hahn, Sang W; Lee, Seung-Hwan

2017-01-01

Objective: Although there is strong evidence that childhood trauma is associated with the development of depression and anxiety, relatively few studies have explored potential mediating factors for this relationship. The present study aimed to evaluate the mediating role of rumination in the link between childhood trauma and mood status such as depression, anxiety and affective lability. Materials and Methods: Two hundred and seven non-clinical participants completed the Childhood Trauma Questionnaire, the Ruminative Response Scale, the Beck Depression Inventory, the State Anxiety Inventory, and the Affective Lability Scale. Structural equation modeling was used to evaluate the results. Results: Our results supported that rumination is a meaningful mediator between childhood trauma and depression/anxiety in non-clinical participants. The mediation model indicated that childhood trauma and its subtypes are linked to depression and anxiety through three subtypes of rumination, thereby supporting a significant indirect relationship (Standardized coefficient [SC] = 0.56, p < 0.001 for the path from trauma to rumination; SC = 0.67, p < 0.001, from rumination to mood). The direct relationship between childhood trauma and mood symptoms was also significant in a model including rumination (SC = 0.68, p < 0.001). The mediation effect of rumination in the relationship between childhood trauma and mood was more predominant in female participants. Conclusions: The present study found that rumination mediates the influence of childhood trauma on the development of mood symptoms in non-clinical participants. Childhood trauma appears to be a critical determinant for developing symptoms of depression and anxiety.

Etiologies of pediatric craniofacial injuries: a comparison of injuries involving all-terrain vehicles and golf carts.

PubMed

White, Lauren C; McKinnon, Brian J; Hughes, C Anthony

2013-03-01

To determine incidence and etiologies of craniofacial injuries in the pediatric population through comparison of injuries caused by all-terrain vehicles and golf cart trauma. Case series with chart review. Level 1 trauma center. Retrospective review of pediatric traumas at a tertiary academic medical center from 2003 to 2012 identified 196 patients whose injuries resulted from accidents involving either all-terrain vehicles or golf carts. Data was collected and variables such as age, gender, driver vs. passenger, location of accident, Glasgow coma scale, Injury severity scale, Abbreviated injury scale, and presence or absence of helmet use were examined. 196 pediatric patients were identified: 68 patients had injuries resulting from golf cart accidents, and 128 patients from ATV accidents. 66.4% of ATV-related traumas were male, compared to 52.9% of golf cart-related traumas. Ages of injured patients were similar between the two modalities with average age of ATV traumas 10.8 (±4.0) years and golf cart traumas 10.0 (±4.6) years. Caucasians were most commonly involved in both ATV (79.7%) and golf cart traumas (85.3%). 58.6% of all ATV related trauma and 69.1% of all golf cart trauma resulted in craniofacial injuries. The most common craniofacial injury was a closed head injury with brief loss of consciousness, occurring in 46.1% of the ATV traumas and 54.4% of the golf cart traumas. Temporal bone fractures were the second most common type of craniofacial injury, occurring in 5.5% of ATV accidents and 7.4% of the golf cart traumas. Length of hospital stay and, cases requiring surgery and severity scores were similar between both populations. Intensive care admissions and injury severity scores approached but not reach statistical significance (0.096 and 0.083, respectively). The only statistically significant differences between the two modalities were helmet use (P=0.00018%) and days requiring ventilator assistance (P=0.025). ATVs and golf carts are often exempt from the safety features and regulations required of motor vehicles, and ATV and golf cart accidents represent a significant portion of pediatric traumas. This study found that ATV and golf cart accidents contribute significantly to craniofacial trauma requiring hospitalization, with resultant morbidity and mortality. Further investigation of these injuries and their prevention in the pediatric population is needed before efforts to promote effective safety regulations for such vehicles in the future can be addressed. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Psychometrics of the Overall Anxiety Severity and Impairment Scale (OASIS) in a sample of women with and without trauma histories.

PubMed

Norman, Sonya B; Allard, Carolyn B; Trim, Ryan S; Thorp, Steven R; Behrooznia, Michelle; Masino, Tonya T; Stein, Murray B

2013-04-01

Many women have unidentified anxiety or trauma histories that can impact their health and medical treatment-seeking behavior. This study examined the sensitivity, specificity, efficiency, and sensitivity to change of the Overall Anxiety Severity and Impairment Scale (OASIS) for identifying an anxiety disorder in a female sample with and without trauma history related to intimate partner violence (IPV). Forty-three women with full or partial PTSD from IPV and 41 women without PTSD completed the OASIS. All participants with trauma history completed the Clinician Administered PTSD Scale. This report is a secondary analysis of a study on the neurobiology of psychological trauma in survivors of IPV recruited from the community. A cut-score of 5 best discriminated those with PTSD from those without, successfully classifying 91% of the sample with 93% sensitivity and 90% specificity. The measure showed strong sensitivity to change in a subsample of 20 participants who completed PTSD treatment and strong convergent and divergent validity in the full sample. This study suggests that the OASIS can identify the presence of an anxiety disorder among a female sample of IPV survivors when PTSD is present.

Relationship between childhood trauma and suicide probability in obsessive-compulsive disorder.

PubMed

Ay, Rukiye; Erbay, Lale Gonenir

2018-03-01

The aim of this study is to assess the relationship between childhood trauma with the probability of suicide in obsessive compulsive disorders. Sixty-seven patients who were diagnosed with OCD were included in the study out of the patients who were admitted to Malatya Training and Research Hospital psychiatry outpatient clinic. The research data were collected using Yale Brawn Obsessive Compulsive Scale (YBOCS), Beck Depression (BDS) and Beck Anxiety Scales (BAS), Childhood Trauma Questionnaire-28 (CTQ-28), and Suicide Probability Scale (SPS). CTQ was detected as ≥ 35 in 36 of 67 patients who were included in the study. Aggression (p = 0.003), sexual (p = 0.007) and religious (p = 0.023) obsessions and rituelistic (p = 0.000) compulsions were significantly higher in the group with CTQ ≥ 35. Mild correlation was detected between the SPS score and the scores of CTQ. Correlation remained even when the effect of BAS and BDS scores were excluded. At the end of our study, childhood traumas were found to be associated with obsessive symptoms. In the group with childhood trauma, increased suicide probability was detected independently from depression and anxiety. Copyright © 2017. Published by Elsevier B.V.

Trauma-Induced Weight Loss and Cognitive Deficits among Former Prisoners of War.

ERIC Educational Resources Information Center

Sutker, Patricia B.; And Others

1990-01-01

Compared former prisoners of war (POWs) reporting confinement weight losses greater than 35 percent (N=60), less than 35 percent (N=113), and non-POW combat veterans (N=50) on Wechsler Adult Intelligence Scale-Revised and Wechsler Memory Scale Logical Memory indices. Findings suggest that severe POW confinement stress reflected by trauma-induced…

Resilience and Function in Adults With Physical Disabilities: An Observational Study.

PubMed

Battalio, Samuel L; Silverman, Arielle M; Ehde, Dawn M; Amtmann, Dagmar; Edwards, Karlyn A; Jensen, Mark P

2017-06-01

To determine if resilience is uniquely associated with functional outcomes (satisfaction with social roles, physical functioning, and quality of life) in individuals with physical disabilities, after controlling for measures of psychological health (depression and anxiety) and symptom severity (pain, fatigue, and sleep disturbance); and to examine the potential moderating effect of sex, age, and diagnosis on the hypothesized associations between resilience and function. Cross-sectional survey study. Surveys were mailed (81% response rate) to a community sample of 1949 individuals with multiple sclerosis, muscular dystrophy, postpoliomyelitis syndrome, or spinal cord injury. Participants were recruited through the Internet or print advertisement (28%), a registry of previous research participants who indicated interest in future studies (21%), a departmental registry of individuals interested in research (19%), disability-specific registries (18%), word of mouth (10%), or other sources (3%). Convenience sample of community-dwelling adults aging with physical disabilities (N=1574), with a mean Connor-Davidson Resilience Scale (10 items) score of 29. Not applicable. Patient-Reported Outcomes Measurement Information System measures of Satisfaction with Social Roles and Activities and Physical Functioning, the World Health Organization's brief Older People's Quality of Life Questionnaire, and the Connor-Davidson Resilience Scale (10 items). After controlling for age, age squared, sex, diagnosis, psychological health, and symptom severity, resilience was significantly and positively associated with satisfaction with social roles (β=.17, P<.001) and quality of life (β=.39, P<.001), but not physical function (β=.04, P>.05). For every 1-point increase in scores of resilience, there was an increase of .50 in the quality of life score and .20 in the satisfaction with social roles score. Sex also moderated the association between resilience and satisfaction with social roles (F 1,1453 =4.09, P=.043). The findings extend past research, providing further evidence indicating that resilience plays a unique role in nonphysical functional outcomes among individuals with physical disabilities. Copyright © 2016 American Congress of Rehabilitation Medicine. All rights reserved.

Differences in the association between childhood trauma history and borderline personality disorder or attention deficit/hyperactivity disorder diagnoses in adulthood.

PubMed

Ferrer, Marc; Andión, Óscar; Calvo, Natalia; Ramos-Quiroga, Josep A; Prat, Mònica; Corrales, Montserrat; Casas, Miguel

2017-09-01

Common environmental etiological factors between borderline personality disorder (BPD) and attention deficit/hyperactivity disorder (ADHD) have not been fully studied. The main aim of this study was to investigate the relationship between childhood trauma histories, assessed by the Childhood Trauma Questionnaire-Short Form (CTQ-SF), with adult BPD, ADHD or BPD-ADHD diagnoses. Comorbid BPD-ADHD patients exhibited significantly higher clinical severity and higher scores in the Total Neglect Scale, compared to BPD and ADHD patients, and only a marginal difference was observed for Sexual Abuse when BPD and ADHD patients were compared. Physical Trauma Scales were associated with ADHD diagnosis, whereas Emotional Abuse and Sexual Abuse Scales were associated with BPD or BPD-ADHD diagnoses. The study findings support the association between experiencing traumatic events in childhood and a higher clinical severity of BPD in adulthood. Furthermore, physical trauma history in childhood could be associated with the persistence of ADHD in adulthood and emotional or sexual abuse with later development of BPD or comorbid BPD-ADHD. Whereas experiencing childhood traumas is associated with later development of more general psychopathology, our study supports that a specific type of traumatic event could increase the risk for the consolidation of a concrete psychiatric disorder in the trajectory from childhood to adulthood of vulnerable subjects.

NEO-P1 Profiles in PTSD as a Function of Trauma Level.

ERIC Educational Resources Information Center

Talbert, F. Suzanne; And Others

1993-01-01

Administered NEO Personality Inventory (NEO-PI) and Combat Exposure Scale to 100 Vietnam veterans with combat-related Posttraumatic Stress Disorder (PTSD) and sorted subjects into three groups based on trauma exposure level. Found no significant differences among personality profiles of three trauma-exposed groups. Revealed normative NEO-PI…

Effects of septic-tank effluent on ground-water quality in northern Williamson County and southern Davidson County, Tennessee

USGS Publications Warehouse

Hanchar, D.W.

1991-01-01

An investigation of the potential contamination of ground water from septic tank systems blasted in bedrock in Williamson and Davidson Counties, Tennessee, was conducted during 1988-89. Water samples were collected from domestic and observation wells, springs, and surface-water sites in a residential subdivision in the northern part of Williamson County near Nashville. The subdivision has a high density of septic-tank field lines installed into blasted bedrock Water samples also were collected from a well located in an area of Davidson County where field lines were installed in 5 feet of soil. Samples were analyzed for major inorganic constituents, nutrients, total organic carbon, optical brighteners, and bacteria. Although results of analyses of water samples from wells indicate no effect of septic-tank effluent on ground-water quality at these sites, water from two springs located downgradient from the subdivision had slightly larger concentrations of nitrite plus nitrate (2.2 and 2.7 milligrams per liter N), and much larger concentrations of fecal coliform and fecal streptococci bacteria (2,000 to 3,200 and 700 to 900 colonies per 100 milliliters of sample, respectively), than other wells and springs sampled during 1988. Water from one of these springs contained optical brighteners, which indicates that septic-tank effluent is affecting ground-water quality.

Assessing the reliability and validity of the Chinese Sexual Assault Symptom Scale (C-SASS): scale development and validation.

PubMed

Wang, Chang-Hwai; Lee, Jin-Chuan; Yuan, Yu-Hsi

2014-01-01

The purpose of this research is to establish and verify the psychometric and structural properties of the self-report Chinese Sexual Assault Symptom Scale (C-SASS) to assess the trauma experienced by Chinese victims of sexual assault. An earlier version of the C-SASS was constructed using a modified list of the same trauma symptoms administered to an American sample and used to develop and validate the Sexual Assault Symptom Scale II (SASS II). The rationale of this study is to revise the earlier version of the C-SASS, using a larger and more representative sample and more robust statistical analysis than in earlier research, to permit a more thorough examination of the instrument and further confirm the dimensions of sexual assault trauma in Chinese victims of rape. In this study, a sample of 418 victims from northern Taiwan was collected to confirm the reliability and validity of the C-SASS. Exploratory factor analysis yielded five common factors: Safety Fears, Self-Blame, Health Fears, Anger and Emotional Lability, and Fears About the Criminal Justice System. Further tests of the validity and composite reliability of the C-SASS were provided by the structural equation modeling (SEM). The results indicated that the C-SASS was a brief, valid, and reliable instrument for assessing sexual assault trauma among Chinese victims in Taiwan. The scale can be used to evaluate victims in sexual assault treatment centers around Taiwan, as well as to capture the characteristics of sexual assault trauma among Chinese victims.

The Concurrent and Incremental Validity of the Trauma Symptom Inventory in Women Reporting Histories of Sexual Maltreatment

ERIC Educational Resources Information Center

Arbisi, Paul A.; Erbes, Christopher R.; Polusny, Melissa A.; Nelson, Nathaniel W.

2010-01-01

The Trauma Symptom Inventory (TSI), Minnesota Multiphasic Personality Inventory-2 (MMPI-2), and Posttraumatic Diagnostic Scale (PDS) were administered to 71 women who reported histories of childhood and/or adult sexual maltreatment and 25 women who did not report a history of victimization. The TSI validity scales were not effective in identifying…

Childhood Trauma and Minimization/Denial in People with and without a Severe Mental Disorder.

PubMed

Church, Chelsea; Andreassen, Ole A; Lorentzen, Steinar; Melle, Ingrid; Aas, Monica

2017-01-01

Background: Childhood trauma has garnered extensive research concerning its role in the psychopathology of mental disorders, including psychosis. The Childhood Trauma Questionnaire (CTQ) utilizes a minimization/denial (MD) scale to denote potential under-reporters of trauma, yet MD scores are infrequently reported and validations of the scale are lacking in the literature. Elucidate differences in MD between patients with severe mental disorders to healthy individuals, and secondly, investigate if MD influences reports of childhood trauma between the groups. Methods: We included 621 patients with a DSM-schizophrenia spectrum, bipolar spectrum diagnosis, or major depression disorder with psychotic features and 299 healthy controls as part of the NORMENT study in Oslo, Norway. History of childhood trauma was obtained using the CTQ. Clinical diagnoses were assessed using the Structured Clinical Interview for DSM Disorders. Results: A significantly greater proportion of healthy controls (42.8%) had a positive MD score compared to patients (26.7%). When controlling for MD, the patient group still exhibited elevated reports of childhood trauma compared to controls (Cohen's d = 1.27), concordant with reports of childhood trauma being more frequently reported in a population of severe mental disorders. Conclusion: Elevated MD in the healthy control group could suggest an enhanced self-serving bias, potentially attenuated in the psychiatric group. Clinicians and researchers would benefit from including the MD component of CTQ when assessing retrospective information on childhood trauma to rule out potential effect of MD.

Trauma centrality and PTSD in veterans returning from Iraq and Afghanistan.

PubMed

Brown, Adam D; Antonius, Daniel; Kramer, Michael; Root, James C; Hirst, William

2010-08-01

Research has demonstrated that the extent to which an individual integrates a traumatic event into their identity ("trauma centrality") positively correlates with posttraumatic stress disorder (PTSD) symptom severity. No research to date has examined trauma centrality in individuals exposed to combat stress. This study investigated trauma centrality using the abridged Centrality of Event Scale (Berntsen & Rubin, 2006) among Operation Enduring Freedom/Operation Iraqi Freedom combat veterans (n = 46). Multiple regression analyses demonstrated that trauma centrality predicted PTSD symptoms. Trauma centrality and PTSD symptoms remained significantly correlated when controlling for depression in subgroups of veterans with or without probable PTSD. This study replicates and extends findings that placing trauma at the center of one's identity is associated with PTSD symptomatology.

Trauma profile in Egyptian adolescents with first-episode schizophrenia: relation to psychopathology and plasma brain-derived neurotrophic factor.

PubMed

Fawzi, Mounir H; Kira, Ibrahim A; Fawzi, Mohab M; Mohamed, Hanan E; Fawzi, Maggie M

2013-01-01

We aimed to investigate the relation of trauma profile to schizophrenia psychopathology in a sample of Egyptian drug-naïve adolescent patients with first-episode schizophrenia. In addition, a hypothesized mediating effect of brain-derived neurotrophic factor (BDNF) in this relation was formally tested. We assessed 74 eligible outpatients using the Positive and Negative Syndrome Scale (PANSS) for measuring psychopathology. Trauma histories were recorded with the help of the Cumulative Trauma Measure. Serum BDNF levels were estimated by enzyme-linked immunosorbent assay. Total cumulative trauma, personal identity trauma, and survival trauma were found to be the significant predictors for schizophrenia psychopathology. BDNF fully mediated the associations between total cumulative trauma and overall schizophrenia psychopathology. BDNF also mediated the associations between some types of trauma and both PANSS-positive and PANSS-negative symptom factors. We concluded that total cumulative trauma and certain trauma types are linked with schizophrenia psychopathology. BDNF appears to mediate these links.

Self-reports of trauma and dissociation: An examination of context effects.

PubMed

Lemons, Peter; Lynn, Steven Jay

2016-08-01

To examine context effects in moderating the link between self-reported trauma and dissociation in undergraduate samples, we administered these measures either in the same or different experimental contexts. Trauma History Screen/THS (Carlson et al., 2011)-Dissociative Experiences Scale/DES-II (Bernstein & Putnam, 1986) correlations revealed a context effect (greater correlations in same test context), although multiple regression analyses did not confirm this finding. A context effect was supported in DES-Taxon scores using multiple regression for the THS but not the Modified Posttraumatic Stress Scale (MPSS-SR; Falsetti, Resnick, Resick, & Kilpatrick, 1993), an effect confirmed with correlation comparisons. Ethnicity influenced the association between measures of trauma and dissociation. Overall, the relation between measures of trauma and dissociation was small to medium, although high correlations were observed between the DES depersonalization/derealization subscale and the Multiscale Dissociation Inventory (Briere, Weathers, & Runtz, 2005) depersonalization and derealization subscales, supporting the construct validity of these measures. Copyright © 2016 Elsevier Inc. All rights reserved.

Child Abuse and Psychiatric Co-morbidity Among Chinese Adolescents: Emotional Processing as Mediator and PTSD from Past Trauma as Moderator.

PubMed

Chung, Man Cheung; Chen, Zhuo Sheng

2017-08-01

This study investigated whether child abuse was associated with psychiatric co-morbidity in a group of Chinese adolescents, and whether this association would be mediated by emotional processing difficulties and moderated by the severity of PTSD from other traumas in the past. Four hundred seventy-four adolescents participated in the study. They completed the Childhood Trauma Questionnaire-Short Form, General Health Questionnaire-28, the Posttraumatic Stress Diagnostic Scale, and Emotional processing scale-25. The results showed that after adjusting for the total number of traumatic events and how long ago the most traumatic event occurred, child abuse was associated with psychiatric co-morbidity. This association was not moderated by the severity of PTSD from past traumas but mediated by emotion processing difficulties. To conclude, adolescents who experience child abuse can develop emotional processing difficulties which in turn impact on psychiatric symptoms. Experience of past trauma does not influence these psychological processes.

Examining the effect of childhood trauma on psychological distress, risk of violence and engagement, in forensic mental health.

PubMed

Macinnes, Marlene; Macpherson, Gary; Austin, Jessica; Schwannauer, Matthias

2016-12-30

Previous research has found an association between childhood trauma and insecure attachment and psychological distress, risk of violence and engagement in therapy. The aim of this study was to investigate the relationships between these factors in a forensic population. Sixty-four participants from three secure psychiatric hospitals completed the Childhood Trauma Questionnaire (CTQ), the Relationship Scales Questionnaire (RSQ) and the Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM). Overall scores from participants' Historical Clinical Risk Management Violence Risk Assessment Scheme, (HCR-20) were calculated. Staff evaluated participants' engagement in therapy via completion of the Service Engagement Scale (SES). This retrospective study found childhood trauma and insecure attachment significantly predicted psychological distress and risk of violence. No associations with engagement were found, but methodological reasons for this outcome were acknowledged. The importance of routinely assessing for a history of childhood trauma and insecure attachment was highlighted. Crown Copyright © 2016. Published by Elsevier Ireland Ltd. All rights reserved.

Cumulative trauma, PTSD and dissociation among Ethiopian refugees in Israel.

PubMed

Finklestein, Michal; Solomon, Zahava

2009-01-01

The aim of this study was to examine the exposure of Ethiopian refugees to pre-, peri- and post-migration stressful events and their implications for both posttraumatic stress disorder (PTSD) and dissociation. A random sample (N = 478) of three groups of refugees took part in the research ("Moses" immigrants, 1984, n = 165; "Solomon" immigrants, 1991, n = 169; "Family Reunification" immigrants, 1995, n = 144). Exposure to stressful events and posttraumatic symptoms were assessed via the Harvard Trauma Questionnaire (HTQ). Post-migration difficulties were assessed via the Post Migration Living Difficulties (PMLD) scale. Dissociation was evaluated using the Dissociation Experience Scale (DES). Significant differences were found among the groups in the rates of PTSD (27%, 15%, and 26%, respectively), but no differences were found in dissociation. A significant relationship was found between PTSD symptoms and cumulative trauma among the three groups, but no such relationship was found between dissociation and cumulative trauma. The differences among the groups were discussed in light of the unique characteristics of cumulative trauma, PTSD and dissociation among Ethiopian refugees.

Penetrating injuries to the duodenum: An analysis of 879 patients from the National Trauma Data Bank, 2010 to 2014.

PubMed

Phillips, Bradley; Turco, Lauren; McDonald, Dan; Mause, Alison; Walters, Ryan W

2017-11-01

Despite wide belief that the duodenal Organ Injury Scale has been validated, this has not been reported in the published literature. Based on clinical experience, we hypothesize that the American Association for Surgery of Trauma Organ Injury Scale (AAST-OIS) for duodenal injuries can independently predict mortality. Our objectives were threefold: (1) describe the national profile of penetrating duodenal injuries, (2) identify predictors of morbidity and mortality, and (3) validate the duodenum AAST-OIS as a statistically significant predictor of mortality. Using the Abbreviated Injury Scale 2005 and International Classification of Diseases-9th Rev.-Clinical Modification (ICD-9-CM) E-codes, we identified 879 penetrating duodenal trauma patients from the National Trauma Data Bank between 2010 and 2014. We controlled patient-level covariates of age, biological sex, systolic blood pressure (SBP), Glasgow Coma Scale (GCS) score, pulse, Injury Severity Score (ISS), and Organ Injury Scale (OIS) grade. We estimated multivariable generalized linear mixed models to account for the nesting of patients within trauma centers. Our results indicated an overall mortality rate of 14.4%. Approximately 10% of patients died within 24 hours of admission, of whom 76% died in the first 6 hours. Patients averaged approximately five associated injuries, 45% of which involved the liver and colon. Statistically significant independent predictors of mortality were firearm mechanism, SBP, GCS, pulse, ISS, and AAST-OIS grade. Specifically, odds of death were decreased with 10 mm Hg higher admission SBP (13% decreased odds), one point higher GCS (14.4%), 10-beat lower pulse (8.2%), and 10-point lower ISS (51.0%). This study is the first to report the national profile of penetrating duodenal injuries. Using the National Trauma Data Bank, we identified patterns of injury, predictors of outcome, and validated the AAST-OIS for duodenal injuries as a statistically significant predictor of morbidity and mortality. Epidemiologic/Prognostic, level IV.

Short report: Influence of culture and trauma history on autobiographical memory specificity.

PubMed

Humphries, Clare; Jobson, Laura

2012-01-01

This study investigated the influence of culture and trauma history on autobiographical memory specificity. Chinese international and British undergraduate university students (N=64) completed the autobiographical memory test, Hopkins symptom checklist-25, twenty statements test, trauma history questionnaire, and impact of events scale-revised. The results indicated that the British group provided significantly more specific memories than the Chinese group. The high trauma exposure group provided significantly fewer specific autobiographical memories than the low trauma exposure group. The interaction was not significant. The findings suggest that even in cultures where specificity is not as evident in autobiographical remembering style, trauma exposure appears to exert similar influence on autobiographical memory specificity.

The Validity and Reliability Work of the Scale That Determines the Level of the Trauma after the Earthquake

ERIC Educational Resources Information Center

Tanhan, Fuat; Kayri, Murat

2013-01-01

In this study, it was aimed to develop a short, comprehensible, easy, applicable, and appropriate for cultural characteristics scale that can be evaluated in mental traumas concerning earthquake. The universe of the research consisted of all individuals living under the effects of the earthquakes which occurred in Tabanli Village on 23.10.2011 and…

The impact of childhood sexual abuse on the outcome of intensive trauma-focused treatment for PTSD.

PubMed

Wagenmans, Anouk; Van Minnen, Agnes; Sleijpen, Marieke; De Jongh, Ad

2018-01-01

Background : It is assumed that PTSD patients with a history of childhood sexual abuse benefit less from trauma-focused treatment than those without such a history. Objective : To test whether the presence of a history of childhood sexual abuse has a negative effect on the outcome of intensive trauma-focused PTSD treatment. Method : PTSD patients, 83% of whom suffered from severe PTSD, took part in a therapy programme consisting of 2 × 4 consecutive days of Prolonged Exposure (PE) and EMDR therapy (eight of each). In between sessions, patients participated in sport activities and psycho-education sessions. No prior stabilization phase was implemented. PTSD symptom scores of clinician-administered and self-administered measures were analysed using the data of 165 consecutive patients. Pre-post differences were compared between four trauma groups; patients with a history of childhood sexual abuse before age 12 (CSA), adolescent sexual abuse (ASA; i.e. sexual abuse between 12 and 18 years of age), sexual abuse (SA) at age 18 and over, or no history of sexual abuse (NSA). Results : Large effect sizes were achieved for PTSD symptom reduction for all trauma groups (Cohen's d  = 1.52-2.09). For the Clinical Administered PTSD Scale (CAPS) and the Impact of Event Scale (IES), no differences in treatment outcome were found between the trauma (age) groups. For the PTSD Symptom Scale Self Report (PSS-SR), there were no differences except for one small effect between CSA and NSA. Conclusions : The results do not support the hypothesis that the presence of a history of childhood sexual abuse has a detrimental impact on the outcome of first-line (intensive) trauma-focused treatments for PTSD.

A Two-Center Validation of "Patient Does Not Follow Commands" and Three Other Simplified Measures to Replace the Glasgow Coma Scale for Field Trauma Triage.

PubMed

Hopkins, Emily; Green, Steven M; Kiemeney, Michael; Haukoos, Jason S

2018-05-02

Out-of-hospital personnel worldwide calculate the 13-point Glasgow Coma Scale (GCS) score as a routine part of field trauma triage. We wish to independently validate a simpler binary assessment to replace the GCS for this task. We analyzed trauma center registries from Loma Linda University Health (2003 to 2015) and Denver Health Medical Center (2009 to 2015) to compare the binary assessment "patient does not follow commands" (ie, GCS motor score <6) with GCS score less than or equal to 13 for the prediction of 5 trauma outcomes: emergency intubation, clinically significant brain injury, need for neurosurgical intervention, Injury Severity Score greater than 15, and mortality. As a secondary analysis, we similarly evaluated 3 other measures simpler than the GCS: GCS motor score less than 5, Simplified Motor Score, and the "alert, voice, pain, unresponsive" scale. In this analysis of 47,973 trauma patients, we found that the binary assessment "patient does not follow commands" was essentially identical to GCS score less than or equal to 13 for the prediction of all 5 trauma outcomes, with slightly superior positive likelihood ratios (eg, those for mortality 2.37 versus 2.13) offsetting slightly inferior negative ones (eg, those for mortality 0.25 versus 0.24) and its graphic depiction of sensitivity versus specificity superimposing the GCS prediction curve. We found similar results for the 3 other simplified measures. In this 2-center external validation, we confirmed that a simple binary assessment-"patient does not follow commands"-could effectively replace the more complicated GCS for field trauma triage. Copyright © 2018 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

The impact of childhood sexual abuse on the outcome of intensive trauma-focused treatment for PTSD

PubMed Central

Wagenmans, Anouk; Van Minnen, Agnes; Sleijpen, Marieke; De Jongh, Ad

2018-01-01

ABSTRACT Background: It is assumed that PTSD patients with a history of childhood sexual abuse benefit less from trauma-focused treatment than those without such a history. Objective: To test whether the presence of a history of childhood sexual abuse has a negative effect on the outcome of intensive trauma-focused PTSD treatment. Method: PTSD patients, 83% of whom suffered from severe PTSD, took part in a therapy programme consisting of 2 × 4 consecutive days of Prolonged Exposure (PE) and EMDR therapy (eight of each). In between sessions, patients participated in sport activities and psycho-education sessions. No prior stabilization phase was implemented. PTSD symptom scores of clinician-administered and self-administered measures were analysed using the data of 165 consecutive patients. Pre-post differences were compared between four trauma groups; patients with a history of childhood sexual abuse before age 12 (CSA), adolescent sexual abuse (ASA; i.e. sexual abuse between 12 and 18 years of age), sexual abuse (SA) at age 18 and over, or no history of sexual abuse (NSA). Results: Large effect sizes were achieved for PTSD symptom reduction for all trauma groups (Cohen’s d = 1.52–2.09). For the Clinical Administered PTSD Scale (CAPS) and the Impact of Event Scale (IES), no differences in treatment outcome were found between the trauma (age) groups. For the PTSD Symptom Scale Self Report (PSS-SR), there were no differences except for one small effect between CSA and NSA. Conclusions: The results do not support the hypothesis that the presence of a history of childhood sexual abuse has a detrimental impact on the outcome of first-line (intensive) trauma-focused treatments for PTSD. PMID:29441153

Convergent Validity of the Early Memory Index in Two Primary Care Samples.

PubMed

Porcerelli, John H; Cogan, Rosemary; Melchior, Katherine A; Jasinski, Matthew J; Richardson, Laura; Fowler, Shannon; Morris, Pierre; Murdoch, William

2016-01-01

Karliner, Westrich, Shedler, and Mayman (1996) developed the Early Memory Index (EMI) to assess mental health, narrative coherence, and traumatic experiences in reports of early memories. We assessed the convergent validity of EMI scales with data from 103 women from an urban primary care clinic (Study 1) and data from 48 women and 24 men from a suburban primary care clinic (Study 2). Patients provided early memory narratives and completed self-report measures of psychopathology, trauma, and health care utilization. In both studies, lower scores on the Mental Health scale and higher scores on the Traumatic Experiences scale were related to higher scores on measures of psychopathology and childhood trauma. Less consistent associations were found between the Mental Health and Traumatic Experiences scores and measures of health care utilization. The Narrative Coherence scale showed inconsistent relationships across measures in both samples. In analyses assessing the overall fit between hypothesized and actual correlations between EMI scores and measures of psychopathology, severity of trauma symptoms, and health care utilization, the Mental Health scale of the EMI demonstrated stronger convergent validity than the EMI Traumatic Experiences scale. The results provide support for the convergent validity of the Mental Health scale of the EMI.

American Association for the Surgery of Trauma Organ Injury Scaling: 50th anniversary review article of the Journal of Trauma.

PubMed

Moore, Ernest E; Moore, Frederick A

2010-12-01

The purpose of a scaling system for specific injuries is to provide a common language to facilitate the clinical decisions and the investigative basis for this decision making. This brief overview describes the evolution of the Organ Injury Scaling (OIS) system developed by the American Association for the Surgery of Trauma. The OIS system is based on the magnitude of anatomic disruption and is graded as 1 (minimal), 2 (mild), 3 (moderate), 4 (severe), 5 (massive), and 6 (lethal). To date, the American Association for the Surgery of Trauma OIS system has been developed for visceral and vascular injuries of the neck, chest, abdomen, and extremities. The fundamental objective of OIS is to provide a common language to describe specific organ injuries. The primary purpose of OIS is to facilitate clinical decision making and the necessary research endeavors to improve this process. A good example of this concept is the tumor, node, metastasis classification for solid organ malignancies: a system used worldwide to guide patient care and clinical investigation.

Aspiration

MedlinePlus

Davidson NE. Breast cancer and benign breast disorders. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 198. Martin P. Approach to the patient ...

Chronic consequences of acute injuries: worse survival after discharge.

PubMed

Shafi, Shahid; Renfro, Lindsay A; Barnes, Sunni; Rayan, Nadine; Gentilello, Larry M; Fleming, Neil; Ballard, David

2012-09-01

The Trauma Quality Improvement Program uses inhospital mortality to measure quality of care, which assumes patients who survive injury are not likely to suffer higher mortality after discharge. We hypothesized that survival rates in trauma patients who survive to discharge remain stable afterward. Patients treated at an urban Level I trauma center (2006-2008) were linked with the Social Security Administration Death Master File. Survival rates were measured at 30, 90, and 180 days and 1 and 2 years from injury among two groups of trauma patients who survived to discharge: major trauma (Abbreviated Injury Scale score ≥ 3 injuries, n = 2,238) and minor trauma (Abbreviated Injury Scale score ≤ 2 injuries, n = 1,171). Control groups matched to each trauma group by age and sex were simulated from the US general population using annual survival probabilities from census data. Kaplan-Meier and log-rank analyses conditional upon survival to each time point were used to determine changes in risk of mortality after discharge. Cox proportional hazards models with left truncation at the time of discharge were used to determine independent predictors of mortality after discharge. The survival rate in trauma patients with major injuries was 92% at 30 days posttrauma and declined to 84% by 3 years (p > 0.05 compared with general population). Minor trauma patients experienced a survival rate similar to the general population. Age and injury severity were the only independent predictors of long-term mortality given survival to discharge. Log-rank tests conditional on survival to each time point showed that mortality risk in patients with major injuries remained significantly higher than the general population for up to 6 months after injury. The survival rate of trauma patients with major injuries remains significantly lower than survival for minor trauma patients and the general population for several months postdischarge. Surveillance for early identification and treatment of complications may be needed for trauma patients with major injuries. Prognostic study, level III.

Social work in oncology-managing vicarious trauma-the positive impact of professional supervision.

PubMed

Joubert, Lynette; Hocking, Alison; Hampson, Ralph

2013-01-01

This exploratory study focused on the experience and management of vicarious trauma in a team of social workers (N = 16) at a specialist cancer hospital in Melbourne. Respondents completed the Traumatic Stress Institute Belief Scale (TSIBS), the Professional Quality of Life Scale (ProQOL), and participated in four focus groups. The results from the TSIBS and the ProQol scales confirm that there is a stress associated with the social work role within a cancer service, as demonstrated by the high scores related to stress. However at the same time the results indicated a high level of satisfaction which acted as a mitigating factor. The study also highlighted the importance of supervision and management support. A model for clinical social work supervision is proposed to reduce the risks associated with vicarious trauma.

Anthony Lopez | NREL

Science.gov Websites

. Carolyn Davidson, Easan Drury, Anthony Lopez, Ryan Elmore, and Robert Margolis. 2014. Modeling . Department of Energy, Office of Indian Energy. Trieu Mai, Easan Drury, Kelly Eurek, Natalie Bodington

The role of anxiety sensitivity in the relationship between posttraumatic stress symptoms and negative outcomes in trauma-exposed adults.

PubMed

Kugler, Brittany B; Phares, Vicky; Salloum, Alison; Storch, Eric A

2016-01-01

The development of posttraumatic stress symptoms (PTSs) following a trauma is related to impairment, diminished quality of life, and physical health issues. Yet it is not clear why some trauma-exposed individuals experience negative outcomes while others do not. The purpose of this study was to determine the role of several influential factors related to PTS severity and negative outcomes. One hundred and twenty-two trauma-exposed adults were administered the following self-report measures: the Posttraumatic Stress Disorder Checklist-Civilian, the Trauma History Questionnaire-Short, the Anxiety Sensitivity Index-3, Depression and Anxiety Stress Scale 21, Sheehan Disability Scale, World Health Organization Quality of Life-BREF, and an abbreviated Patient Health Questionnaire. PTS severity was positively correlated with depressive symptom severity (r = 0.54, p < 0.001), chronicity of the most distressing trauma (r = 0.21, p = 0.017), and number of traumas (r = 0.22, p = 0.012). Main effects were found for PTS severity (β = -0.38, p < 0.01) and anxiety sensitivity (AS; β = -0.39, p < 0.01) on quality of life. No interaction was found between PTS severity and AS with any negative outcome. PTS severity mediated the relationship between AS and physical health issues (0.05; 95% CI: 0.02-0.08). This study helps clarify the role of various factors in the relationship between trauma and negative outcomes. Clinical and research implications are discussed.

Prevalence of seizures in cats after head trauma.

PubMed

Grohmann, Kristina S; Schmidt, Martin J; Moritz, Andreas; Kramer, Martin

2012-12-01

To determine the prevalence of seizures in cats after head trauma. Retrospective cross-sectional study. 52 cats with head trauma. Information was obtained from medical records of cats with head trauma and via telephone interviews of owners at least 2 years after cats had head trauma. Severity of head trauma in cats was classified with the modified Glasgow coma scale (mGCS), and the association between scores and development of seizures was determined. 9 cats had moderate head trauma (mGCS score, 9 to 14), and 43 cats had mild head trauma (mGCS score, 15 to 18). None of the cats developed seizures during the follow-up period (≥ 2 years after head injury). The calculated 95% confidence interval for prevalence of seizures in cats after head injury was 0% to 5.6%. There was no significant relationship between severity of head trauma and the risk of seizures in cats. Results indicated the probability that cats with mild to moderate head trauma would develop posttraumatic seizures was low. However, clinicians should monitor cats with a history of head trauma for development of secondary epilepsy.

Prevalence of childhood trauma and correlations between childhood trauma, suicidal ideation, and social support in patients with depression, bipolar disorder, and schizophrenia in southern China.

PubMed

Xie, Peng; Wu, Kai; Zheng, Yingjun; Guo, Yangbo; Yang, Yuling; He, Jianfei; Ding, Yi; Peng, Hongjun

2018-03-01

Childhood trauma has long-term adverse effects on physical and psychological health. Previous studies demonstrated that suicide and mental disorders were related to childhood trauma. In China, there is insufficient research available on childhood trauma in patients with mental disorders. Outpatients were recruited from a psychiatric hospital in southern China, and controls were recruited from local communities. The demographic questionnaire, the Childhood Trauma Questionnaire-Short Form (CTQ-SF), and the Social Support Rating Scale (SSRS) were completed by all participants, and the Self-rating Idea of Suicide Scale (SIOSS) were completed only by patients. Prevalence rates of childhood trauma were calculated. Kruskal-Wallis test and Dunnett test were used to compare CTQ-SF and SSRS scores between groups. Logistic regression was used to control demographic characteristics and examine relationships between diagnosis and CTQ-SF and SSRS scores. Spearman's rank correlation test was conducted to analyze relationships between suicidal ideation and childhood trauma and suicidal ideation and social support. The final sample comprised 229 patients with depression, 102 patients with bipolar, 216 patient with schizophrenia, and 132 healthy controls. In our sample, 55.5% of the patients with depression, 61.8% of the patients with bipolar disorder, 47.2% of the patients with schizophrenia, and 20.5% of the healthy people reported at least one type of trauma. In patient groups, physical neglect (PN) and emotional neglect (EN) were most reported, and sexual abuse (SA) and physical abuse (PA) were least reported. CTQ-SF and SSRS total scores, and most of their subscale scores in patient groups were significantly different from the control group. After controlling demographic characteristics, mental disorders were associated with higher CTQ-SF scores and lower SSRS scores. CTQ-SF scores and number of trauma types were positively correlated with the SIOSS score. Negative correlations existed between SSRS scores and the SIOSS score. Our sample may not be sufficiently representative. Some results might have been interfered by demographic characteristics. The SIOSS was not completed by controls. Data from self-report scales were not sufficiently objective. In southern China, childhood trauma is more severe and more prevalent in patients with mental disorders (depression, bipolar disorder and schizophrenia) than healthy people. Among patients with mental disorders in southern China, suicidal ideation is associated with childhood trauma and poor social support. Copyright © 2017 Elsevier B.V. All rights reserved.

The Effect of Child Sexual Abuse on Social Functioning in Schizophrenia Spectrum Disorders.

PubMed

López-Mongay, Daniel; Ahuir, Maribel; Crosas, Josep Mª; Navarro, J Blas; Monreal, José Antonio; Obiols, Jordi E; Palao, Diego

2018-06-01

The objective of this study was to explore social functioning in schizophrenic patients who have suffered child sexual abuse (CSA) in comparison with those who have not suffered from it in a Spanish sample of 50 patients with schizophrenia or schizoaffective disorder. The Quality of Life (QOL) Scale, the Childhood Trauma Questionnaire (CTQ-SF), and the NEO Five Factor Inventory (NEO-FFI) were administered in this study. We found a CSA prevalence of 22% in our sample. Results showed that QOL global scores reduced by 9.34% at a statistically significant level ( p = .037) in sexually abused patients in comparison with those who did not report experiencing sexual abuse. Regression analysis in the QOL scales showed no differences in intrapsychic foundation scores or in the social relations scale. Scores in the instrumental role scale were reduced by 4.42 points in patients with CSA ( p = .009). Neither neuroticism nor extraversion results differ between the trauma group and those who did not suffer trauma. Clinical implications of these results are discussed.

The relation of childhood trauma to suicide ideation in patients suffering from obsessive-compulsive disorder with lifetime suicide attempts.

PubMed

Khosravani, Vahid; Kamali, Zoleikha; Jamaati Ardakani, Razieh; Samimi Ardestani, Mehdi

2017-09-01

The aim of this study was to evaluate the relations of childhood trauma (CT) and obsessive-compulsive (OC) symptom dimensions to suicide ideation in patients with obsessive-compulsive disorder (OCD). Seventy OCD outpatients with lifetime suicide attempts and 60 controls were included. Participants completed the Scale for Suicide Ideation (SSI), the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Dimensional Obsessive-Compulsive Scale (DOCS) and the Depression Anxiety Stress Scales (DASS-21). Among OCD patients, 97.1% had current suicide ideation. OCD patients revealed higher scores on CT, suicide ideation, depression and anxiety than controls. The CT history of sexual abuse (SA) and OC symptom dimension of unacceptable thoughts explained suicide ideation. It was concluded that SA and unacceptable thoughts may contribute to high suicidality and have important implications for the assessment and treatment of suicide risk in OCD patients with lifetime suicide attempts. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Vicarious traumatization, secondary traumatic stress, and burnout in sexual assault and domestic violence agency staff.

PubMed

Baird, Stephanie; Jenkins, Sharon Rae

2003-02-01

This study investigated three occupational hazards of therapy with trauma victims: vicarious trauma and secondary traumatic stress (or "compassion fatigue"), which describe therapists' adverse reactions to clients' traumatic material, and burnout, a stress response experienced in many emotionally demanding "people work" jobs. Among 101 trauma counselors, client exposure workload and being paid as a staff member (vs. volunteer) were related to burnout sub-scales, but not as expected to overall burnout or vicarious trauma, secondary traumatic stress, or general distress. More educated counselors and those seeing more clients reported less vicarious trauma. Younger counselors and those with more trauma counseling experience reported more emotional exhaustion. Findings have implications for training, treatment, and agency support systems.

ROBOTS TO ROCKET CITY

NASA Image and Video Library

2016-03-06

HIGH SCHOOL STUDENTS FROM NORTH ALABAMA GATHER AT THE U.S. SPACE AND ROCKET CENTER'S DAVIDSON CENTER FOR THE "ROBOTS TO ROCKET CITY" EVENT SHOWCASING THEIR INDIVIDUAL ROBOTS PRIOR TO LATER COMPETITIONS.

Weak turbulence theory for beam-plasma interaction

NASA Astrophysics Data System (ADS)

Yoon, Peter H.

2018-01-01

The kinetic theory of weak plasma turbulence, of which Ronald C. Davidson was an important early pioneer [R. C. Davidson, Methods in Nonlinear Plasma Theory, (Academic Press, New York, 1972)], is a venerable and valid theory that may be applicable to a large number of problems in both laboratory and space plasmas. This paper applies the weak turbulence theory to the problem of gentle beam-plasma interaction and Langmuir turbulence. It is shown that the beam-plasma interaction undergoes various stages of physical processes starting from linear instability, to quasilinear saturation, to mode coupling that takes place after the quasilinear stage, followed by a state of quasi-static "turbulent equilibrium." The long term quasi-equilibrium stage is eventually perturbed by binary collisional effects in order to bring the plasma to a thermodynamic equilibrium with increased entropy.

Comparison of gray-scale contrast-enhanced ultrasonography with contrast-enhanced computed tomography in different grading of blunt hepatic and splenic trauma: an animal experiment.

PubMed

Tang, Jie; Li, Wenxiu; Lv, Faqin; Zhang, Huiqin; Zhang, Lihai; Wang, Yuexiang; Li, Junlai; Yang, Li

2009-04-01

To compare the diagnostic value of contrast-enhanced ultrasonography (CEUS) with contrast-enhanced computed tomography (CECT) for the detection of different grading of solid organ injuries in blunt abdominal trauma in animals. A self-made miniature tools were used as models to simulate a blunt hepatic or splenic trauma in 16 and 14 anesthetized dogs, respectively. Baseline ultrasound, CEUS and CECT were used to detect traumatic injuries of livers and spleens. The degree of injuries was determined by CEUS according to the American Association for the Surgery of Trauma (AAST) scale and the results compared with injury scale based on CECT evaluation. CEUS showed 22 hepatic injury sites in 16 animals and 17 splenic injury sites in other 14 animals. According to AAST scale, 2 grade I, 4 grade II, 3 grade III, 5 grade IV and 2 grade V hepatic lesions were present in 16 animals; 2 grade I, 4 grade II, 6 grade III and 2 grade IV splenic lesions in 14 animals. On CECT scan, 21 hepatic and 17 splenic injuries were demonstrated. According to Becker CT scaling for hepatic injury, 1 grade I, 2 grade II, 4 grade III, 5 grade IV and 2 grade V hepatic injuries were present. On the basis of Buntain spleen scaling, 2 grade I, 5 grade II, 5 grade III, 2 grade IV splenic injuries were showed. After Spearman rank correlation analysis, the agreement of CEUS with CECT on the degree of hepatic and splenic injury is 93.3% and 92.9%, respectively. CT is currently considered as the reference method for grading blunt abdominal trauma, according to experiment results, CEUS grading showed high levels of concordance with CECT. CEUS can accurately determine the degree of injury and will play an important role in clinical application.

Mental practice: a simple tool to enhance team-based trauma resuscitation.

PubMed

Lorello, Gianni R; Hicks, Christopher M; Ahmed, Sana-Ara; Unger, Zoe; Chandra, Deven; Hayter, Megan A

2016-03-01

Effective trauma resuscitation requires the coordinated efforts of an interdisciplinary team. Mental practice (MP) is defined as the mental rehearsal of activity in the absence of gross muscular movements and has been demonstrated to enhance acquiring technical and procedural skills. The role of MP to promote nontechnical, team-based skills for trauma has yet to be investigated. We randomized anaesthesiology, emergency medicine, and surgery residents to two-member teams randomly assigned to either an MP or control group. The MP group engaged in 20 minutes of MP, and the control group received 20 minutes of Advanced Trauma Life Support (ATLS) training. All teams then participated in a high-fidelity simulated adult trauma resuscitation and received debriefing on communication, leadership, and teamwork. Two blinded raters independently scored video recordings of the simulated resuscitations using the Mayo High Performance Teamwork Scale (MHPTS), a validated team-based behavioural rating scale. The Mann-Whitney U-test was used to assess for between-group differences. Seventy-eight residents provided informed written consent and were recruited. The MP group outperformed the control group with significant effect on teamwork behaviour as assessed using the MHPTS: r=0.67, p<0.01. MP leads to improvement in team-based skills compared to traditional simulation-based trauma instruction. We feel that MP may be a useful and inexpensive tool for improving nontechnical skills instruction effectiveness for team-based trauma care.

Adaptation and validation of the Spanish-language Trauma Symptom Inventory in Puerto Rico.

PubMed

Gutiérrez Wang, Lisa; Cosden, Merith; Bernal, Guillermo

2011-02-01

This research was conducted to assess the Spanish-language Trauma Symptom Inventory's (Briere, 1995) suitability for use with a Puerto Rican sample. Minor revisions were made to the original instrument following a comprehensive appraisal involving a bilingual committee and pilot focus group. The present study outlines the review and adaptation process and examines the psychometric properties of the revised instrument, the Inventario de Síntomas de Trauma-Revisado (IST-R). A sample of 225 students (155 women, 70 men) at the University of Puerto Rico, age 20 to 59 (M = 23.24, SD = 4.69), participated in the validation study. Participants completed a demographic questionnaire; a self-report trauma exposure instrument; and measures of psychological distress, including Spanish-language versions of the Beck Depression Inventory, Symptom Checklist-36, and the Dissociative Experiences Scale. Reliability coefficients for the IST-R clinical scales ranged from .69 to .91 (mean α = .84), and correlation coefficients were strongest for scales measuring the same constructs. Factor loadings obtained were consistent with those reported in the literature. Results support the internal consistency and construct validity of the IST-R. Culturally and linguistically appropriate assessment instruments are needed to address the mental health needs of diverse populations. Results from this study provide evidence for the clinical and research promise of the IST-R as a screening tool for trauma-related symptoms.

Early-Life Trauma in Hospitalized Patients With Mood Disorders and Its Association With Clinical Outcomes.

PubMed

Parsaik, Ajay K; Abdelgawad, Noha; Chotalia, Jigar K; Lane, Scott D; Pigott, Teresa A

2017-01-01

The prevalence of childhood trauma and its impact on clinical outcomes in hospitalized patients with mood disorders is unknown. We studied the frequency of childhood trauma among inpatient adults with mood disorders and its association with clinical outcomes. Patients admitted to our hospital with a primary diagnosis of mood disorders completed the short form of the Early Trauma Inventory-Self-Report (ETISR-SF), the Sheehan Disability Scale, and the Clinician-Rated Dimensions of Psychosis Symptom Severity scale. A regression model adjusted for multiple comparisons was used to examine the association between scores on the ETISR-SF and clinical outcomes. Subjects were 167 patients, all of whom reported ≥1 types of childhood trauma: 90% general trauma, 75% physical abuse, 71% emotional abuse, 50% sexual abuse, and 35% all 4 types of abuse. The subtypes of abuse did not differ by sex or race. Diagnoses in the sample were bipolar disorder 56%, major depressive disorder 24%, schizoaffective disorder 14%, and substance-induced mood disorder 5%. The mean age in the sample was 35±11.5 years, 53% were male, and 64% also had substance abuse disorders. Higher scores on the ETISR-SF were associated with longer hospital stays [odds ratio (OR)=1.13; 95% confidence interval (CI), 1.05-1.22], and greater disruption of work/school life (OR=1.12; 95% CI, 1.04-1.21). There was also a trend for higher ETISR-SF scores to be associated with more severe psychotic symptoms (OR=1.13; 95% CI, 1.01-1.27) and more disruption in social (OR=1.14; 95% CI, 1.06-1.22) and family life (OR=1.09; 95% CI, 1.02-1.17). Childhood trauma was reported by all of the 167 patients, with general trauma the most common and approximately half reporting sexual abuse. Childhood trauma was associated with poor clinical outcomes. Early recognition of trauma and trauma-related therapeutic interventions may improve outcomes.

Postpartum Perineal Pain in a Low Episiotomy Setting: Association with Severity of Genital Trauma, Labor Care and Birth Variables

PubMed Central

Leeman, Lawrence; Fullilove, Anne M.; Borders, Noelle; Manocchio, Regina; Albers, Leah L.; Rogers, Rebecca G.

2013-01-01

Background Perineal pain is common after childbirth. We studied the effect of genital tract trauma, labor care, and birth variables on the incidence of pain in a population of healthy women exposed to low rates of episiotomy and operative delivery. Methods A prospective study of genital trauma at birth and assessment of postpartum perineal pain and analgesic use was conducted in 565 midwifery patients. Perineal pain was assessed using the Present Pain Intensity (PPI) and Visual Analog Scale (VAS) components of the validated short form McGill pain scale. Multivariate logistic regression examined which patient characteristics or labor care measures were significant determinants of perineal pain and use of analgesic medicines. Results At hospital discharge, women with major trauma reported higher VAS pain scores (2.16 +/− 1.61 vs 1.48 +/− 1.40; P< 0.001) and were more likely to use analgesic medicines (76.3 vs 23.7%, P= 0.002) than women with mild or no trauma. By 3 months average VAS scores were low in each group and not significantly different. Perineal pain at the time of discharge was associated in univariate analysis with higher education level, ethnicity (non-Hispanic white), nulliparity, and longer length of active maternal pushing efforts. In a multivariate model only trauma group and length of active pushing predicted pain at hospital discharge. In women with minor or no trauma, only length of the active part of second stage labor had a positive relationship with pain. In women with major trauma, the length of active second stage labor had no independent effect on level of pain at discharge beyond its effect on the incidence of major trauma. Conclusions Women with spontaneous perineal trauma reported very low rates of postpartum perineal pain. Women with major trauma reported increased perineal pain compared with women who had no or minor trauma; however, by 3 months postpartum this difference was no longer present. In women with minor or no perineal trauma, a longer period of active pushing was associated with increased perineal pain. PMID:20002420

Beta-blocker use is associated with improved outcomes in adult trauma patients.

PubMed

Arbabi, Saman; Campion, Eric M; Hemmila, Mark R; Barker, Melissa; Dimo, Mary; Ahrns, Karla S; Niederbichler, Andreas D; Ipaktchi, Kyros; Wahl, Wendy L

2007-01-01

Beta-adrenoreceptor blocker (beta-blocker) therapy may improve outcomes in surgical patients by decreasing cardiac oxygen consumption and hypermetabolism. Because beta-blockers can lower the systemic blood pressure and cerebral perfusion pressure, there is concern regarding their use in patients with head injury. However, beta-blockers may protect beta-receptor rich brain cells by attenuating cerebral oxygen consumption and metabolism. We hypothesized that beta-blockers are safe in trauma patients, even if they have suffered a significant head injury. Using pharmacy and trauma registry data of a Level I trauma center, we identified a cohort of trauma patients who received beta-blockers during their hospital stay (beta-cohort). Trauma admissions who did not receive beta-blockers were in the control cohort. beta-blocker status, in combination with other variables associated with mortality, were placed in a stepwise multivariate logistic regression to identify independent predictors of fatal outcome. In all, 303 (7%) of 4,117 trauma patients received beta-blockers. In the beta-cohort, 45% of patients were on beta-blockers preinjury. The most common reason to initiate beta-blocker therapy was blood pressure (60%) and heart rate (20%) control. The overall mortality rate was 5.6% and head injury was considered to be the major cause of death. After adjusting for age, Injury Severity Scale score, blood pressure, Glasgow Coma Scale score, respiratory status, and mechanism of injury, the odds ratio for fatal outcome was 0.3 (p < 0.001) for beta-cohort as compared with control. Decreased risk of fatal outcome was more pronounced in patients with a significant head injury. beta-blocker therapy is safe and may be beneficial in selected trauma patients with or without head injury. Further studies looking at beta-blocker therapy in trauma patients and their effect on cerebral metabolism are warranted.

Development of a Middle-Age and Geriatric Trauma Mortality Risk Score A Tool to Guide Palliative Care Consultations.

PubMed

Konda, Sanjit R; Seymour, Rachel; Manoli, Arthur; Gales, Jordan; Karunakar, Madhav A

2016-11-01

This study aimed to develop a tool to quantify risk of inpatient mortality among geriatric and middleaged trauma patients. This study sought to demonstrate the ability of the novel risk score in the early identification of high risk trauma patients for resource-sparing interventions, including referral to palliative medicine. This retrospective cohort study utilized data from a single level 1 trauma center. Regression analysis was used to create a novel risk of inpatient mortality score. A total of 2,387 low energy and 1,201 high-energy middle-aged (range: 55 to 64 years of age) and geriatric (65 years of age or odler) trauma patients comprised the study cohort. Model validation was performed using 37,474 lowenergy and 97,034 high-energy patients from the National Trauma Databank (NTDB). Potential hospital cost reduction was calculated for early referral of high risk trauma patients to palliative medicine services in comparison to no palliative medicine referral. Factors predictive of inpatient mortality among the study and validation patient cohorts included; age, Glasgow Coma Scale, and Abbreviated Injury Scale for the head and neck and chest. Within the validation cohort, the novel mortality risk score demonstrated greater predictive capacity than existing trauma scores [STTGMALE-AUROC: 0.83 vs. TRISS 0.80, (p < 0.01), STTGMAHE-AUROC: 0.86 vs. TRISS 0.85, (p < 0.01)]. Our model demonstrated early palliative medicine evaluation could produce $1,083,082 in net hospital savings per year. This novel risk score for older trauma patients has shown fidelity in prediction of inpatient mortality; in the study and validation cohorts. This tool may be used for early intervention in the care of patients at high risk of mortality and resource expenditure.

The Trauma Symptom Checklist for Young Children (TSCYC): reliability and association with abuse exposure in a multi-site study.

PubMed

Briere, J; Johnson, K; Bissada, A; Damon, L; Crouch, J; Gil, E; Hanson, R; Ernst, V

2001-08-01

The Trauma Symptom Checklist for Young Children (TSCYC) is a 90-item caretaker-report measure of children's trauma- and abuse-related symptomatology. It contains two reporter validity scales and eight clinical scales [Post-traumatic Stress-Intrusion (PTS-I), Post-traumatic Stress-Avoidance (PTS-AV), Post-traumatic Stress-Arousal (PTS-AR), Post-traumatic Stress-Total (PTS-TOT), Sexual Concerns (SC), Dissociation (DIS), Anxiety (ANX), Depression (DEP), and Anger/Aggression (ANG)], as well as an item assessing hours per week of caretaker contact with the child. This paper introduces the TSCYC and describes its psychometric properties in a multisite validity study. A total of 219 TSCYCs administered by six clinician/researchers across the United States were analyzed for scale reliability and association with several types of childhood maltreatment. The TSCYC clinical scales have good reliability and are associated with exposure to childhood sexual abuse, physical abuse, and witnessing domestic violence. The PTS-I, PTS-AV, PTS-AR, and PTS-TOT scales were most predictive, followed by SC in the case of sexual abuse and DIS in the case of physical abuse. There were a small number of age, sex, and race effects on TSCYC scores. The TSCYC appears to have reasonable psychometric characteristics, and correlates as expected with various types of trauma exposure. Subject to continued validation and the development of general population norms, its use as a clinical measure is supported.

A Multidisciplinary Clinical Pathway Decreases Rib Fracture-Associated Infectious Morbidity and Mortality in High-Risk Trauma Patients

DTIC Science & Technology

2006-01-01

cough. Pain was assessed during incentive spirometry or coughing using a visual analogue scale (score from 1 to 10) with failure being a score...fracture multidisciplinary clinical pathway. SIMU Surgical Intermediate Care Unit; STICU Shock Trauma Intensive Care Unit; IS incentive spirometry ...monitored bed (Surgical Intermediate Care Unit or Shock Trauma Intensive Care Unit) where they received patient-controlled analgesia and incentive

Factor Structure and Reliability of the Childhood Trauma Questionnaire and Prevalence Estimates of Trauma for Male and Female Street Youth

ERIC Educational Resources Information Center

Forde, David R.; Baron, Stephen W.; Scher, Christine D.; Stein, Murray B.

2012-01-01

This study examines the psychometric properties of the Childhood Trauma Questionnaire short form (CTQ-SF) with street youth who have run away or been expelled from their homes (N = 397). Internal reliability coefficients for the five clinical scales ranged from 0.65 to 0.95. Confirmatory Factor Analysis (CFA) was used to test the five-factor…

The alpha1-adrenergic antagonist prazosin ameliorates combat trauma nightmares in veterans with posttraumatic stress disorder: a report of 4 cases.

PubMed

Raskind, M A; Dobie, D J; Kanter, E D; Petrie, E C; Thompson, C E; Peskind, E R

2000-02-01

Central nervous system (CNS) adrenergic hyperresponsiveness may be involved in the pathophysiology of posttraumatic stress disorder (PTSD). Two Vietnam combat veterans with PTSD prescribed the centrally active alpha1-adrenergic antagonist prazosin for symptoms of benign prostatic hypertrophy unexpectedly reported elimination of combat trauma nightmares. This observation prompted an open-label feasibility trial of prazosin for combat trauma nightmares in chronic combat-induced PTSD. Four consecutively identified combat veterans with chronic DSM-IV PTSD and severe intractable combat trauma nightmares participated in an 8-week open trial of escalating-dose prazosin. Nightmare severity response was rated using the nightmare item of the Clinician Administered PTSD Scale and the Clinical Global Impressions-Change scale. The 2 patients who achieved a daily prazosin dose of at least 5 mg were markedly improved, with complete elimination of trauma nightmares and resumption of normal dreaming. The 2 subjects limited to 2 mg of prazosin to avoid excessive blood pressure reduction were moderately improved with at least 50% reduction in nightmare severity. These clinical observations, together with neurobiological evidence for alpha1-adrenergic regulation of CNS neurobiological systems relevant to PTSD, provide rationale for placebo-controlled trials of prazosin for PTSD combat trauma nightmares.

Impact of the version of the abbreviated injury scale on injury severity characterization and quality assessment of trauma care.

PubMed

Tohira, Hideo; Jacobs, Ian; Matsuoka, Tetsuya; Ishikawa, Kazuo

2011-07-01

The Abbreviated Injury Scale (AIS) was updated in 2008 (AIS 2008). We aimed to investigate the impact of AIS 2008 on the characterization of injury severity and quality assessment of trauma care. We identified all blunt trauma patients in the Japan Trauma Data Bank. First, we converted AIS 98 codes to AIS 2008 codes using a mapping table. Next, we compared Injury Severity Scores (ISSs) and New ISSs (NISSs) based on AIS 98 and AIS 2008. We compared the proportion of major trauma (ISS >15) between the two AISs. We derived risk-adjusted models using the two AISs and separately ranked hospitals according to the observed-to-expected death (OE) ratio. We counted the number of performance outliers for the two rankings. We analyzed the association between the percent change in OE ratios and the proportion of NISS outliers (change in NISS of <-12). There were 19,899 subjects. The ISSs and NISSs based on AIS 2008 were significantly less than those based on AIS 98. The proportion of major trauma was 46.3% and 38.9% for AIS 98 and AIS 2008, respectively (p < 0.001). The numbers of performance outliers were different between the two rankings. There was a significant positive linear relationship between the percent change in the OE ratio and the proportion of NISS outliers. The use of different AIS versions influenced the selection of major trauma patients and affected the quality assessment of the trauma care. Researchers should be aware of these findings when selecting the version of the AIS.

Treatment of trauma-affected refugees with venlafaxine versus sertraline combined with psychotherapy - a randomised study.

PubMed

Sonne, Charlotte; Carlsson, Jessica; Bech, Per; Elklit, Ask; Mortensen, Erik Lykke

2016-11-08

The prevalence of trauma-related psychiatric disorders is high among refugees. Despite this, little is known about the effect of pharmacological treatment for this patient group. The objective of the present study was therefore to examine differences in the effects of venlafaxine and sertraline on Post-Traumatic Stress Disorder (PTSD), depression and functional impairment in trauma-affected refugees. The study was a randomised pragmatic trial comparing venlafaxine and sertraline in combination with psychotherapy and social counselling. PTSD symptoms were measured on the Harvard Trauma Questionnaire - part IV, which was the primary outcome measure. Other outcome measures included: Hopkins Symptom Check List-25 (depression and anxiety), Social Adjustment Scale - short version (social functioning), WHO-5 Well-being Index (quality of life), Crisis Support Scale (support from social network), Sheehan Disability Scale (disability in three areas of functioning), Hamilton Depression and Anxiety scale, the somatisation items of the Symptoms Checklist-90, Global Assessment of Functioning scales and the summarised score of pain in four body areas rated on visual analogue scales. Two hundred seven adult refugee patients were included in the trial (98 in the venlafaxine and 109 in the sertraline group). Of these, 195 patients were eligible for intention-to-treat analyses. Small but significant pre-treatment to post-treatment differences were found on the Harvard Trauma Questionnaire and a number of other ratings in both groups. On the primary outcome measure, no difference was found in treatment effect between the sertraline and venlafaxine group. A significant group difference was found in favour of sertraline on the Sheehan Disability Scale. Sertraline had a slightly better outcome than venlafaxine on some of the secondary outcome measures, but not on the primary outcome measure. Furthermore, a higher percentage of dropouts was found in the venlafaxine group compared to the sertraline group. Although this could indicate that sertraline was better tolerated, which is supported by other studies, a final conclusion on tolerability cannot be drawn from the current study due to lack of systematic reporting of side effects. ClinicalTrials.gov NCT01569685 . Registration date: 28/2/12.

Childhood trauma and compulsive buying.

PubMed

Sansone, Randy A; Chang, Joy; Jewell, Bryan; Rock, Rachel

2013-02-01

Childhood trauma has been empirically associated with various types of self-regulatory difficulties in adulthood. However, according to the extant literature, no study has examined relationships between various types of childhood trauma and compulsive buying behavior in adulthood. Using a self-report survey methodology in a cross-sectional consecutive sample of 370 obstetrics/gynecology patients, we examined five types of childhood trauma before the age of 12 years (i.e. witnessing violence, physical neglect, emotional abuse, physical abuse, sexual abuse) in relationship to compulsive buying as assessed by the Compulsive Buying Scale (CBS). All forms of trauma demonstrated statistically significant correlations with the CBS. Using a linear regression analysis, both witnessing violence and emotional abuse significantly contributed to CBS scores. Further analyses indicated that race did not moderate the relationship between childhood trauma and compulsive buying. Findings indicate that various forms of childhood trauma are correlated with compulsive buying behavior, particularly witnessing violence and emotional abuse.

The role of N2O derived from crop-based biofuels, and from agriculture in general, in Earth's climate

PubMed Central

Smith, Keith A.; Mosier, Arvin R.; Crutzen, Paul J.; Winiwarter, Wilfried

2012-01-01

In earlier work, we compared the amount of newly fixed nitrogen (N, as synthetic fertilizer and biologically fixed N) entering agricultural systems globally to the total emission of nitrous oxide (N2O). We obtained an N2O emission factor (EF) of 3–5%, and applied it to biofuel production. For ‘first-generation’ biofuels, e.g. biodiesel from rapeseed and bioethanol from corn (maize), that require N fertilizer, N2O from biofuel production could cause (depending on N uptake efficiency) as much or more global warming as that avoided by replacement of fossil fuel by the biofuel. Our subsequent calculations in a follow-up paper, using published life cycle analysis (LCA) models, led to broadly similar conclusions. The N2O EF applies to agricultural crops in general, not just to biofuel crops, and has made possible a top-down estimate of global emissions from agriculture. Independent modelling by another group using bottom-up IPCC inventory methodology has shown good agreement at the global scale with our top-down estimate. Work by Davidson showed that the rate of accumulation of N2O in the atmosphere in the late nineteenth and twentieth centuries was greater than that predicted from agricultural inputs limited to fertilizer N and biologically fixed N (Davidson, E. A. 2009 Nat. Geosci. 2, 659–662.). However, by also including soil organic N mineralized following land-use change and NOx deposited from the atmosphere in our estimates of the reactive N entering the agricultural cycle, we have now obtained a good fit between the observed atmospheric N2O concentrations from 1860 to 2000 and those calculated on the basis of a 4 per cent EF for the reactive N. PMID:22451102

Select-divide-and-conquer method for large-scale configuration interaction

NASA Astrophysics Data System (ADS)

Bunge, Carlos F.; Carbó-Dorca, Ramon

2006-07-01

A select-divide-and-conquer variational method to approximate configuration interaction (CI) is presented. Given an orthonormal set made up of occupied orbitals (Hartree-Fock or similar) and suitable correlation orbitals (natural or localized orbitals), a large N-electron target space S is split into subspaces S0,S1,S2,…,SR. S0, of dimension d0, contains all configurations K with attributes (energy contributions, etc.) above thresholds T0≡{T0egy,T0etc.}; the CI coefficients in S0 remain always free to vary. S1 accommodates Ks with attributes above T1⩽T0. An eigenproblem of dimension d0+d1 for S0+S1 is solved first, after which the last d1 rows and columns are contracted into a single row and column, thus freezing the last d1 CI coefficients hereinafter. The process is repeated with successive Sj(j ⩾2) chosen so that corresponding CI matrices fit random access memory (RAM). Davidson's eigensolver is used R times. The final energy eigenvalue (lowest or excited one) is always above the corresponding exact eigenvalue in S. Threshold values {Tj;j=0,1,2,…,R} regulate accuracy; for large-dimensional S, high accuracy requires S0+S1 to be solved outside RAM. From there on, however, usually a few Davidson iterations in RAM are needed for each step, so that Hamiltonian matrix-element evaluation becomes rate determining. One μhartree accuracy is achieved for an eigenproblem of order 24×106, involving 1.2×1012 nonzero matrix elements, and 8.4×109 Slater determinants.

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... 23320870 . Berry RB, Wagner MH. Behavioral treatment of insomnia. In: Berry RB, Wagner MH, eds. Sleep Medicine ... Davidson JR, Beaulieu-Bonneau S. Cognitive behavior therapies for insomnia. In: Kryger M, Roth T, Dement WC, eds. ...

Genetics Home Reference: autosomal dominant vitreoretinochoroidopathy

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Evaluation of massive transfusion protocol practices by type of trauma at a level I trauma center.

PubMed

Givergis, Roshan; Munnangi, Swapna; Fayaz M Fomani, Katayoun; Boutin, Anthony; Zapata, Luis Carlos; Angus, Ld George

2018-04-18

To evaluate massive transfusion protocol practices by trauma type at a level I trauma center. A retrospective analysis was performed on a sample of 76 trauma patients with MTP activation between March 2010 and January 2015 at a regional trauma center. Patient demographics, transfusion practices, and clinical outcomes were compared by type of trauma sustained. Penetrating trauma patients who required MTP activation were significantly younger, had lower injury severity score (ISS), higher probability of survival (POS), decreased mortality, and higher Glasgow Coma scale (GCS) compared to blunt trauma patients. Overall, the mortality rate was 38.16%. The most common injury sustained among blunt trauma patients was head injury (36.21%), whereas the majority of the penetrating trauma patients sustained abdominal injuries (55.56%). Although the admission coagulation parameters and timing of coagulopathy were not significantly different between the two groups of patients, a significantly higher proportion of penetrating trauma patients received high plasma content therapy relative to blunt trauma patients (p < 0.01). Despite the use of the same MTP for all injured patients requiring massive transfusion, significant differences existed between blunt trauma patients and penetrating trauma patients. These differences in transfusion characteristics and outcomes following MTP activation underscore the complexity of implementing MTPs and warrant vigilant transfusion practices to improve outcomes in trauma patients. Copyright © 2018 Daping Hospital and the Research Institute of Surgery of the Third Military Medical University. Production and hosting by Elsevier B.V. All rights reserved.

Post-Traumatic Stress Disorder Among Health Care Providers Following the Israeli Attacks Against Gaza Strip in 2014: A Call for Immediate Policy Actions.

PubMed

Abu-El-Noor, Nasser Ibrahim; Aljeesh, Yousef Ibrahim; Radwan, AbdalKarim Said; Abu-El-Noor, Mysoon Khalil; Qddura, Ibrahim Abdel-Ilhady; Khadoura, Khalid Jamal; Alnawajha, Samer Khader

2016-04-01

This study aimed to assess the level of posttraumatic stress disorder and to examine the relationship between exposure to war stress and posttraumatic symptoms among health care providers following Israeli offensives against Gaza Strip in 2014. A cross-sectional design was used for this study. We targeted all nurses and doctors working in three governmental hospitals in the Gaza Strip and worked with victims of the last war, more specifically, those who were working in emergency departments, intensive care units, operating rooms, surgical departments, and burn units. A demographic sheet and Impact Event Scale-Revised were used in this study. The Impact Event Scale-Revised has three sub-scales; intrusion, avoidance, and hyper-arousal. The results showed that 291 (89.8%) of 324 participants had scores more than 35 (threshold cut-off point) on the Impact Event Scale-Revised. Scores ranged from zero to 80 with a mean of 52.13. Females had higher levels of stress (55.79) than males (51.63) and nurses (54.85) had more stress than physicians (47.38). The most frequent symptoms of trauma subscales was "avoidance" (mean=20.04), followed by "intrusion" (mean=17.83), and then "hyper-arousal" (mean=14.27). Levels of trauma symptoms were not affected by place of living, hospital of work, while level of education had impacted level of trauma. The findings showed that health care providers suffered from severe posttraumatic symptoms after exposure to prolonged war stress. This level of trauma among health care providers warrants intervention programs to reduce stress and trauma among Gaza health care providers after the war. Copyright © 2015 Elsevier Inc. All rights reserved.

Selecting a measure for assessing secondary trauma in nurses.

PubMed

Watts, Jenny; Robertson, Noelle

2015-11-01

To summarise the usefulness of available psychometric tools in assessing secondary trauma in nursing staff and examine their limitations, as well as their strengths, to enable researchers to select the most suitable measures. Secondary trauma is an extreme persistent reaction that can be experienced by nursing staff following exposure to a potentially life-threatening situation. This relatively new concept is increasingly used to explore staff distress, but is complicated by various definitions. In this growing and popular field, few rigorously tested measures are used. Therefore, it is timely to examine the measures available and their robustness. In March 2014 the following databases were used: BNI, CINAHL, EMBASE, PILOTS, Medline, PsycINFO and the Cochrane Library. A systematic search of nurse and health research databases was conducted from 1980 to 2014 using the terms nurs* AND PTSD OR Posttraumatic Stress Disorder OR secondary trauma OR secondary traumatic stress OR STS OR compassion fatigue. To strengthen confidence in research findings and make the most useful contribution to practice, researchers should use the most rigorous measures available. Of the assessment tools used, the only one subject to robust peer review is the Secondary Traumatic Stress Scale (STSS). The scale most frequently used to assess secondary traumatic stress is the Professional Quality of Life Scale (ProQOL); its lack of psychometric evaluation is a potential weakness. CONCLUSION The STSS is the only validated tool reported in the peer-reviewed, published literature and the authors suggest greater application when secondary trauma is a suspected consequence of nursing work. Validated tools such as the HADS and GHQ-28 are more useful in assessing broader-based psychological morbidity. The authors suggest greater application of the STSS when secondary trauma is a suspected consequence of nursing work. Researchers interested in assessing more than trauma responses are advised to use HADS and GHQ-28.

Outcome differences in adolescent blunt severe polytrauma patients managed at pediatric versus adult trauma centers.

PubMed

Rogers, Amelia T; Gross, Brian W; Cook, Alan D; Rinehart, Cole D; Lynch, Caitlin A; Bradburn, Eric H; Heinle, Colin C; Jammula, Shreya; Rogers, Frederick B

2017-12-01

Previous research suggests adolescent trauma patients can be managed equally effectively at pediatric and adult trauma centers. We sought to determine whether this association would be upheld for adolescent severe polytrauma patients. We hypothesized that no difference in adjusted outcomes would be observed between pediatric trauma centers (PTCs) and adult trauma centers (ATCs) for this population. All severely injured adolescent (aged 12-17 years) polytrauma patients were extracted from the Pennsylvania Trauma Outcomes Study database from 2003 to 2015. Polytrauma was defined as an Abbreviated Injury Scale (AIS) score ≥3 for two or more AIS-defined body regions. Dead on arrival, transfer, and penetrating trauma patients were excluded from analysis. ATC were defined as adult-only centers, whereas standalone pediatric hospitals and adult centers with pediatric affiliation were considered PTC. Multilevel mixed-effects logistic regression models assessed the adjusted impact of center type on mortality and total complications while controlling for age, shock index, Injury Severity Score, Glasgow Coma Scale motor score, trauma center level, case volume, and injury year. A generalized linear mixed model characterized functional status at discharge (FSD) while controlling for the same variables. A total of 1,606 patients met inclusion criteria (PTC: 868 [54.1%]; ATC: 738 [45.9%]), 139 (8.66%) of which died in-hospital. No significant difference in mortality (adjusted odds ratio [AOR]: 1.10, 95% CI 0.54-2.24; p = 0.794; area under the receiver operating characteristic: 0.89) was observed between designations in adjusted analysis; however, FSD (AOR: 0.38, 95% CI 0.15-0.97; p = 0.043) was found to be lower and total complication trends higher (AOR: 1.78, 95% CI 0.98-3.32; p = 0.058) at PTC for adolescent polytrauma patients. Contrary to existing literature on adolescent trauma patients, our results suggest patients aged 12-17 presenting with polytrauma may experience improved overall outcomes when managed at adult compared to pediatric trauma centers. Epidemiologic study, level III.

The definition of polytrauma: variable interrater versus intrarater agreement--a prospective international study among trauma surgeons.

PubMed

Butcher, Nerida E; Enninghorst, Natalie; Sisak, Krisztian; Balogh, Zsolt J

2013-03-01

The international trauma community has recognized the lack of a validated consensus definition of "polytrauma." We hypothesized that using a subjective definition, trauma surgeons will not have substantial agreement; thus, an objective definition is needed. A prospective observational study was conducted between December 2010 and June 2011 (John Hunter Hospital, Level I trauma center). Inclusion criteria were all trauma call patients with subsequent intensive care unit admission. The study was composed of four stages as follows: (1) four trauma surgeons assessed patients until 24 hours, then coded as either "yes" or "no" for polytrauma, and results compared for agreement; (2) eight trauma surgeons representing the United States, Germany, and the Netherlands graded the same prospectively assessed patients and coded as either "yes" or "no" for polytrauma; (3) 12 months later, the original four trauma surgeons repeated assessment via data sheets to test intrarater variability; and (4) individual subjective definitions were compared with three anatomic scores, namely, (a) Injury Severity Score (ISS) of greater than 15, (b) ISS of greater 17, and (c) Abbreviated Injury Scale (AIS) score of greater than 2 in at least two ISS body regions. A total of 52 trauma patients were included. Results for each stage were as follows: (1) κ score of 0.50, moderate agreement; (2) κ score of 0.41, moderate agreement; (3) Rater 1 had moderate intrarater agreement (κ score, 0.59), while Raters 2, 3, 4 had substantial intrarater agreement (κ scores, 0.75, 0.66, and 0.71, respectively); and (4) none had most agreement with ISS of greater than 15 (κ score, 0.16), while both definitions ISS greater than 17 and Abbreviated Injury Scale (AIS) score of greater than 2 in at least two ISS body regions had on average fair agreement (κ scores, 0.27 and 0.39, respectively). Based on subjective assessments, trauma surgeons do not agree on the definition of polytrauma, with the subjective definition differing both within and across institutions.

A Preliminary Analysis of Compassion Fatigue in a Surgeon Population: Are Female Surgeons at Heightened Risk?

PubMed

Wu, Daniel; Gross, Brian; Rittenhouse, Katelyn; Harnish, Carissa; Mooney, Claire; Rogers, Frederick B

2017-11-01

Compassion fatigue (CF), a state of physical/emotional distress caused by repeatedly caring for those experiencing traumatic episodes, is a prevalent issue for today's healthcare provider. We sought to characterize levels of CF within a surgeon population, particularly comparing trauma surgery with other surgical specialties. A survey containing the Professional Quality of Life Scale (ProQOL), a validated tool assessing compassion satisfaction (CS), CF, and burnout (BO) was distributed via electronic newsletter to members of the American College of Surgeons. Demographic data and Professional Quality of Life Scale scores for CS, BO, and CF were collected and compared within specialty and gender subgroups. A total of 178 surgeons completed surveys. Respondents were predominantly male, general surgeons, >55 years old. Trauma surgeons composed the second largest subgroup. Levels of CS were significantly lower in the trauma surgeon subgroup compared to other surgical specialties (trauma: 37.1 ± 5.28, other: 39.5 ± 6.30; P = 0.044). Female surgeons from all specialties exhibited significantly higher levels of BO (female: 26.7 ± 6.10, male: 24.6 ± 6.79; P = 0.035) and CF (female: 24.2 ± 6.29, male: 21.9 ± 6.11; P = 0.021) compared with male surgeons. Subanalyses comparing female trauma surgeons to female surgeons in other specialties found female trauma surgeons exhibited significantly lower levels of CS (trauma: 34.8 ± 4.63, other: 38.8 ± 5.99; P = 0.038) and higher levels of BO (trauma: 29.1 ± 3.14, other: 25.3 ± 6.41; P = 0.049). Trauma surgeons, particularly female trauma surgeons, may be at a heightened risk for developing a poorer overall professional quality of life compared with surgeons of other specialties. In addition, female surgeons may be at greater risk for developing CF compared with male counterparts.

Psychometric properties of the Posttraumatic Cognition Inventory within a Northern Ireland adolescent sample.

PubMed

Hyland, Philip; Murphy, Jamie; Shevlin, Mark; Murphy, Siobhan; Egan, Arlene; Boduszek, Daniel

2015-11-01

This study sought to investigate the psychometric properties of the Posttraumatic Cognitions Inventory (PTCI; Foa et al., 1999, Psychol. Assess., 11, 303) among a cohort of older adolescents and to determine the relationship between post-traumatic cognitions and a variety of psychological outcomes including depression, anxiety, stress, and loneliness. The PTCI was investigated among a large sample (N = 785) of Northern Irish adolescents. Confirmatory factor analysis and composite reliability analysis were conducted to assess the psychometric properties of the scale. The familiar three-factor solution of negative cognitions of self, negative cognitions of the world and others, and self-blame was supported; however, it was necessary to remove eight items from the original 33-item scale. The three-factor structure was subsequently demonstrated to be factorially invariant across gender and to possess satisfactory internal reliability. The three PTCI factors were found to correlate with depression, anxiety, stress, and three dimensions of loneliness. These results provide the first piece of evidence that older adolescents cognitively respond to trauma in a similar manner to adults, that the PTCI is factorially invariant between genders, and that trauma cognitions are correlated with feelings of loneliness. The contextual dependent nature of the structure of the PTCI factors is discussed in relation to future research efforts. The PTCI is a valid and reliable measure of trauma-related cognitions among adolescents and works equally well for male adolescents and female adolescents. Trauma cognitions are associated with a range of mental health problems beyond post-traumatic stress disorder including depression, anxiety, stress, and various aspects of loneliness. Reductions in trauma cognitions in survivors of trauma will have wide-scale clinical benefits to patient well-being. The exact structure and make-up of items in the PTCI may well be dependent on culture, context, and the nature of the trauma. The study is limited due to the fact that the authors could not assess the severity of the trauma experienced by the adolescent sample. © 2015 The British Psychological Society.

Adherence to the Dietary Guidelines for Americans Is Associated with Psychological Resilience in Young Adults: A Cross-Sectional Study.

PubMed

Lutz, Laura J; Gaffney-Stomberg, Erin; Williams, Kelly W; McGraw, Susan M; Niro, Philip J; Karl, J Philip; Cable, Sonya J; Cropper, Thomas L; McClung, James P

2017-03-01

The 2010 Healthy Eating Index (HEI-2010), a measure of diet quality, is used to quantify adherence to the Dietary Guidelines for Americans. Better HEI scores have been associated with positive health outcomes; however, the relationship between diet quality and psychological resilience, a mental health attribute for coping with adversity, has not been assessed. The objective of the present study was to assess the relationship between diet quality and psychological resilience, and the relationship between resilience and demographics, anthropometrics, socioeconomic status, and health behavior. In this cross-sectional study, HEI-2010 scores and resilience were assessed using the Block food frequency questionnaire and the Connor-Davidson Resilience Scale. Other factors that can affect the relationship between HEI-2010 scores and resilience were assessed using surveys, and height and weight were measured to calculate body mass index. Male and female Army and Air Force recruits (n=834) enrolled in a randomized controlled trial and 656 (mean±standard deviation [SD] age=21±3.3 years) were included in this analysis. Data were collected before the initiation of military training at Fort Sill, OK (2012-2013) and Lackland Air Force Base, TX (2013-2014). Participants were split into low- and high-resilience groups based on Connor-Davidson Resilience Scale scores. Student's t test and χ 2 tests were used to determine differences between groups for continuous and categorical variables, respectively. Logistic regression was utilized to identify predictors of resilience. Better diet quality was associated with resilience; higher HEI predicted an increased likelihood (odds ratio=1.02; 95% CI 1.01 to 1.04) of a participant being in the high-resilience group after including race, ethnicity, education, smoking, age, body mass index, sex, and military branch in the full model. The data indicate that with every 10-point increase in HEI score, there was a 22% increased likelihood of being in the high-resilience group. Registered dietitian nutritionists should continue to encourage attainable changes to improve diet; study data suggest that small improvements in diet quality can be associated with better psychological resilience. Published by Elsevier Inc.

An exploratory examination of the associations among racial and ethnic discrimination, racial climate, and trauma-related symptoms in a college student population.

PubMed

Pieterse, Alex L; Carter, Robert T; Evans, Sarah A; Walter, Rebecca A

2010-07-01

In this study, we examined the association among perceptions of racial and/or ethnic discrimination, racial climate, and trauma-related symptoms among 289 racially diverse college undergraduates. Study measures included the Perceived Stress Scale, the Perceived Ethnic Discrimination Questionnaire, the Posttraumatic Stress Disorder Checklist-Civilian Version, and the Racial Climate Scale. Results of a multivariate analysis of variance (MANOVA) indicated that Asian and Black students reported more frequent experiences of discrimination than did White students. Additionally, the MANOVA indicated that Black students perceived the campus racial climate as being more negative than did White and Asian students. A hierarchical regression analysis showed that when controlling for generic life stress, perceptions of discrimination contributed an additional 10% of variance in trauma-related symptoms for Black students, and racial climate contributed an additional 7% of variance in trauma symptoms for Asian students. (c) 2010 APA, all rights reserved.

[Systematic development of a scale for determination of health-related quality of life in multiple trauma patients. The Polytrauma Outcome (POLO) Chart].

PubMed

Pirente, N; Bouillon, B; Schäfer, B; Raum, M; Helling, H J; Berger, E; Neugebauer, E

2002-05-01

Even years after having sustained multiple injuries patients often suffer from its sequelae. These comprise restrictions in physical function, but also pain, social and psychological impairments. Although the Meran Consensus Conference in 1990 defined the contents of "quality of life" (QoL) measures in surgery, still no instrument is available for the valid assessment of all relevant QoL domains in multiple injured patients. This paper describes the systematic development of a modular instrument for the assessment of health related QoL. Within three phases (phase I: generation of items, phase II: item reduction, phase III: pre-testing in 70 multiple injured and control patients) a questionnaire of 57 items was developed, which measures all relevant trauma-related aspects of QoL after acute hospital care. In combination with the Glascow Outcome Scale (GOS), the EUROQOL and the SF-36, the newly developed instrument builds the Polytrauma Outcome Chart (POLO-Chart) which will also be used as "Part E" for outcome assessment within the "Trauma registry" of the German Society for Trauma Surgery. In phase IV, the POLO-Chart will finally be validated in five trauma centres (Celle, Essen, Hanover, Cologne und Munich).

Depression and dissociation as predictors of physical health symptoms among female rape survivors with posttraumatic stress disorder.

PubMed

Scioli-Salter, Erica R; Johnides, Benjamin D; Mitchell, Karen S; Smith, Brian N; Resick, Patricia A; Rasmusson, Ann M

2016-09-01

To investigate the relative contributions of depression and dissociation, as well as posttraumatic stress disorder (PTSD), to physical health symptoms and to examine the relationships among somatic symptoms, PTSD, depression, and dissociation in relation to childhood and adult trauma exposure. Cross-sectional data are from 132 female rape survivors with PTSD assessed before engaging in a study of trauma-focused cognitive therapy for PTSD. Measures included the Pennebaker Inventory of Limbic Languidness, Clinician Administered PTSD Scale, Beck Depression Inventory, Trauma Symptom Inventory-Dissociation Subscale, Childhood Sexual Abuse Exposure Questionnaire, and Assessing Environments-III-Physical Punishment Scale. Hierarchical regression analyses revealed that only dissociative and depression symptoms contributed significantly to physical health symptoms. Similarly, among the subsample of women with either childhood sexual or physical abuse, depression and dissociation were significant predictors of somatic symptoms. However, among women without childhood abuse, only dissociation significantly predicted somatic symptoms. Understanding the psychological and biological mechanisms that link childhood versus adult trauma exposure, PTSD, and comorbid depression or dissociation to physical health symptoms may aid development of individualized treatments for the physical and psychological consequences of trauma. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Depression and Dissociation as Predictors of Physical Health Symptoms Among Female Rape Survivors with PTSD

PubMed Central

Scioli-Salter, Erica R.; Johnides, Benjamin D.; Mitchell, Karen S.; Smith, Brian N.; Resick, Patricia A.; Rasmusson, Ann M.

2016-01-01

Objective To investigate the relative contributions of depression and dissociation, as well as PTSD, to physical health symptoms and to examine the relationships among somatic symptoms, PTSD, depression, and dissociation in relation to childhood and adult trauma exposure. Method Cross-sectional data are from 132 female rape survivors with PTSD assessed prior to engaging in a study of trauma-focused cognitive therapy for PTSD. Measures included the Pennebaker Inventory of Limbic Languidness, Clinician Administered PTSD Scale, Beck Depression Inventory, Trauma Symptom Inventory-Dissociation Subscale, Childhood Sexual Abuse Exposure Questionnaire, and Assessing Environments-III-Physical Punishment Scale. Results Hierarchical regression analyses revealed that only dissociative and depression symptoms contributed significantly to physical health symptoms. Similarly, among the subsample of women with either childhood sexual or physical abuse, depression and dissociation were significant predictors of somatic symptoms. However, among women without childhood abuse, only dissociation significantly predicted somatic symptoms. Conclusion Understanding the psychological and biological mechanisms that link childhood versus adult trauma exposure, PTSD, and comorbid depression or dissociation to physical health symptoms may aid development of individualized treatments for the physical and psychological consequences of trauma. PMID:27149157

Presence of the dissociative subtype of PTSD does not moderate the outcome of intensive trauma-focused treatment for PTSD

PubMed Central

2018-01-01

ABSTRACT Background: There is a widely-held belief in the trauma field that the presence of dissociative symptoms is associated with poor treatment response. However, previous research on the effect of dissociation in treatment outcomes pertained to specific patients and trauma populations. Objective: To test the hypothesis that the presence of the dissociative subtype of PTSD (DS) would have a detrimental effect on the outcome of an intensive trauma-focused treatment programme. Methods: PTSD symptom scores (Clinician Administered PTSD Scale [CAPS] and PTSD Symptom Scale Self-Report [PSS-SR]) were analysed using the data of 168 consecutive patients (70.6% female) who had been exposed to a wide variety of multiple traumas, including childhood sexual abuse, and of whom 98.2% were diagnosed with severe PTSD (CAPS > 65). Most of them suffered from multiple comorbidities and 38 (22.6%) met the criteria for DS. They took part in an intensive trauma-focused treatment programme for PTSD. Pre- and post-treatment differences were compared between patients with and without DS. Results: Large effect sizes were achieved for PTSD symptom reduction on CAPS and the PSS-SR, both for patients with DS and those without. Although patients with DS showed a significantly greater PTSD symptom severity at the beginning, and throughout, treatment, both groups showed equal reductions in PTSD symptoms. Of those who met the criteria for DS, 26 (68.4%) no longer fulfilled the criteria for this classification after treatment. Conclusion: The results provide no support for the notion that the presence of DS negatively impacts trauma-focused treatment outcomes. Accordingly, PTSD patients with DS should not be denied effective trauma-focused treatments. PMID:29805779

Presence of the dissociative subtype of PTSD does not moderate the outcome of intensive trauma-focused treatment for PTSD.

PubMed

Zoet, Harmen A; Wagenmans, Anouk; van Minnen, Agnes; de Jongh, Ad

2018-01-01

Background : There is a widely-held belief in the trauma field that the presence of dissociative symptoms is associated with poor treatment response. However, previous research on the effect of dissociation in treatment outcomes pertained to specific patients and trauma populations. Objective : To test the hypothesis that the presence of the dissociative subtype of PTSD (DS) would have a detrimental effect on the outcome of an intensive trauma-focused treatment programme. Methods : PTSD symptom scores (Clinician Administered PTSD Scale [CAPS] and PTSD Symptom Scale Self-Report [PSS-SR]) were analysed using the data of 168 consecutive patients (70.6% female) who had been exposed to a wide variety of multiple traumas, including childhood sexual abuse, and of whom 98.2% were diagnosed with severe PTSD (CAPS > 65). Most of them suffered from multiple comorbidities and 38 (22.6%) met the criteria for DS. They took part in an intensive trauma-focused treatment programme for PTSD. Pre- and post-treatment differences were compared between patients with and without DS. Results : Large effect sizes were achieved for PTSD symptom reduction on CAPS and the PSS-SR, both for patients with DS and those without. Although patients with DS showed a significantly greater PTSD symptom severity at the beginning, and throughout, treatment, both groups showed equal reductions in PTSD symptoms. Of those who met the criteria for DS, 26 (68.4%) no longer fulfilled the criteria for this classification after treatment. Conclusion : The results provide no support for the notion that the presence of DS negatively impacts trauma-focused treatment outcomes. Accordingly, PTSD patients with DS should not be denied effective trauma-focused treatments.

Sexual Behavior and Concerns in a Sample of Elderly, Former Indentured Swiss Child Laborers

PubMed Central

Burri, Andrea; Maercker, Andreas

2015-01-01

Abstract Introduction Past research suggests a link between post‐traumatic stress disorder (PTSD) and an increased risk for sexual problems. However, there is still no clear picture whether these higher rates are related to trauma exposure or to PTSD itself. Aim The aim of the present study was to complement existing knowledge on the relative impact of trauma and PTSD on sexuality in later life, considering different aspects of trauma exposure on both men and women. Methods The study was conducted on a unique population sample of former Swiss indentured child laborers (55 men, M age 78, age range 60–95 years) who have repeatedly experienced a variety of severe childhood traumas. Main Outcome Measures Sexual outcomes were measured using two scales from the Trauma Symptom Inventory—Dysfunctional Sexual Behavior (DSB) and Sexual Concerns (SC). PTSD symptoms and trauma were assessed with the Short Screening Scale for PTSD and the Composite International Diagnostic Interview, respectively. Results Twenty‐two individuals showed PTSD symptoms, and 53 reported having experienced childhood trauma. Significant differences between men and women were reported for DSB and SC. Men reported a significantly higher prevalence of both SC and DSB compared with women. Conclusions This is the very first study investigating DSB and SC in a sample of older adults exposed to similar traumatic experiences and settings. However, some study limitations need to be considered such as the small sample size. Additional studies are needed to further explore the relative role of traumatization and PTSD on sexual behavior and well‐being, especially to improve sexual therapy for patients who experience trauma. Rechsteiner K, Burri A, and Maercker A. Sexual behavior and concerns in a sample of elderly, former indentured Swiss child laborers. Sex Med 2015;3:305–314. PMID:26797066

Military-related trauma is associated with eating disorder symptoms in male veterans.

PubMed

Arditte Hall, Kimberly A; Bartlett, Brooke A; Iverson, Katherine M; Mitchell, Karen S

2017-11-01

Eating disorders are understudied among male veterans, who may be at increased risk due to the high rates of trauma exposure and experiences of multiple traumatization in this population. This study sought to examine the associations between specific types of trauma (i.e., childhood physical abuse, adult physical assault, childhood sexual abuse, adult sexual assault, and military-related trauma) and eating disorder symptoms in a large, nationally-representative sample of trauma-exposed male veterans. Survey data were collected from N = 642 male veterans. Traumatic experiences in childhood and adulthood were assessed using the Trauma History Screen and the National Stressful Events Survey. Eating disorder symptoms were assessed with the Eating Disorder Diagnostic Scale. Analyses also controlled for age and body mass index. Multiple traumatization was associated with increased eating disorder symptoms. However, military-related trauma was the only trauma type that was uniquely associated with eating disorder symptoms when controlling for other trauma types. Examination of different types of military-related trauma indicated that this association was not driven by exposure to combat. Noncombat, military-related trauma was associated with eating disorder symptom severity in male veterans. Results highlight the need for better assessment of eating disorder symptoms in this population. © 2017 Wiley Periodicals, Inc.

Parenting style, resilience, and mental health of community-dwelling elderly adults in China.

PubMed

Zhong, Xue; Wu, Daxing; Nie, Xueqing; Xia, Jie; Li, Mulei; Lei, Feng; Lim, Haikel A; Kua, Ee-Heok; Mahendran, Rathi

2016-07-08

Given the increasing elderly population worldwide, the identification of potential determinants of successful ageing is important. Many studies have shown that parenting style and mental resilience may influence mental health; however, little is known about the psychological mechanisms that underpin this relationship. The current study sought to explore the relationships among mental resilience, perceptions of parents' parenting style, and depression and anxiety among community-dwelling elderly adults in China. In total, 439 community-dwelling elderly Chinese adults aged 60-91 years completed the Personal and Parents' Parenting Style Scale, Connor-Davidson Resilience Scale, Zung Self-Rating Depression Scale, and Zung Self-Rating Anxiety Scale. Elderly adults whose parents preferred positive and authoritative parenting styles had higher levels of mental resilience and lower levels of depression and anxiety. Elderly adults parented in the authoritarian style were found to have higher levels of depression and anxiety, with lower mental resilience. The findings of this study provide evidence related to successful ageing and coping with life pressures, and highlight the important effects of parenting on mental health. The results suggest that examination of the proximal determinants of successful ageing is not sufficient-distal factors may also contribute to the 'success' of ageing by modifying key psychological dispositions that promote adaptation to adversity.

Pettiness: Conceptualization, measurement and cross-cultural differences.

PubMed

Ng, Reuben; Levy, Becca

2018-01-01

Although pettiness, defined as the tendency to get agitated over trivial matters, is a facet of neuroticism which has negative health implications, no measure exists. The goal of the current study was to develop, and validate a short pettiness scale. In Study 1 (N = 2136), Exploratory Factor Analysis distilled a one-factor model with five items. Convergent validity was established using the Big Five Inventory, DASS, Satisfaction with Life Scale, and Conner-Davidson Resilience Scale. As predicted, pettiness was positively associated with neuroticism, depression, anxiety and stress but negatively related to extraversion, agreeableness, conscientiousness, openness, life satisfaction and resilience. Also, as predicted, pettiness was not significantly related to physical functioning, or blind and constructive patriotism, indicating discriminant validity. Confirmatory Factor Analysis in Study 2 (N = 734) revealed a stable one-factor model of pettiness. In Study 3 (N = 532), the scale, which showed a similar factor structure in the USA and Singapore, also reflected predicted cross-cultural patterns: Pettiness was found to be significantly lower in the United States, a culture categorized as "looser" than in Singapore, a culture classified as "tighter" in terms of Gelfand and colleagues' framework of national tendencies to oppose social deviance. Results suggest that this brief 5-item tool is a reliable and valid measure of pettiness, and its use in health research is encouraged.

The impact of major earthquakes on the psychological functioning of medical students: a Christchurch, New Zealand study.

PubMed

Carter, Frances A; Bell, Caroline J; Ali, Anthony N; McKenzie, Janice; Wilkinson, Timothy J

2014-07-18

No previous studies have systematically assessed the psychological functioning of medical students following a major disaster. To describe the psychological functioning of medical students following the earthquakes in Canterbury, New Zealand, and identify predictors of adverse psychological functioning. 7 months following the most severe earthquake, medical students completed the Depression, Anxiety and Stress Scale (DASS), the Post-Traumatic Stress Disorder Checklist, the Eysenck Personality Questionnaire, the Connor Davidson Resilience Scale, the Work and Adjustment Scale, and Likert scales assessing psychological functioning at worst and currently. A substantial minority of medical students reported moderate-extreme difficulties on the DASS subscales 7 months following the most severe earthquake (Depression =12%; Anxiety =9%; Stress =10%). Multiple linear modelling produced a model that predicted 27% of the variance in total scores on the DASS. Variables contributing significantly to the model were: year of medical course, presence of mental health problems prior to the earthquakes, not being New Zealand European, and being higher on retrospectively rated neuroticism prior to the earthquakes. Around 10% of medical students experienced moderate-extreme psychological difficulties 7 months following the most severe earthquake on 22 February 2011. Specific groups at high risk for ongoing psychological symptomatology were able to be identified.

Predictors of psychological resilience amongst medical students following major earthquakes.

PubMed

Carter, Frances; Bell, Caroline; Ali, Anthony; McKenzie, Janice; Boden, Joseph M; Wilkinson, Timothy; Bell, Caroline

2016-05-06

To identify predictors of self-reported psychological resilience amongst medical students following major earthquakes in Canterbury in 2010 and 2011. Two hundred and fifty-three medical students from the Christchurch campus, University of Otago, were invited to participate in an electronic survey seven months following the most severe earthquake. Students completed the Connor-Davidson Resilience Scale, the Depression, Anxiety and Stress Scale, the Post-traumatic Disorder Checklist, the Work and Adjustment Scale, and the Eysenck Personality Questionnaire. Likert scales and other questions were also used to assess a range of variables including demographic and historical variables (eg, self-rated resilience prior to the earthquakes), plus the impacts of the earthquakes. The response rate was 78%. Univariate analyses identified multiple variables that were significantly associated with higher resilience. Multiple linear regression analyses produced a fitted model that was able to explain 35% of the variance in resilience scores. The best predictors of higher resilience were: retrospectively-rated personality prior to the earthquakes (higher extroversion and lower neuroticism); higher self-rated resilience prior to the earthquakes; not being exposed to the most severe earthquake; and less psychological distress following the earthquakes. Psychological resilience amongst medical students following major earthquakes was able to be predicted to a moderate extent.

The use of computer adaptive tests in outcome assessments following upper limb trauma.

PubMed

Jayakumar, P; Overbeek, C; Vranceanu, A-M; Williams, M; Lamb, S; Ring, D; Gwilym, S

2018-06-01

Aims Outcome measures quantifying aspects of health in a precise, efficient, and user-friendly manner are in demand. Computer adaptive tests (CATs) may overcome the limitations of established fixed scales and be more adept at measuring outcomes in trauma. The primary objective of this review was to gain a comprehensive understanding of the psychometric properties of CATs compared with fixed-length scales in the assessment of outcome in patients who have suffered trauma of the upper limb. Study designs, outcome measures and methodological quality are defined, along with trends in investigation. Materials and Methods A search of multiple electronic databases was undertaken on 1 January 2017 with terms related to "CATs", "orthopaedics", "trauma", and "anatomical regions". Studies involving adults suffering trauma to the upper limb, and undergoing any intervention, were eligible. Those involving the measurement of outcome with any CATs were included. Identification, screening, and eligibility were undertaken, followed by the extraction of data and quality assessment using the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) criteria. The review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria and reg istered (PROSPERO: CRD42016053886). Results A total of 31 studies reported trauma conditions alone, or in combination with non-traumatic conditions using CATs. Most were cross-sectional with varying level of evidence, number of patients, type of study, range of conditions and methodological quality. CATs correlated well with fixed scales and had minimal or no floor-ceiling effects. They required significantly fewer questions and/or less time for completion. Patient-Reported Outcomes Measurement Information System (PROMIS) CATs were the most frequently used, and the use of CATs is increasing. Conclusion Early studies show valid and reliable outcome measurement with CATs performing as well as, if not better than, established fixed scales. Superior properties such as floor-ceiling effects and ease of use support their use in the assessment of outcome after trauma. As CATs are being increasingly used in patient outcomes research, further psychometric evaluation, especially involving longitudinal studies and groups of patients with specific injuries are required to inform clinical practice using these contemporary measures. Cite this article: Bone Joint J 2018;100-B:693-702.

Factor structure and reliability of the childhood trauma questionnaire and prevalence estimates of trauma for male and female street youth.

PubMed

Forde, David R; Baron, Stephen W; Scher, Christine D; Stein, Murray B

2012-01-01

This study examines the psychometric properties of the Childhood Trauma Questionnaire short form (CTQ-SF) with street youth who have run away or been expelled from their homes (N = 397). Internal reliability coefficients for the five clinical scales ranged from .65 to .95. Confirmatory Factor Analysis (CFA) was used to test the five-factor structure of the scales yielding acceptable fit for the total sample. Additional multigroup analyses were performed to consider items by gender. Results provided only evidence of weak factorial invariance. Constrained models showed invariance in configuration, factor loadings, and factor covariances but failed for equality of intercepts. Mean trauma scores for street youth tended to fall in the moderate to severe range on all abuse/neglect clinical scales. Females reported higher levels of abuse and neglect. Prevalence of child maltreatment of individual forms was very high with 98% of street youth reporting one or more forms; 27.4% of males and 48.9% of females reported all five forms. Results of this study support the viability of the CTQ-SF for screening maltreatment in a highly vulnerable street population. Caution is recommended when comparing prevalence estimates for male and female street youth given the failure of the strong factorial multigroup model.

Management of adult blunt hepatic trauma.

PubMed

Kozar, Rosemary A; McNutt, Michelle K

2010-12-01

To review the nonoperative and operative management of blunt hepatic injury in the adult trauma population. Although liver injury scale does not predict need for surgical intervention, a high-grade complex liver injury should alert the physician to a patient at increased risk of hepatic complications following nonoperative management. Blunt hepatic injury remains a frequent intraabdominal injury in the adult trauma population. The management of blunt hepatic injury has undergone a major paradigm shift from mandatory operative exploration to nonoperative management. Hemodynamic instability with a positive focused abdominal sonography for trauma and peritonitis are indications for emergent operative intervention. Although surgical intervention for blunt hepatic trauma is not as common as in years past, it is imperative that the current trauma surgeon be familiar with the surgical skill set to manage complex hepatic injuries. This study represents a review of both nonoperative and operative management of blunt hepatic injury.

Assessment of injury severity in patients with major trauma.

PubMed

Stanford, Penelope; Booth, Nicola; Suckley, Janet; Twelvetree, Timothy; Thomas, Debbie

2016-08-03

Major trauma centres provide specialised care for patients who have experienced serious traumatic injury. This article provides information about major trauma centres and outlines the assessment tools used in this setting. Since patients in major trauma centres will be transferred to other settings, including inpatient wards and primary care, this article is relevant for both nurses working in major trauma centres and in these areas. Traumatic injuries require rapid assessment to ensure the patient receives prompt, adequate and appropriate treatment. A range of assessment tools are available to assist nurses in major trauma centres and emergency care to assess the severity of a patient's injury. The most commonly used tools are triage, Catastrophic Haemorrhage Airway to Exposure assessment, pain assessment and the Glasgow Coma Scale. This article summarises the use of these assessment tools in these settings, and discusses the use of the Injury Severity Score (ISS) to determine the severity of patient injuries.

PTSD symptoms and perception of cognitive problems: The roles of posttraumatic cognitions and trauma coping self-efficacy.

PubMed

Samuelson, Kristin W; Bartel, Alisa; Valadez, Racquel; Jordan, Joshua T

2017-09-01

Posttraumatic stress disorder (PTSD) is associated with mild neurocognitive deficits, yet clients often complain of cognitive problems that exceed what their objective performance demonstrates. In addition, PTSD is associated with negative appraisals about the self, traumatic event, and one's ability to cope. This study examined posttraumatic cognitions as a moderator, and trauma coping self-efficacy as a mediator, of the relationship between PTSD symptoms and self-report of cognitive problems. A sample of 268 trauma-exposed adults completed the PTSD Checklist for DSM-5, the Posttraumatic Cognitions Inventory, the Trauma Coping Self-Efficacy Scale, the Cognitive Self-Report Questionnaire, and the Quality of Life Scale. Negative self-appraisals was a significant moderator in the relationship between PTSD symptoms and perception of cognitive problems (β = -.252, p = .001). In participants with high levels of negative posttraumatic cognitions, perception of cognitive problems was high regardless of PTSD symptom level. In a mediator analysis, there was a significant indirect effect of trauma coping self-efficacy (b = .125, 95% CI [.088, .172]). Finally, there was evidence of moderated mediation, such that trauma coping self-efficacy was a mediator only when posttraumatic cognitions were low or average. Results indicate that posttraumatic appraisals and coping self-efficacy play significant roles in perception of cognitive problems following trauma. Clinically, in patients for which there is a perception of cognitive impairment that is not borne out in neuropsychological testing, cognitive-behavioral therapy focused on altering negative self-perceptions and appraisals may be beneficial. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

21. Historic American Buildings Survey, W. Jeter Eason Deputy District ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

21. Historic American Buildings Survey, W. Jeter Eason- Deputy District Officer, Photographer November 21, 1936 DETAIL OF DECORATIVE STAIR RISERS. - The Hermitage, U.S. Highway 70 North (4580 Rachel's Lane), Nashville, Davidson County, TN

Patient's Guide to Living Confidently with Chronic Heart Failure

MedlinePlus

... GG , Adams KF Jr . , Dupree CS , Bensimhon DR , Johnson KS , Trivedi R , Bowers M , Christenson RH , O’ ... Boineau R , Domanski M , Troutman C , Anderson J , Johnson G , McNulty SE , Clapp-Channing N , Davidson-Ray ...

Alexithymia, Dissociation, and Social Desirability: Investigating Individual Differences in the Narrative Content of False Allegations of Trauma

ERIC Educational Resources Information Center

Peace, Kristine A.; Bouvier, Kristen A.

2008-01-01

This study examined the potential influence of alexithymia, dissociation, and social desirability on the narrative features associated with truthful and fabricated traumatic events. Participants (N = 291) wrote narratives describing both genuine and fabricated traumas and completed scales measuring individual differences. Alexithymia was…

Relationship between Child Abuse History, Trauma, and Dissociation in Russian College Students

ERIC Educational Resources Information Center

Dalenberg, Constance J.; Palesh, Oxana Gronskaya

2004-01-01

Objective: The research was conducted to determine the relationship between violent trauma, child abuse history, and dissociative symptoms in a Russian population. Method: Three hundred and one undergraduate students from Moscow State Linguistics University participated in the study and completed the Dissociation Continuum Scale, the Violence…

A Multidimensional Assessment of Children in Conflictual Contexts: The Case of Kenya

ERIC Educational Resources Information Center

Okech, Jane E. Atieno

2012-01-01

Children in Kenya's Kisumu District Primary Schools (N = 430) completed three measures of trauma. Respondents completed the "My Worst Experience Scale" (MWES; Hyman and Snook 2002) and its supplement, the "School Alienation and Trauma Survey" (SATS; Hyman and Snook 2002), sharing their worst experiences overall and specifically…

An approach to the interpretation of Cole-Davidson and Cole-Cole dielectric functions

NASA Astrophysics Data System (ADS)

Iglesias, T. P.; Vilão, G.; Reis, João Carlos R.

2017-08-01

Assuming that a dielectric sample can be described by Debye's model at each frequency, a method based on Cole's treatment is proposed for the direct estimation at experimental frequencies of relaxation times and the corresponding static and infinite-frequency permittivities. These quantities and the link between dielectric strength and mean molecular dipole moment at each frequency could be useful to analyze dielectric relaxation processes. The method is applied to samples that follow a Cole-Cole or a Cole-Davidson dielectric function. A physical interpretation of these dielectric functions is proposed. The behavior of relaxation time with frequency can be distinguished between the two dielectric functions. The proposed method can also be applied to samples following a Navriliak-Negami or any other dielectric function. The dielectric relaxation of a nanofluid consisting of graphene nanoparticles dispersed in the oil squalane is reported and discussed within the novel framework.

Engaging the Public Through an Interactive Astronomy Outreach Program

NASA Astrophysics Data System (ADS)

Thompson, Kristen

2018-01-01

The growing technology sector of the U.S. economy in an increasingly complex world has made it more important than ever for students to gather information, think critically, and solve problems. These skills are often acquired through the study of STEM disciplines. In an effort to inspire students and the public in the Charlotte, NC area to take an interest in STEM related fields, the Physics Department at Davidson College has recently developed an interactive astronomy community engagement program. This program is comprised of off-campus events that bring STEM programming to K-12 children, on-campus public star parties, and a day-long astronomy fair called Davidson Space Day. This presentation will illustrate the implementation of each of these components of our outreach program, present an evaluation of their success, and describe future goals and lessons learned thus far. This outreach program was made possible through funding from the NC Space Grant Consortium.

Dielectric relaxation and hydrogen bonding interaction in xylitol-water mixtures using time domain reflectometry

NASA Astrophysics Data System (ADS)

Rander, D. N.; Joshi, Y. S.; Kanse, K. S.; Kumbharkhane, A. C.

2016-01-01

The measurements of complex dielectric permittivity of xylitol-water mixtures have been carried out in the frequency range of 10 MHz-30 GHz using a time domain reflectometry technique. Measurements have been done at six temperatures from 0 to 25 °C and at different weight fractions of xylitol (0 < W X ≤ 0.7) in water. There are different models to explain the dielectric relaxation behaviour of binary mixtures, such as Debye, Cole-Cole or Cole-Davidson model. We have observed that the dielectric relaxation behaviour of binary mixtures of xylitol-water can be well described by Cole-Davidson model having an asymmetric distribution of relaxation times. The dielectric parameters such as static dielectric constant and relaxation time for the mixtures have been evaluated. The molecular interaction between xylitol and water molecules is discussed using the Kirkwood correlation factor ( g eff ) and thermodynamic parameter.

Bending space-time: a commentary on Dyson, Eddington and Davidson (1920) 'A determination of the deflection of light by the Sun's gravitational field'.

PubMed

Longair, Malcolm

2015-04-13

The famous eclipse expedition of 1919 to Sobral, Brazil, and the island of Principe, in the Gulf of Guinea, led by Dyson, Eddington and Davidson was a turning point in the history of relativity, not only because of its importance as a test of Einstein's General Theory of Relativity, but also because of the intense public interest which was aroused by the success of the expedition. The dramatic sequence of events which occurred is reviewed, as well as the long-term impact of its success. The gravitational bending of electromagnetic waves by massive bodies is a subject of the greatest importance for contemporary and future astronomy, astrophysics and cosmology. Examples of the potential impact of this key tool of modern observational astronomy are presented. This commentary was written to celebrate the 350th anniversary of the journal Philosophical Transactions of the Royal Society.

Trauma-Informed Medical Care: Patient Response to a Primary Care Provider Communication Training

PubMed Central

Green, Bonnie L.; Saunders, Pamela A.; Power, Elizabeth; Dass-Brailsford, Priscilla; Schelbert, Kavitha Bhat; Giller, Esther; Wissow, Larry; Hurtado de Mendoza, Alejandra; Mete, Mihriye

2016-01-01

Trauma exposure predicts mental disorders and health outcomes; yet there is little training of primary care providers about trauma’s effects, and how to better interact with trauma survivors. This study adapted a theory-based approach to working with trauma survivors, Risking Connection, into a 6-hour CME course, Trauma-Informed Medical Care (TI-Med), to evaluate its feasibility and preliminary efficacy. We randomized four primary care sites to training or wait-list conditions; PCPs at wait-list sites were trained after reassessment. Primary care providers (PCPs) were Family Medicine residents (n = 17; 2 sites) or community physicians (n = 13; 2 sites). Outcomes reported here comprised a survey of 400 actual patients seen by the PCPs in the study. Patients, mostly minority, completed surveys before or after their provider received training. Patients rated PCPs significantly higher after training on a scale encompassing partnership issues. Breakdowns showed lower partnership scores for those with trauma or posttraumatic stress symptoms. Future studies will need to include more specific trauma-related outcomes. Nevertheless, this training is a promising initial approach to teaching trauma-informed communication skills to PCPs. PMID:27721673

Correlation between traumatic events and posttraumatic stress disorder among North Korean defectors in South Korea.

PubMed

Jeon, WooTaek; Hong, ChangHyung; Lee, ChangHo; Kim, Dong Kee; Han, Mooyoung; Min, SungKil

2005-04-01

The number of North Korean defectors entering South Korea has been increasing rapidly since 1994. Two hundred North Korean defectors in South Korea were studied to identify their experiences of traumatic events in North Korea and during defection, and the correlation with Posttraumatic Stress Disorder (PTSD). Researchers conducted face-to-face interviews and assisted defectors in performing a self-report assessment of this survey. The study questionnaire consisted of demographic characteristics, the Traumatic Experiences Scale for North Korean Defectors, and the PTSD part of the Structured Clinical Interview for DSM-III-R Korean version. Prevalence rate of PTSD in defectors was 29.5%, with a higher rate for women. In factor analysis, the 25 items of traumatic events experienced in North Korea were divided into three factors: Physical Trauma, Political-Ideological Trauma, and Family-Related Trauma. In addition, the 19 items of traumatic events during defection were grouped into four factors: Physical Trauma, Detection and Capture-Related Trauma, Family-Related Trauma, and Betrayal-Related Trauma. In multifactorial logistic regression analysis, Family-Related Trauma in North Korea had a significant odds ratio.

Luchando y logrando/struggling and achieving: Resilience of Latina/o math and science teacher candidates at California Hispanic-Serving Institutions: A critical race perspective

NASA Astrophysics Data System (ADS)

Gonzalez, Laura

Latin math and science students represent a resilient, determined, and encouraging group of high achievers. This qualitative study presents the narratives of 10 Latin science and math teacher candidates currently attending Hispanic-Serving Institutions in California. Semi structured, in-depth interviews were conducted, where participants shared the challenges they experienced and the factors that contributed to their resilience. The Connor Davidson Resilience Scale CD-RISC was used to present resilience measures for each participant. This score is compared to a group of college students throughout the nation. The findings provide insight into the critical need for universities to examine institutional practices and efforts to support these high achievers who have already beaten tremendous odds by entering the halls of higher education.

A combined analysis of the Frost Multidimensional Perfectionism Scale (FMPS), Child and Adolescent Perfectionism Scale (CAPS), and Almost Perfect Scale-Revised (APS-R): Different perfectionist profiles in adolescent high school students.

PubMed

Sironic, Amanda; Reeve, Robert A

2015-12-01

To investigate differences and similarities in the dimensional constructs of the Frost Multidimensional Perfectionism Scale (FMPS; Frost, Marten, Lahart, & Rosenblate, 1990), Child and Adolescent Perfectionism Scale (CAPS; Flett, Hewitt, Boucher, Davidson, & Munro, 2000), and Almost Perfect Scale-Revised (APS-R; Slaney, Rice, Mobley, Trippi, & Ashby, 2001), 938 high school students completed the 3 perfectionism questionnaires, as well as the Depression Anxiety Stress Scales (DASS; Lovibond & Lovibond, 1995). Preliminary analyses revealed commonly observed factor structures for each perfectionism questionnaire. Exploratory factor analysis of item responses from the questionnaires (combined) yielded a 4-factor solution (factors were labeled High Personal Standards, Concerns, Doubts and Discrepancy, Externally Motivated Perfectionism, and Organization and Order). A latent class analysis of individuals' mean ratings on each of the 4 factors yielded a 6-class solution. Three of the 6 classes represented perfectionist subgroups (labeled adaptive perfectionist, externally motivated maladaptive perfectionist, and mixed maladaptive perfectionist), and 3 represented nonperfectionist subgroups (labeled nonperfectionist A, nonperfectionist B, and order and organization nonperfectionist). Each of the 6 subgroups was meaningfully associated with the DASS. Findings showed that 3 out of 10 students were classified as maladaptive perfectionists, and maladaptive perfectionists were more prevalent than adaptive perfectionists. In sum, it is evident that combined ratings from the FMPS, CAPS, and APS-R offer a meaningful characterization of perfectionism. (c) 2015 APA, all rights reserved).

Strategic proposal for a national trauma system in France.

PubMed

Gauss, Tobias; Balandraud, Paul; Frandon, Julien; Abba, Julio; Ageron, Francois Xavier; Albaladejo, Pierre; Arvieux, Catherine; Barbois, Sandrine; Bijok, Benjamin; Bobbia, Xavier; Charbit, Jonathan; Cook, Fabrice; David, Jean-Stephane; Maurice, Guillaume De Saint; Duranteau, Jacques; Garrigue, Delphine; Gay, Emmanuel; Geeraerts, Thomas; Ghelfi, Julien; Hamada, Sophie; Harrois, Anatole; Kobeiter, Hicham; Leone, Marc; Levrat, Albrice; Mirek, Sebastien; Nadji, Abdel; Paugam-Burtz, Catherine; Payen, Jean Francois; Perbet, Sebastien; Pirracchio, Romain; Plenier, Isabelle; Pottecher, Julien; Rigal, Sylvain; Riou, Bruno; Savary, Dominique; Secheresse, Thierry; Tazarourte, Karim; Thony, Frederic; Tonetti, Jerome; Tresallet, Christophe; Wey, Pierre-Francois; Picard, Julien; Bouzat, Pierre

2018-05-29

In this road map for trauma in France, we focus on the main challenges for system implementation, surgical and radiology training, and upon innovative training techniques. Regarding system organisation: procedures for triage, designation and certification of trauma centres are mandatory to implement trauma networks on a national scale. Data collection with registries must be created, with a core dataset defined and applied through all registries. Regarding surgical and radiology training, diagnostic-imaging processes should be standardised and the role of the interventional radiologist within the trauma team and the trauma network should be clearly defined. Education in surgery for trauma is crucial and recent changes in medical training in France will promote trauma surgery as a specific sub-specialty. Innovative training techniques should be implemented and be based on common objectives, scenarios and evaluation, so as to improve individual and team performances. The group formulated 14 proposals that should help to structure and improve major trauma management in France over the next 10 years. Copyright © 2018 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

Attachment style as a mediator between childhood maltreatment and the experience of betrayal trauma as an adult.

PubMed

Hocking, Elise C; Simons, Raluca M; Surette, Renata J

2016-02-01

Previous research has demonstrated a positive association between child maltreatment and adult interpersonal trauma (Arata, 2000; Crawford & Wright, 2007). From a betrayal trauma theory perspective, evidence suggests that the experience of trauma high in betrayal (e.g., child maltreatment by parents or guardians) increases ones risk of betrayal trauma as an adult (Gobin & Freyd, 2009). However, the mechanisms explaining these associations are not well understood; attachment theory could provide further insight. Child maltreatment is associated with insecure attachment (Baer & Martinez, 2006; Muller et al., 2000). Insecure attachment is also associated with deficits in interpersonal functioning and risk for intimate partner violence, suggesting insecure attachment may mediate the relationship between child maltreatment and the experience of betrayal trauma as an adult. The current study tested this hypothesis in a sample of 601 college students. Participants completed online questionnaires including the Child Abuse and Trauma Scale (CATS), the Experiences in Close Relationships - Revised (ECR-R) and the Brief Betrayal Trauma Survey (BBTS). Results indicated that child maltreatment is associated with adult betrayal trauma and anxious attachment partially mediates this relationship. Copyright © 2016 Elsevier Ltd. All rights reserved.

Lifetime trauma exposure in veterans with military-related posttraumatic stress disorder: association with current symptomatology.

PubMed

Clancy, Carolina P; Graybeal, Anna; Tompson, Whitney P; Badgett, Kourtni S; Feldman, Michelle E; Calhoun, Patrick S; Erkanli, Alaattin; Hertzberg, Michael A; Beckham, Jean C

2006-09-01

This study examined whether trauma exposure before, during, and/or after military service contributed to current levels of post-traumatic stress disorder (PTSD) and adjustment. Further, we investigated whether trauma exposure before military service was mediated or moderated by military trauma in its effects on current PTSD and adjustment. In this retrospective study, archival data from the medical records of 422 male veterans diagnosed with PTSD between December 2001 and July 2004 at a Veterans Administration Medical Center PTSD clinic were analyzed. Measures included the Clinician-Administered PTSD Scale interview as well as self-report measures assessing trauma history, health problems, and general psychopathology (including PTSD). Findings indicated that nonmilitary-related trauma was prevalent in this sample (90%). Regression analyses for PTSD symptom severity revealed that age, greater combat exposure, and a history of physical assault after military service were significantly associated with more severe PTSD symptoms. Childhood physical abuse, adult sexual trauma, and a history of being physically assaulted during military service were also significantly associated with PTSD symptom severity. Mediational analyses indicated that childhood trauma was associated with both adult trauma and increased symptomatology on various outcome measures. Moderational analyses indicated that adult trauma exposure moderated the effect of childhood trauma exposure on health complaints. Results suggest that several variables, including age, greater combat exposure, and premilitary and postmilitary traumas, are associated with increased PTSD symptomatology. This finding underscores the importance of conducting a thorough assessment of trauma when diagnosing PTSD.

76 FR 71455 - Approval and Promulgation of Implementation Plans and Designation of Areas for Air Quality...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-18

...EPA is taking final action to approve a request submitted on December 18, 2009, and supplemented on December 22, 2010, from the State of North Carolina, through the North Carolina Department of Environment and Natural Resources (NC DENR), Division of Air Quality (DAQ), to redesignate the Greensboro-Winston-Salem-High Point fine particulate matter (PM2.5) nonattainment area (hereafter the ``Greensboro Area'' or ``Area'') to attainment for the 1997 Annual PM2.5 National Ambient Air Quality Standards (NAAQS). The Greensboro Area is comprised of Davidson and Guilford Counties in their entireties. EPA's approval of the redesignation request is based on the determination that the State of North Carolina has met the criteria for redesignation to attainment set forth in the Clean Air Act (CAA or Act), including the determination that the Greensboro Area has attained the 1997 Annual PM2.5 NAAQS by its applicable attainment date of April 5, 2010. Additionally, EPA is approving a revision to the North Carolina State Implementation Plan (SIP) to include the 1997 Annual PM2.5 maintenance plan for the Greensboro Area that contains the new 2011 and 2021 motor vehicle emission budgets (MVEBs) for nitrogen oxides (NOX) and PM2.5 for both Davidson and Guilford Counties. This action also approves the emissions inventory submitted with the maintenance plan. Further, EPA is correcting a typographical error for the citation associated with a previous adequacy finding the Agency made for the NOX and PM2.5 MVEBs for both Davidson and Guilford Counties.

Multicenter Retrospective Cohort Study of "Talk and Die" After Traumatic Brain Injury.

PubMed

Shibahashi, Keita; Sugiyama, Kazuhiro; Okura, Yoshihiro; Hoda, Hidenori; Hamabe, Yuichi

2017-11-01

Patients who "talk and die" after traumatic brain injury (TBI) are potentially salvageable. The reported incidences and risk factors for the "talk and die" phenomenon are conflicting and do not take into account recent improvements in trauma care. The aim of this study was to determine the incidences of "talk and die" after TBI in a modern trauma care system, as well as associated risk factors. We identified patients who experienced TBI (abbreviated injury scale 3-5) between 2004 and 2015 who talked on admission (i.e., their verbal component on the Glasgow Coma Scale was ≥3 on admission) using a nationwide trauma registry (the Japan Trauma Data Bank). The end point was in-hospital mortality. We compared patients who talked and died with those who talked and survived. During the study period, 236,698 patients were registered in the database. Of the 24,833 patients who were eligible for analysis, 956 (4.0%) patients subsequently died in the hospital. The in-hospital mortality rate significantly decreased over the past 12 years. Older age; male sex; a higher injury severity score; a lower Glasgow Coma Scale score; comorbidities (congestive heart failure, chronic kidney disease, liver cirrhosis, and hematologic disorders); hypotension on arrival; subdural hemorrhage; contusion; and vault fracture were independently associated with higher in-hospital mortality. Even in modern trauma care systems, some patients still talk and die after TBI. We identified certain risk factors in patients with TBI that elicit the requirement for close observation, even if these patients talk after TBI. Copyright © 2017 Elsevier Inc. All rights reserved.

1. PHOTOGRAPH TAKEN FROM THE SOUTH LOOKING NORTH ACROSS AN ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

1. PHOTOGRAPH TAKEN FROM THE SOUTH LOOKING NORTH ACROSS AN ERODED AREA. THE SOUTH END OF THE FLUME HAS COLLAPSED. - Davidson Ditch Waste Water Weir, Mile 63 of Alaska's Steese Highway, Chatanika, Fairbanks North Star Borough, AK

The Association among Childhood Trauma, Pathological Dissociation and Gambling Severity in Casino Gamblers.

PubMed

Imperatori, Claudio; Innamorati, Marco; Bersani, Francesco Saverio; Imbimbo, Francesca; Pompili, Maurizio; Contardi, Anna; Farina, Benedetto

2017-01-01

The aim of the present study was to explore the role of pathological dissociation in mediating the association between childhood trauma (CT) and gambling severity. One hundred seventy-one (134 men and 37 women) gamblers recruited in gambling environments (i.e., two Italian casinos) have been enrolled in the study. Psychopathological assessments included the Childhood Trauma Questionnaire (CTQ), the Dissociative Experiences Scale-Taxon (DES-T), the South Oaks Gambling Screen (SOGS), the CAGE and the Hospital Anxiety and Depression Scale. A mediational model, analyzing the direct and indirect effects of CTQ on SOGS through the mediating role of DES-T, showed that the relation between CTQ and SOGS was fully mediated by DES-T scores (b = 0.07; se = 0.15; p < 0.001). This finding raises the possibility that CT explains gambling severity through the presence of pathological dissociative symptoms and dissociative pathogenetic processes. Copyright © 2015 John Wiley & Sons, Ltd. Gambling severity is associated with both childhood trauma and pathological dissociation in casino gamblers. A mediational model shows that the effect of childhood trauma on gambling severity is entirely mediated by pathological dissociation. From a clinical point of view, our results highlight the importance of assessing, and possibly treating, dissociative symptoms in individuals with gambling disorder. Copyright © 2015 John Wiley & Sons, Ltd.

Readability of Orthopedic Trauma Patient Education Materials on the Internet.

PubMed

Mohan, Rohith; Yi, Paul H; Morshed, Saam

In this study, we used the Flesch-Kincaid Readability Scale to determine the readability levels of orthopedic trauma patient education materials on the American Academy of Orthopaedic Surgeons (AAOS) website and to examine how subspecialty coauthorship affects readability level. Included articles from the AAOS online patient education library and the AAOS OrthoPortal website were categorized as trauma or broken bones and injuries on the AAOS online library or were screened by study authors for relevance to orthopedic trauma. Subsequently, the Flesch-Kincaid scale was used to determine each article's readability level, which was reported as a grade level. Subspecialty coauthorship was noted for each article. A total of 115 articles from the AAOS website were included in the study and reviewed. Mean reading level was grade 9.1 for all articles reviewed. Nineteen articles (16.5%) were found to be at or below the eighth-grade level, and only 1 article was at or below the sixth-grade level. In addition, there was no statistically significant difference between articles coauthored by the various orthopedic subspecialties and those authored exclusively by AAOS. Orthopedic trauma readability materials on the AAOS website appear to be written at a reading comprehension level too high for the average patient to understand.

Childhood trauma, depression, and sleep quality and their association with psychotic symptoms and suicidality in schizophrenia.

PubMed

Kilicaslan, Esin Evren; Esen, Asli Tugba; Kasal, Meltem Izci; Ozelci, Erdal; Boysan, Murat; Gulec, Mustafa

2017-12-01

This study involved the examination of the relationship between childhood trauma and both psychotic symptoms and suicidality in patients with schizophrenia after controlling for the possible confounding factors, such as clinical features, depression, and sleep quality. The Childhood Trauma Questionnaire-Short Form, Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), Pittsburgh Sleep Quality Index (PSQI), and the suicidality subscale of Mini-International Neuropsychiatric Interview (MINI) were administered to 199 patients with schizophrenia. We used sequential multiple stepwise regression analyses in which positive symptoms, negative symptoms, overall psychopathology, total symptoms of schizophrenia, and suicidality were dependent variables. Depressive symptomatology and childhood physical abuse significantly contributed to positive, negative, general psychopathology, and global schizophrenia symptomatology. Interestingly, general psychopathology scores were negatively associated with childhood physical neglect. Also, subjective sleep quality significantly contributed to positive schizophrenia symptoms. Although prior suicide attempts and depression were significant antecedents of suicidal ideation, no association between suicidality and both childhood trauma and sleep was found. Childhood physical abuse could have an impact on psychopathology in schizophrenia. In addition to childhood trauma, depression, sleep disturbances, and clinical features should be considered and inquired about in the course of clinical care of schizophrenia patients. Copyright © 2017 Elsevier B.V. All rights reserved.

Factors Affecting Morbidity in Solid Organ Injuries

PubMed Central

Baygeldi, Serdar; Karakose, Oktay; Özcelik, Kazım Caglar; Pülat, Hüseyin; Damar, Sedat; Eken, Hüseyin; Zihni, İsmail; Çalta, Alpaslan Fedai; Baç, Bilsel

2016-01-01

Background and Aim. The aim of this study was to investigate the effects of demographic characteristics, biochemical parameters, amount of blood transfusion, and trauma scores on morbidity in patients with solid organ injury following trauma. Material and Method. One hundred nine patients with solid organ injury due to abdominal trauma during January 2005 and October 2015 were examined retrospectively in the General Surgery Department of Dicle University Medical Faculty. Patients' age, gender, trauma interval time, vital status (heart rate, arterial tension, and respiratory rate), hematocrit (HCT) value, serum area aminotransferase (ALT) and aspartate aminotransferase (AST) values, presence of free abdominal fluid in USG, trauma mechanism, extra-abdominal system injuries, injured solid organs and their number, degree of injury in abdominal CT, number of blood transfusions, duration of hospital stay, time of operation (for those undergoing operation), trauma scores (ISS, RTS, Glasgow coma scale, and TRISS), and causes of morbidity and mortality were examined. In posttraumatic follow-up period, intra-abdominal hematoma infection, emboli, catheter infection, and deep vein thrombosis were monitored as factors of morbidity. Results. One hundred nine patients were followed up and treated due to isolated solid organ injury following abdominal trauma. There were 81 males (74.3%) and 28 females (25.7%), and the mean age was 37.6 ± 18.28 (15–78) years. When examining the mechanism of abdominal trauma in patients, the following results were obtained: 58 (53.3%) traffic accidents (22 out-vehicle and 36 in-vehicle), 27 (24.7%) falling from a height, 14 (12.9%) assaults, 5 (4.5%) sharp object injuries, and 5 (4.5%) gunshot injuries. When evaluating 69 liver injuries scaled by CT the following was detected: 14 (20.3%) of grade I, 32 (46.4%) of grade II, 22 (31.8%) of grade III, and 1 (1.5%) of grade IV. In 63 spleen injuries scaled by CT the following was present: grade I in 21 (33.3%), grade II in 27 (42.9%), grade III in 11 (17.5%), and grade IV in 4 (6.3%). The mean length of hospital stay after trauma was 6.46 days in the medically followed patients. This ratio was 8.13 days in 22 patients with morbidity and 5.98 days in 78 patients without morbidity. There was a morbidity in 22 (22%) patients medically followed after trauma. In this study, nonoperative treatment was observed to be performed safely in solid organ injuries after trauma in case of absence of hemodynamic stability and peritoneal irritation. It has been emphasized that injury of both liver and spleen (p < 0.01), high respiratory rate (p < 0.01), trauma scores (GKS, ISS, RTS) (p < 0.0001), and elevation of ALT AST values (p < 0.01) are stimulants for morbidity that may occur during follow-up. Conclusion. Medical follow-up can be considered in patients with high grade injuries similar to patients with low-grade solid organ injury after trauma. The injury of both liver and spleen, high respiratory rate, high GCS and ISS, low RTS, and elevation of ALT AST values were found to increase morbidity again in the follow-up of these patients. PMID:27375316

Factors Affecting Morbidity in Solid Organ Injuries.

PubMed

Baygeldi, Serdar; Karakose, Oktay; Özcelik, Kazım Caglar; Pülat, Hüseyin; Damar, Sedat; Eken, Hüseyin; Zihni, İsmail; Çalta, Alpaslan Fedai; Baç, Bilsel

2016-01-01

Background and Aim. The aim of this study was to investigate the effects of demographic characteristics, biochemical parameters, amount of blood transfusion, and trauma scores on morbidity in patients with solid organ injury following trauma. Material and Method. One hundred nine patients with solid organ injury due to abdominal trauma during January 2005 and October 2015 were examined retrospectively in the General Surgery Department of Dicle University Medical Faculty. Patients' age, gender, trauma interval time, vital status (heart rate, arterial tension, and respiratory rate), hematocrit (HCT) value, serum area aminotransferase (ALT) and aspartate aminotransferase (AST) values, presence of free abdominal fluid in USG, trauma mechanism, extra-abdominal system injuries, injured solid organs and their number, degree of injury in abdominal CT, number of blood transfusions, duration of hospital stay, time of operation (for those undergoing operation), trauma scores (ISS, RTS, Glasgow coma scale, and TRISS), and causes of morbidity and mortality were examined. In posttraumatic follow-up period, intra-abdominal hematoma infection, emboli, catheter infection, and deep vein thrombosis were monitored as factors of morbidity. Results. One hundred nine patients were followed up and treated due to isolated solid organ injury following abdominal trauma. There were 81 males (74.3%) and 28 females (25.7%), and the mean age was 37.6 ± 18.28 (15-78) years. When examining the mechanism of abdominal trauma in patients, the following results were obtained: 58 (53.3%) traffic accidents (22 out-vehicle and 36 in-vehicle), 27 (24.7%) falling from a height, 14 (12.9%) assaults, 5 (4.5%) sharp object injuries, and 5 (4.5%) gunshot injuries. When evaluating 69 liver injuries scaled by CT the following was detected: 14 (20.3%) of grade I, 32 (46.4%) of grade II, 22 (31.8%) of grade III, and 1 (1.5%) of grade IV. In 63 spleen injuries scaled by CT the following was present: grade I in 21 (33.3%), grade II in 27 (42.9%), grade III in 11 (17.5%), and grade IV in 4 (6.3%). The mean length of hospital stay after trauma was 6.46 days in the medically followed patients. This ratio was 8.13 days in 22 patients with morbidity and 5.98 days in 78 patients without morbidity. There was a morbidity in 22 (22%) patients medically followed after trauma. In this study, nonoperative treatment was observed to be performed safely in solid organ injuries after trauma in case of absence of hemodynamic stability and peritoneal irritation. It has been emphasized that injury of both liver and spleen (p < 0.01), high respiratory rate (p < 0.01), trauma scores (GKS, ISS, RTS) (p < 0.0001), and elevation of ALT AST values (p < 0.01) are stimulants for morbidity that may occur during follow-up. Conclusion. Medical follow-up can be considered in patients with high grade injuries similar to patients with low-grade solid organ injury after trauma. The injury of both liver and spleen, high respiratory rate, high GCS and ISS, low RTS, and elevation of ALT AST values were found to increase morbidity again in the follow-up of these patients.

Factors Associated with Resilience of Adult Survivors Five Years after the 2008 Sichuan Earthquake in China

PubMed Central

Ni, Cuiping; Chow, Meyrick Chum Ming; Jiang, Xiaolian; Li, Sijian; Pang, Samantha Mei Che

2015-01-01

Given the paucity of quantitative empirical research on survivors’ resilience and its predictors in the context of long-term recovery after disasters, we examined how resilience predictors differed by gender among adult survivors five years after the Sichuan earthquake. This was a cross-sectional survey study of adult survivors (N = 495; aged 18–60) living in reconstructed communities five years into the recovery process after the Wenchuan earthquake. The instruments we used included assessments of sociodemographic characteristics and earthquake exposure level, the Connor-Davidson Resilience Scale, and the Social Support Rating Scale. Support-seeking behaviors emerged as a significant predictor of male survivors’ resilience, while subjective support and marital status were found to be predictors of female survivors’ resilience. Annual household income and chronic disease were predictors for both male and female groups. The findings of this study can be used in devising methods to boost survivors’ resilience by promoting their satisfaction with social support and their ability to obtain effective support. Additionally, the results suggest how to assist survivors who may have relatively poor resilience. PMID:25811775

A Network Approach to Psychosis: Pathways Between Childhood Trauma and Psychotic Symptoms

PubMed Central

Isvoranu, Adela-Maria; van Borkulo, Claudia D.; Boyette, Lindy-Lou; Wigman, Johanna T. W.; Vinkers, Christiaan H.; Borsboom, Denny

2017-01-01

Childhood trauma (CT) has been identified as a potential risk factor for the onset of psychotic disorders. However, to date, there is limited consensus with respect to which symptoms may ensue after exposure to trauma in early life, and whether specific pathways may account for these associations. The aim of the present study was to use the novel network approach to investigate how different types of traumatic childhood experiences relate to specific symptoms of psychotic disorders and to identify pathways that may be involved in the relationship between CT and psychosis. We used data of patients diagnosed with a psychotic disorder (n = 552) from the longitudinal observational study Genetic Risk and Outcome of Psychosis Project and included the 5 scales of the Childhood Trauma Questionnaire-Short Form and all original symptom dimensions of the Positive and Negative Syndrome Scale. Our results show that all 5 types of CT and positive and negative symptoms of psychosis are connected through symptoms of general psychopathology. These findings are in line with the theory of an affective pathway to psychosis after exposure to CT, with anxiety as a main connective component, but they also point to several additional connective paths between trauma and psychosis: eg, through poor impulse control (connecting abuse to grandiosity, excitement, and hostility) and motor retardation (connecting neglect to most negative symptoms). The results of the current study suggest that multiple paths may exist between trauma and psychosis and may also be useful in mapping potential transdiagnostic processes. PMID:27165690

The spatial epidemiology of trauma: the potential of geographic information science to organize data and reveal patterns of injury and services

PubMed Central

Schuurman, Nadine; Hameed, S. Morad; Fiedler, Robert; Bell, Nathaniel; Simons, Richard K.

2008-01-01

Despite important advances in the prevention and treatment of trauma, preventable injuries continue to impact the lives of millions of people. Motor vehicle collisions and violence claim close to 3 million lives each year worldwide. Public health agencies have promoted the need for systematic and ongoing surveillance as a foundation for successful injury control. Surveillance has been used to quantify the incidence of injury for the prioritization of further research, monitor trends over time, identify new injury patterns, and plan and evaluate prevention and intervention efforts. Advances in capability to handle spatial data and substantial increases in computing power have positioned geographic information science (GIS) as a potentially important tool for health surveillance and the spatial organization of health care, and for informing prevention and acute care interventions. Two themes emerge in the trauma literature with respect to GIS theory and techniques: identifying determinants associated with the risk of trauma to guide injury prevention efforts and evaluating the spatial organization and accessibility of acute trauma care systems. We review the current literature on trauma and GIS research and provide examples of the importance of accounting for spatial scale when using spatial analysis for surveillance. The examples illustrate the effect of scale on incident analysis, the geographic variation of major injury across British Columbia's health service delivery areas (HSDAs) and the rates of variation of injury within individual HSDAs. PMID:18841227

The Relationship between Childhood Trauma and Suicidal Ideation: Role of Maltreatment and Potential Mediators.

PubMed

Bahk, Yong-Chun; Jang, Seon-Kyeong; Choi, Kee-Hong; Lee, Seung-Hwan

2017-01-01

Childhood trauma is recognized as an important risk factor in suicidal ideation, however it is not fully understood how the different types of childhood maltreatment influence suicidal ideation nor what variables mediate the relationship between childhood trauma and suicidal ideation. This study examined the path from childhood trauma to suicidal ideation, including potential mediators. A sample of 211 healthy adults completed the Childhood Trauma Questionnaire (CTQ), Beck scale for Suicidal Ideation (BSI), Functional Social Support Questionnaire (FSSQ) and Hospital Anxiety and Depression Scale (HADS). Path analysis was used to investigate the relationship among study variables. Of the several types of childhood maltreatment we considered, only childhood sexual abuse directly predicted suicidal ideation (β=0.215, p=0.001). Childhood physical abuse (β=0.049, 95% confidence interval: 0.011-0.109) and childhood emotional abuse (β=0.042, 95% confidence interval: 0.001-0.107) indirectly predicted suicidal ideation through their association with anxiety. Childhood neglect indirectly predicted suicidal ideation through association with perceived social support (β=0.085, 95% confidence interval: 0.041-0.154). Our results confirmed that childhood sexual abuse is a strong predictor of suicidal ideation. Perceived social support mediated the relationship between suicidal ideation and neglect. Anxiety fully mediated the relationship between suicidal ideation and both physical abuse and emotional abuse. Interventions to reduce suicidal ideation among survivors of childhood trauma should focus on anxiety symptoms and attempt to increase their social support.

Attachment style and interpersonal trauma in refugees.

PubMed

Morina, Naser; Schnyder, Ulrich; Schick, Matthis; Nickerson, Angela; Bryant, Richard A

2016-12-01

Refugees can suffer many experiences that threaten their trust in others. Although models of refugee mental health have postulated that attachment securities may be damaged by refugee experiences, this has yet to be empirically tested. This study aimed to understand the relationship between the nature of traumatic experiences sustained by refugees and attachment styles. In a cross-sectional study, treatment-seeking refugees (N = 134) were assessed for traumatic exposure using the Harvard Trauma Questionnaire and Posttraumatic Diagnostic Scale. Attachment style was assessed using the Experiences in Close Relationship Scale. Whereas gender and severity of interpersonal traumatic events predicted avoidant attachment style (accounting for 11% of the variance), neither these factors nor non-interpersonal trauma predicted anxious attachment. Exposure to interpersonal traumatic events, including torture, is associated with enduring avoidant attachment tendencies in refugees. This finding accords with attachment theories that prior adverse interpersonal experiences can undermine secure attachment systems, and may promote avoidance of attachment seeking. This finding may point to an important process maintaining poor psychological health in refugees affected by interpersonal trauma. © The Royal Australian and New Zealand College of Psychiatrists 2016.

The impact of coping and emotional intelligence on the relationship between posttraumatic stress disorder from past trauma, adjustment difficulty, and psychological distress following divorce.

PubMed

Slanbekova, Gulnara; Chung, Man Cheung; Abildina, Saltanat; Sabirova, Raikhan; Kapbasova, Gulzada; Karipbaev, Baizhol

2017-08-01

Focusing on a group of Kazakh divorcees, this study examined the inter-relationship between posttraumatic stress disorder (PTSD) from past trauma, coping strategies, emotional intelligence, adjustment difficulties, and psychiatric symptom severity following divorce. One hundred and twenty divorcees participated in the research and completed the Emotional Intelligence Questionnaire, Posttraumatic Stress Diagnostic Scale, General Health Questionnaire-28, Brief COPE, and Fisher's Divorce Adjustment Scale Results: About 29% reported no trauma; 53%, 21%, and 26% met the criteria for no-PTSD, partial-PTSD, and full-PTSD respectively. Emotion-focused coping and managing emotions predicted adjustment difficulties. Controlling for gender, PTSD, problem-focused coping, and managing emotions predicted psychiatric symptom severity. Problem-focused coping mediated the direct effect of the path between PTSD and psychiatric symptom severity with its mediational effect being moderated by the effect of managing emotions. Following divorce, people can experience psychological distress which is influenced by the effects of PTSD from past trauma, and whether they used problem-focused coping and were able to manage their emotions.

Is there a dissociative process in sleepwalking and night terrors?

PubMed Central

Hartman, D; Crisp, A; Sedgwick, P; Borrow, S

2001-01-01

The enduring and contentious hypothesis that sleepwalking and night terrors are symptomatic of a protective dissociative mechanism is examined. This is mobilised when intolerable impulses, feelings and memories escape, within sleep, the diminished control of mental defence mechanisms. They then erupt but in a limited motoric or affective form with restricted awareness and subsequent amnesia for the event. It has also been suggested that such processes are more likely when the patient has a history of major psychological trauma. In a group of 22 adult patients, referred to a tertiary sleep disorders service with possible sleepwalking/night terrors, diagnosis was confirmed both clinically and polysomnographically, and only six patients had a history of such trauma. More commonly these described sleepwalking/night terrors are associated with vivid dream-like experiences or behaviour related to flight from attack. Two such cases, suggestive of a dissociative process, are described in more detail.
The results of this study are presented largely on account of the negative findings. Scores on the dissociation questionnaire (DIS-Q) were normal, although generally higher in the small "trauma" subgroup. These were similar to scores characterising individuals with post-traumatic stress disorder. This "trauma" group also scored particularly highly on the anxiety, phobic, and depression scales of the Crown-Crisp experiential index. In contrast the "no trauma" group scored more specifically highly on the anxiety scale, along with major trends to high depression and hysteria scale scores. Two cases are presented which illustrate exceptional occurrence of later onset of sleepwalking/night terrors with accompanying post-traumatic symptoms during wakefulness. It is concluded that a history of major psychological trauma exists in only a minority of adult patients presenting with sleepwalking/night terror syndrome. In this subgroup trauma appears to dictate the subsequent content of the attacks. However, the symptoms express themselves within the form of the sleepwalking/night terror syndrome rather than as rapid eye movement sleep related nightmares. The main group of subjects with the syndrome and with no history of major psychological trauma show no clinical or DIS-Q evidence of dissociation during wakefulness. The proposition that, within the character structure of this group, the mechanism still operates but exclusively within sleep remains a possibility.


Keywords: sleepwalking; night terrors; dissociation; post-traumatic stress disorder PMID:11264487

The mediating role of emotion dysregulation and depression on the relationship between childhood trauma exposure and emotional eating.

PubMed

Michopoulos, Vasiliki; Powers, Abigail; Moore, Carla; Villarreal, Stephanie; Ressler, Kerry J; Bradley, Bekh

2015-08-01

Exposure to childhood adversity is implicated in the etiology of adverse health outcomes, including depression, posttraumatic stress disorder (PTSD), and obesity. The relationship between childhood trauma and obesity may be related to the association of childhood trauma and risk for emotional eating. One pathway between trauma exposure, psychopathology, and emotional eating may be through emotion dysregulation and depression. The current study was undertaken to characterize demographic, environmental, and psychological risk factors for emotional eating in a primarily African American, low socioeconomic status (SES), inner-city population (N = 1110). Emotional eating was measured using the Dutch Eating Behavioral Questionnaire and the Emotional Dysregulation Scale was used to assess emotion regulation. The Beck Depression Inventory and the modified PTSD Symptom Scale were used to assess depression and PTSD, respectively. Higher levels of emotional eating were associated with body mass index, income, childhood and adulthood trauma exposure, depressive and PTSD symptoms, negative affect and emotion dysregulation. Childhood emotional abuse was the most associated with emotional eating in adulthood. Hierarchical linear regression and mediation analyses indicated that the association between childhood trauma exposure (and emotional abuse specifically) and emotional eating was fully mediated by depression symptoms and emotion dysregulation, with emotional dysregulation contributing more to the mediation effect. Together these findings support a model in which obesity and related adverse health outcomes in stress- and trauma-exposed populations may be directly related to self-regulatory coping strategies accompanying emotion dysregulation. Our data suggest that emotion dysregulation is a viable therapeutic target for emotional eating in at-risk populations. Copyright © 2015 Elsevier Ltd. All rights reserved.

Scoring severity in trauma: comparison of prehospital scoring systems in trauma ICU patients.

PubMed

Llompart-Pou, J A; Chico-Fernández, M; Sánchez-Casado, M; Salaberria-Udabe, R; Carbayo-Górriz, C; Guerrero-López, F; González-Robledo, J; Ballesteros-Sanz, M Á; Herrán-Monge, R; Servià-Goixart, L; León-López, R; Val-Jordán, E

2017-06-01

We evaluated the predictive ability of mechanism, Glasgow coma scale, age and arterial pressure (MGAP), Glasgow coma scale, age and systolic blood pressure (GAP), and triage-revised trauma Score (T-RTS) scores in patients from the Spanish trauma ICU registry using the trauma and injury severity score (TRISS) as a reference standard. Patients admitted for traumatic disease in the participating ICU were included. Quantitative data were reported as median [interquartile range (IQR), categorical data as number (percentage)]. Comparisons between groups with quantitative variables and categorical variables were performed using Student's T Test and Chi Square Test, respectively. We performed receiving operating curves (ROC) and evaluated the area under the curve (AUC) with its 95 % confidence interval (CI). Sensitivity, specificity, positive predictive and negative predictive values and accuracy were evaluated in all the scores. A value of p < 0.05 was considered significant. The final sample included 1361 trauma ICU patients. Median age was 45 (30-61) years. 1092 patients (80.3 %) were male. Median ISS was 18 (13-26) and median T-RTS was 11 (10-12). Median GAP was 20 (15-22) and median MGAP 24 (20-27). Observed mortality was 17.7 % whilst predicted mortality using TRISS was 16.9 %. The AUC in the scores evaluated was: TRISS 0.897 (95 % CI 0.876-0.918), MGAP 0.860 (95 % CI 0.835-0.886), GAP 0.849 (95 % CI 0.823-0.876) and T-RTS 0.796 (95 % CI 0.762-0.830). Both MGAP and GAP scores performed better than the T-RTS in the prediction of hospital mortality in Spanish trauma ICU patients. Since these are easy-to-perform scores, they should be incorporated in clinical practice as a triaging tool.

78 FR 42148 - North Carolina Disaster #NC-00052

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-15

... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 13651 and 13652] North Carolina Disaster NC... Administrative declaration of a disaster for the State of North Carolina dated 07/09/2013. Incident: Severe... the disaster: Primary Counties: Stanly. Contiguous Counties: North Carolina: Anson, Cabarrus, Davidson...

Education Matters, December 2008

ERIC Educational Resources Information Center

Beckner, Gary, Ed.; Prause, Kelley, Ed.

2008-01-01

"Education Matters" is the monthly newsletter of the Association of American Educators (AAE), an organization dedicated to advancing the American teaching profession through personal growth, professional development, teacher advocacy and protection. This issue of the newsletter includes: (1) Historical Change (Barbara R. Davidson); (2)…

Admissions for isolated nonoperative mild head injuries: Sharing the burden among trauma surgery, neurosurgery, and neurology.

PubMed

Zhao, Ting; Mejaddam, Ali Y; Chang, Yuchiao; DeMoya, Marc A; King, David R; Yeh, Daniel D; Kaafarani, Haytham M A; Alam, Hasan B; Velmahos, George C

2016-10-01

Isolated nonoperative mild head injuries (INOMHI) occur with increasing frequency in an aging population. These patients often have multiple social, discharge, and rehabilitation issues, which far exceed the acute component of their care. This study was aimed to compare the outcomes of patients with INOMHI admitted to three services: trauma surgery, neurosurgery, and neurology. Retrospective case series (January 1, 2009 to August 31, 2013) at an academic Level I trauma center. According to an institutional protocol, INOMHI patients with Glasgow Coma Scale (GCS) of 13 to 15 were admitted on a weekly rotational basis to trauma surgery, neurosurgery, and neurology. The three populations were compared, and the primary outcomes were survival rate to discharge, neurological status at hospital discharge as measured by the Glasgow Outcome Score (GOS), and discharge disposition. Four hundred eighty-eight INOMHI patients were admitted (trauma surgery, 172; neurosurgery, 131; neurology, 185). The mean age of the study population was 65.3 years, and 58.8% of patients were male. Seventy-seven percent of patients has a GCS score of 15. Age, sex, mechanism of injury, Charlson Comorbidity Index, Injury Severity Score, Abbreviated Injury Scale in head and neck, and GCS were similar among the three groups. Patients who were admitted to trauma surgery, neurosurgery and neurology services had similar proportions of survivors (98.8% vs 95.7% vs 94.7%), and discharge disposition (home, 57.0% vs 61.6% vs 55.7%). The proportion of patients with GOS of 4 or 5 on discharge was slightly higher among patients admitted to trauma (97.7% vs 93.0% vs 92.4%). In a logistic regression model adjusting for Charlson Comorbidity Index CCI and Abbreviated Injury Scale head and neck scores, patients who were admitted to neurology or neurosurgery had significantly lower odds being discharged with GOS 4 or 5. While the trauma group had the lowest proportion of repeats of brain computed tomography (61.6%), the neurosurgery group had the highest proportion of intensive care unit admission (29.8%), and the neurology group had the longest emergency department stay (7.5 hours), there were no significant differences in duration of hospital stay, in-hospital complications, and readmission within 30 days. Although there were differences in use of health care resources, and the proportion of patients with GOS of 4 or 5 on discharge was slightly higher among patients admitted to trauma, most clinical outcomes were similar in INOMHI patients admitted to trauma surgery, neurosurgery, or neurology in our institution. A rotational policy of admitting INOMHI patients is feasible among services with expertise in and commitment to the care of these patients. Therapeutic/care management study, level IV.

Measuring historical trauma in an American Indian Community Sample: Contributions of substance dependence, affective disorder, conduct disorder and PTSD

PubMed Central

Ehlers, Cindy L.; Gizer, Ian R.; Gilder, David A.; Ellingson, Jarrod M.; Yehuda, Rachel

2013-01-01

Background The American Indian experience of historical trauma is thought of as both a source of intergenerational trauma responses as well as a potential causative factor for long-term distress and substance abuse among communities. The aims of the present study were to evaluate the extent to which the frequency of thoughts of historical loss and associated symptoms are influenced by: current traumatic events, post traumatic stress disorder (PTSD), cultural identification, percent Native American Heritage, substance dependence, affective/anxiety disorders, and conduct disorder/antisocial personality disorder (ASPD). Methods Participants were American Indians recruited from reservations that were assessed with the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA), The Historical Loss Scale and The Historical Loss Associated Symptoms Scale (to quantify frequency of thoughts and symptoms of historical loss) the Stressful-Life-Events Scale (to assess experiences of trauma) and the Orthogonal Cultural Identification Scale (OCIS). Results Three hundred and six (306) American Indian adults participated in the study. Over half of them indicated that they thought about historical losses at least occasionally, and that it caused them distress. Logistic regression revealed that significant increases in how often a person thought about historical losses were associated with: not being married, high degrees of Native Heritage, and high cultural identification. Additionally, anxiety/affective disorders and substance dependence were correlated with historical loss associated symptoms. Conclusions In this American Indian community, thoughts about historical losses and their associated symptomatology are common and the presences of these thoughts are associated with Native American Heritage, cultural identification, and substance dependence. PMID:23791028

The relationship of psychological trauma with trichotillomania and skin picking.

PubMed

Özten, Eylem; Sayar, Gökben Hızlı; Eryılmaz, Gül; Kağan, Gaye; Işık, Sibel; Karamustafalıoğlu, Oğuz

2015-01-01

Interactions between psychological, biological and environmental factors are important in development of trichotillomania and skin picking. The aim of this study is to determine the relationship of traumatic life events, symptoms of post-traumatic stress disorder and dissociation in patients with diagnoses of trichotillomania and skin picking disorder. The study included patients who was diagnosed with trichotillomania (n=23) or skin picking disorder (n=44), and healthy controls (n=37). Beck Depression Inventory, Traumatic Stress Symptoms Scale and Dissociative Experiences Scale were administered. All groups checked a list of traumatic life events to determine the exposed traumatic events. There was no statistical significance between three groups in terms of Dissociative Experiences Scale scores (P=0.07). But Beck Depression Inventory and Traumatic Stress Symptoms Scale scores of trichotillomania and skin picking groups were significantly higher than the control group. Subjects with a diagnosis of trichotillomania and skin picking reported statistically significantly higher numbers of traumatic and negative events in childhood compared to healthy subjects. We can conclude that trauma may play a role in development of both trichotillomania and skin picking. Increased duration of trichotillomania or skin picking was correlated with decreased presence of post-traumatic stress symptoms. The reason for the negatively correlation of severity of post-traumatic stress symptoms and self-harming behavior may be speculated as developing trichotillomania or skin picking symptoms helps the patient to cope with intrusive thoughts related to trauma. Future longitudinal research must focus on whether trauma and post-traumatic stress or trichotillomania and skin picking precede the development of mental disorder.

Long-term outcome in 324 polytrauma patients: what factors are associated with posttraumatic stress disorder and depressive disorder symptoms?

PubMed

Falkenberg, Lisa; Zeckey, Christian; Mommsen, Philipp; Winkelmann, Marcel; Zelle, Boris A; Panzica, Martin; Pape, Hans-Christoph; Krettek, Christian; Probst, Christian

2017-10-30

Physical impairment is well-known to last for many years after a severe injury, and there is a high impact on the quality of the survivor's life. The purpose of this study was to examine if this is also true for psychological impairment with symptoms of posttraumatic stress disorder or depression after polytrauma. Retrospective cohort outcome study. Level I trauma centre. 637 polytrauma trauma patients who were treated at our Level I trauma centre between 1973 and 1990. Minimum follow-up was 10 years after the injury. Patients were asked to fill in a questionnaire, including parts of the Posttraumatic Stress Diagnostic Scale, the Impact of Event Scale-Revised and the German Hospital Anxiety and Depression Scale, to evaluate mental health. Clinical outcome was assessed before by standardised scores. Three hundred and twenty-four questionnaires were evaluated. One hundred and forty-nine (45.9%) patients presented with symptoms of mental impairment. Quality of life was significantly higher in the mentally healthy group, while the impaired group achieved a lower rehabilitation status. Mental impairment can be found in multiple trauma victims, even after 10 years or more. Treating physicians should not only focus on early physical rehabilitation but also focus on early mental rehabilitation to prevent long-term problems in both physical and mental disability.

Investigating the Impact of Past Trauma and Defense Styles on Posttraumatic Stress Following Homicide and Psychiatric Co-morbidity.

PubMed

Di, Xiaohua; Chung, Man Cheung; Wan, King Hung

2018-06-01

To examine the prevalence of PTSD following homicide and investigate the relationship between PTSD from past traumas, defense styles and PTSD following homicide and psychiatric co-morbidity. 167 male homicide perpetrators participated in the study and completed the Posttraumatic Stress Diagnostic Scale, the General Health Questionnaire-28 and the Defense Styles Questionnaire. 45% met the criteria for PTSD following homicide and 55% for no-PTSD. With the number of times for imprisonment adjusted, regression analyses showed that immature defense style was associated with PTSD following homicide with the severity of PTSD from past traumas as a moderator. Neurotic and immature defense styles and PTSD from past trauma were significantly and independently associated with psychiatric co-morbidity. Homicide perpetrators could develop PTSD following homicide. The severity of PTSD from past traumas could affect PTSD following homicide and other psychological problems, and influence the effect of using immature defense against PTSD from homicide. Past trauma, immature and neurotic defense styles had a unique and specific pattern of influence on psychological symptoms, other than trauma symptoms.

Reduced Trauma Symptoms and Perceived Stress in Male Prison Inmates through the Transcendental Meditation Program: A Randomized Controlled Trial.

PubMed

Nidich, Sanford; O'connor, Tom; Rutledge, Thomas; Duncan, Jeff; Compton, Blaze; Seng, Angela; Nidich, Randi

2016-01-01

Trauma events are four times more prevalent in inmates than in the general public and are associated with increased recidivism and other mental and physical health issues. To evaluate the effects of Transcendental Meditation (TM) on trauma symptoms in male inmates. One hundred eighty-one inmates with a moderate- to high-risk criminal profile were randomly assigned to either the TM program or to a usual care control group. The Trauma Symptom Checklist and the Perceived Stress Scale were administered at baseline and four-month posttest. Significant reductions in total trauma symptoms, anxiety, depression, dissociation, and sleep disturbance subscales, and perceived stress in the TM group were found compared with controls (all p values < 0.001). The high-trauma subgroup analysis further showed a higher magnitude of effects in the TM group compared with controls on all outcomes, with Cohen effect sizes ranging from 0.67 to 0.89. Results are consistent with those of prior studies of the TM program in other populations and its effects on trauma symptoms and perceived stress.

Motorcycle-related hospitalization of adolescents in a Level I trauma center in southern Taiwan: a cross-sectional study.

PubMed

Liang, Chi-Cheng; Liu, Hang-Tsung; Rau, Cheng-Shyuan; Hsu, Shiun-Yuan; Hsieh, Hsiao-Yun; Hsieh, Ching-Hua

2015-08-28

The aim of this study was to investigate and compare the injury pattern, mechanisms, severity, and mortality of adolescents and adults hospitalized for treatment of trauma following motorcycle accidents in a Level I trauma center. Detailed data regarding patients aged 13-19 years (adolescents) and aged 30-50 years (adults) who had sustained trauma due to a motorcycle accident were retrieved from the Trauma Registry System between January 1, 2009 and December 31, 2012. The Pearson's chi-squared test, Fisher's exact test, or the independent Student's t-test were performed to compare the adolescent and adult motorcyclists and to compare the motorcycle drivers and motorcycle pillion. Analysis of Abbreviated Injury Scale (AIS) scores revealed that the adolescent patients had sustained higher rates of facial, abdominal, and hepatic injury and of cranial, mandibular, and femoral fracture but lower rates of thorax and extremity injury; hemothorax; and rib, scapular, clavicle, and humeral fracture compared to the adults. No significant differences were found between the adolescents and adults regarding Injury Severity Score (ISS), New Injury Severity Score (NISS), Trauma-Injury Severity Score (TRISS), mortality, length of hospital stay, or intensive care unit (ICU) admission rate. A significantly greater percentage of adolescents compared to adults were found not to have worn a helmet. Motorcycle riders who had not worn a helmet were found to have a significantly lower first Glasgow Coma Scale (GCS) score, and a significantly higher percentage was found to present with unconscious status, head and neck injury, and cranial fracture compared to those who had worn a helmet. Adolescent motorcycle riders comprise a major population of patients hospitalized for treatment of trauma. This population tends to present with a higher injury severity compared to other hospitalized trauma patients and a bodily injury pattern differing from that of adult motorcycle riders, indicating the need to emphasize use of protective equipment, especially helmets, to reduce their rate and severity of injury.

Measuring spine fracture outcomes: common scales and checklists.

PubMed

Schoenfeld, Andrew J; Bono, Christopher M

2011-03-01

Although outcome instruments have been used extensively in spine surgical research, few studies at present specifically address their use in investigations regarding spine trauma. In this review we provide a summary of the outcome instruments used most frequently in spine trauma research, identify the unique challenges of studying outcomes of spine trauma patients, and propose an integrated approach that may be beneficial for future studies. We reviewed the use of outcome instruments applicable to spine trauma research, including generic health measures, inventories of back-specific function, pain scales, health related quality of life (HRQOL) instruments, and radiographic determinants of outcome. Several inventories have been utilised to measure clinical outcomes following spinal trauma. Excluding measures of neurological function (e.g. ASIA motor score), none have been specifically validated for use with spine fractures. The SF-36, RMDQ, and ODI are amongst the most commonly used instruments. Importantly, the use of validated functional outcome measures in spine trauma research is hampered by the fact that the pre-morbid state of patients who sustain spine trauma may not be accurately represented by normative values established for the general population. The VAS is used most frequently to assess degree of neck and back pain. Most studies have relied on non-validated measures to determine radiographic results of treatment, although more elegant radiographic metrics exist. Functional outcome measurement of traumatically injured spine patients is challenging because available generic and spine-specific instruments were not designed for or validated in this population. Furthermore, no single inventory is capable of capturing global data necessary to evaluate results following these injuries. Investigations seeking to quantify outcomes following spine trauma should consider the use of a combination of existing surveys in a complementary fashion that should include a generic health survey, a measure of back-specific function, and determinants of bodily pain and work-related disability. Copyright © 2010 Elsevier Ltd. All rights reserved.

Aged care managers' perceptions of staff preparedness for caring for older survivors of genocide and mass trauma in Australia: How prepared are aged care workers?

PubMed

Teshuva, Karen; Wells, Yvonne

2017-03-01

To investigate aged care managers' perceptions of staff preparedness for working with older people who experienced genocide or mass trauma earlier in their lives (referred to in this paper as 'older survivors'). A survey of 60 aged care service managers was conducted (50% response rate). Trauma knowledge and skills scales with Cronbach's alpha scores of 0.74 and 0.90 respectively, were used. Scores across groups were compared using Student's t-tests. Three-quarters of the respondents reported that their agency had provided aged care services for older survivors. The majority of these managers perceived their staff to be moderately informed about trauma-related issues and half rated staff trauma-related skills positively. These ratings were positively associated with trauma-related staff training, service type and service location. Results suggest that, overall, managers perceive a need to improve aged care staff's preparedness for providing care for older survivors. © 2016 AJA Inc.

The transmission of trauma in refugee families: associations between intra-family trauma communication style, children's attachment security and psychosocial adjustment.

PubMed

Dalgaard, Nina Thorup; Todd, Brenda Kathryn; Daniel, Sarah I F; Montgomery, Edith

2016-01-01

This study explores the transmission of trauma in 30 Middle Eastern refugee families in Denmark, where one or both parents were referred for treatment of PTSD symptoms and had non-traumatized children aged 4-9 years. The aim of the study was to explore potential risk and protective factors by examining the association between intra-family communication style regarding the parents' traumatic experiences from the past, children's psychosocial adjustment and attachment security. A negative impact of parental trauma on children might be indicated, as children's Total Difficulties Scores on the Strengths and Difficulties Questionnaire (SDQ) were significantly higher than the Danish norms. A negative association between children's attachment security as measured by the Attachment and Traumatization Story Task and higher scores on the SDQ Total Difficulties Scale approached significance, suggesting that the transmission of trauma may be associated with disruptions in children's attachment representations. Furthermore a significant association between parental trauma communication and children's attachment style was found.

Assessing the Sensitivity and Specificity of the MAYSI-2 for Detecting Trauma among Youth in Juvenile Detention

ERIC Educational Resources Information Center

Kerig, Patricia K.; Moeddel, Melissa Arnzen; Becker, Stephen P.

2011-01-01

This study investigated the sensitivity and specificity of the most widely used mental health screening instrument in juvenile detention, the Massachusetts Youth Screening Instrument (MAYSI-2), for detecting trauma and symptoms of posttraumatic stress disorder (PTSD) among detained youth. The MAYSI-2 scales measuring Substance Use,…

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

ERIC Educational Resources Information Center

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…

An Exploratory Examination of the Associations among Racial and Ethnic Discrimination, Racial Climate, and Trauma-Related Symptoms in a College Student Population

ERIC Educational Resources Information Center

Pieterse, Alex L.; Carter, Robert T.; Evans, Sarah A.; Walter, Rebecca A.

2010-01-01

In this study, we examined the association among perceptions of racial and/or ethnic discrimination, racial climate, and trauma-related symptoms among 289 racially diverse college undergraduates. Study measures included the Perceived Stress Scale, the Perceived Ethnic Discrimination Questionnaire, the Posttraumatic Stress Disorder…

Pressure ulcer development in trauma patients with suspected spinal injury; the influence of risk factors present in the Emergency Department.

PubMed

Ham, H W Wietske; Schoonhoven, L Lisette; Schuurmans, M Marieke J; Leenen, L Luke P H

2017-01-01

To explore the influence of risk factors present at Emergency Department admission on pressure ulcer development in trauma patients with suspected spinal injury, admitted to the hospital for evaluation and treatment of acute traumatic injuries. Prospective cohort study setting level one trauma center in the Netherlands participants adult trauma patients transported to the Emergency Department on a backboard, with extrication collar and headblocks and admitted to the hospital for treatment or evaluation of their injuries. Between January and December 2013, 254 trauma patients were included. The following dependent variables were collected: Age, Skin color and Body Mass Index, and Time in Emergency Department, Injury Severity Score, Mean Arterial Pressure, hemoglobin level, Glasgow Coma Score, and admission ward after Emergency Department. Pressure ulcer development during admission was associated with a higher age (p 0.00, OR 1.05) and a lower Glasgow Coma Scale score (p 0.00, OR 1.21) and higher Injury Severity Scores (p 0.03, OR 1.05). Extra nutrition decreases the probability of PU development during admission (p 0.04, OR 0.20). Pressure ulcer development within the first 48h of admission was positively associated with a higher age (p 0.01, OR 1.03) and a lower Glasgow Coma Scale score (p 0.01, OR 1.16). The proportion of patients admitted to the Intensive Care Unit and Medium Care Unit was higher in patients with pressure ulcers. The pressure ulcer risk during admission is high in patients with an increased age, lower Glasgow Coma Scale and higher Injury Severity Score in the Emergency Department. Pressure ulcer risk should be assessed in the Emergency Department to apply preventive interventions in time. Copyright © 2016 Elsevier Ltd. All rights reserved.

Childhood trauma is associated with depressive symptoms in Mexico City women.

PubMed

Openshaw, Maria; Thompson, Lisa M; de Pheils, Pilar Bernal; Mendoza-Flores, Maria Eugenia; Humphreys, Janice

2015-05-01

To describe childhood trauma and depressive symptoms in Mexican women and to explore the relationships between number and type of childhood traumatic events and depressive symptoms. A community-based sample of 100 women was interviewed using a demographic questionnaire, the Life Stressor Checklist-Revised (LSC-R), and the Center for Epidemiologic Studies Depression Scale (CES-D). Childhood trauma (trauma at or before 16 years of age) and depressive symptoms were described, and logistic and linear regressions were used to analyze the relationship between childhood traumatic events and current depressive symptoms. Participants reported a mean of 9.46 (standard deviation (SD): 4.18) lifetime traumas and 2.76 (SD: 2.34) childhood traumas. The mean CES-D score was 18.9 (SD: 12.0) and 36.0% of participants had clinically significant depression (CES-D > 24). Depression scores were correlated with lifetime trauma, childhood trauma, education level, employment status, and number of self-reported current medical conditions. Depression scores were not significantly correlated with age, marital status, number of children, or socioeconomic status. For every additional childhood trauma experienced, the odds of clinically significant depressive symptoms (CES-D > 24) increased by 50.0% (adjusted odds ratio (OR): 1.50; 95% confidence interval: 1.14-1.96), after controlling for number of children, age, education level, employment status, and number of self-reported medical conditions. The results indicated that the number of childhood trauma exposures is associated with current depression among urban Mexican women, suggesting a need for trauma-informed care in this setting.

Personality traits as possible mediators in the relationship between childhood trauma and depressive symptoms in Chinese adolescents.

PubMed

Zhang, Minli; Han, Juan; Shi, Junxin; Ding, Huisi; Wang, Kaiqiao; Kang, Chun; Gong, Jiangling

2018-08-01

Childhood trauma has been found to be a critical risk factor for depression in adolescents. Personality traits have been linked with mental health. However, the relationship between childhood trauma, personality traits, and depressive symptoms in adolescents is largely unclear. This study tried to examine the mediating effect of personality traits between childhood trauma and depressive symptoms among adolescents. Meanwhile, the possible bidirectional association between personality traits and depression was considered in the study. A group of community-based adolescents aged 10-17 years (N = 5793) were recruited from nine schools in Wuhan city, China. The participants completed self-report questionnaires, including the Center for Epidemiologic Studies Depression Scale (CES-D), the Childhood Trauma Questionnaire (CTQ) and the NEO-Five Factor Inventory (NEO-FFI). Results showed that childhood trauma experiences were positively related with depressive symptoms and neuroticism, and negatively related with extraversion and conscientiousness; depressive symptoms were related with high neuroticism, low extraversion, and conscientiousness. Neuroticism and extraversion partially mediated the relationship between childhood trauma and depressive symptoms. And 'childhood trauma-personality traits-depression' models showed better property than the alternative models of 'childhood trauma-depression-personality traits'. The current study provides preliminary evidence for mediation roles of neuroticism and extraversion in the effect of childhood trauma to depressive symptoms in adolescents. These findings may contribute to better prevention and interventions for depressive symptoms among adolescents with childhood trauma via personality traits improvement. Copyright © 2018. Published by Elsevier Ltd.

24. Historic American Buildings Survey, W. Jeter Eason Deputy District ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

24. Historic American Buildings Survey, W. Jeter Eason- Deputy District Officer, Photographer November 21, 1936 PLASTER ORNAMENT ON CEILING AND PLASTER CORNICE BACK PARLOR (FRONT PARLOR SIMLAR). - The Hermitage, U.S. Highway 70 North (4580 Rachel's Lane), Nashville, Davidson County, TN

77 FR 67324 - Proposed Flood Elevation Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-09

...). Specifically, it addresses the flooding sources Big Run, Little Loyalsock Creek, Loyalsock Creek, and Muncy..., Pennsylvania (All Jurisdictions)'' addressed the flooding sources Big Run, Little Loyalsock Creek, Loyalsock... Sullivan County, Pennsylvania (All Jurisdictions) Big Run At the Muncy Creek +968 +965 Township of Davidson...

27 CFR 9.174 - Yadkin Valley.

Code of Federal Regulations, 2010 CFR

2010-04-01

...”. (b) Approved maps. The appropriate maps for determining the boundaries of the Yadkin Valley...-Salem, N.C.; VA; Tenn. (1953, Limited Revision 1962), and, (2) Charlotte, North Carolina; South Carolina... North Carolina within Wilkes, Surry, Yadkin and portions of Stokes, Forsyth, Davidson, and Davie...

Document Design: Part 1.

ERIC Educational Resources Information Center

Andrews, Deborah C., Ed.; Dyrud, Marilyn, Ed.

1996-01-01

Presents four articles that provide suggestions for teaching document design: (1) "Teaching the Rhetoric of Document Design" (Michael J. Hassett); (2) "Teaching by Example: Suggestions for Assignment Design" (Marilyn A. Dyrud); (3) "Teaching the Page as a Visual Unit" (Bill Hart-Davidson); and (4) "Designing a…

Motorcycles on the Move

ERIC Educational Resources Information Center

McIntosh, Phyllis

2013-01-01

Motorcycles are the subject of this feature article, which explores such topics as the history of motorcycles, types of motorcycles, special interest motorcycle clubs, motorcycle rallies, the Harley-Davidson company, and Rolling Thunder. A list of websites of interest and a glossary of "motorcycle jargon" are included.

15 CFR Appendix F to Subpart M of... - Davidson Seamount Management Zone

Code of Federal Regulations, 2013 CFR

2013-01-01

... Trade (Continued) NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE OCEAN AND COASTAL RESOURCE MANAGEMENT NATIONAL MARINE SANCTUARY PROGRAM REGULATIONS Monterey Bay National Marine... [Coordinates in this appendix are unprojected (Geographic Coordinate System) and are calculated using the North...

15 CFR Appendix F to Subpart M of... - Davidson Seamount Management Zone

Code of Federal Regulations, 2012 CFR

2012-01-01

... Trade (Continued) NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE OCEAN AND COASTAL RESOURCE MANAGEMENT NATIONAL MARINE SANCTUARY PROGRAM REGULATIONS Monterey Bay National Marine... [Coordinates in this appendix are unprojected (Geographic Coordinate System) and are calculated using the North...

15 CFR Appendix F to Subpart M of... - Davidson Seamount Management Zone

Code of Federal Regulations, 2014 CFR

2014-01-01

... Trade (Continued) NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE OCEAN AND COASTAL RESOURCE MANAGEMENT NATIONAL MARINE SANCTUARY PROGRAM REGULATIONS Monterey Bay National Marine... [Coordinates in this appendix are unprojected (Geographic Coordinate System) and are calculated using the North...

A descriptive title

NASA Astrophysics Data System (ADS)

Martin, John C.; Williams, Steven C.; Darnley, Matt; Humphreys, Roberta M.

2017-06-01

In ATEL 10383 we reported the classical Luminous Blue Variable (Humphreys & Davidson, 1994) AF And = J004333.08+411210.3 = Var 19 in M31 (Hubble & Sandage, 1953) has brightened and grown redder over the last 800 days, indicating the start of a possible S Dor outburst.

Sociodemographic factors and health conditions associated with the resilience of people with chronic diseases: a cross sectional study 1

PubMed Central

Böell, Julia Estela Willrich; da Silva, Denise Maria Guerreiro Vieira; Hegadoren, Kathleen Mary

2016-01-01

ABSTRACT Objective: to investigate the association between resilience and sociodemographic variables and the health of people with chronic kidney disease and / or type 2 diabetes mellitus. Method: a cross-sectional observational study performed with 603 people with chronic kidney disease and / or type 2 diabetes mellitus. A tool to collect socio-demographic and health data and the Resilience Scale developed by Connor and Davidson were applied. A descriptive and multivariate analysis was performed. Results: the study participants had on average 61 years old (SD= 13.2), with a stable union (52.24%), religion (96.7%), retired (49.09%), with primary education (65%) and income up to three minimum wages. Participants with kidney disease showed less resilience than people with diabetes. Conclusion: the type of chronic illness, disease duration, body mass index and religious beliefs influenced the resilience of the study participants. PMID:27598377

When the brain does not adequately feel the body: Links between low resilience and interoception.

PubMed

Haase, Lori; Stewart, Jennifer L; Youssef, Brittany; May, April C; Isakovic, Sara; Simmons, Alan N; Johnson, Douglas C; Potterat, Eric G; Paulus, Martin P

2016-01-01

This study examined neural processes of resilience during aversive interoceptive processing. Forty-six individuals were divided into three groups of resilience Low (LowRes), high (HighRes), and normal (NormRes), based on the Connor-Davidson Resilience Scale (2003). Participants then completed a task involving anticipation and experience of loaded breathing during functional magnetic resonance imaging (fMRI) recording. Compared to HighRes and NormRes groups, LowRes self-reported lower levels of interoceptive awareness and demonstrated higher insular and thalamic activation across anticipation and breathing load conditions. Thus, individuals with lower resilience show reduced attention to bodily signals but greater neural processing to aversive bodily perturbations. In low resilient individuals, this mismatch between attention to and processing of interoceptive afferents may result in poor adaptation in stressful situations. Copyright © 2015 Elsevier B.V. All rights reserved.

Psychosocial Factors Associated with Resilience in a National Community-Based Cohort of Australian Gay Men Living with HIV.

PubMed

Lyons, Anthony; Heywood, Wendy; Rozbroj, Tomas

2016-08-01

HIV-positive gay men may experience multiple sources of adversity and stress, related both to their HIV diagnosis and sexual identity. Most of these men, however, do not experience mental health problems. Little is known about factors that help them achieve resilience in the face of life challenges. This study examined psychosocial factors associated with resilience in a national community-based sample of 357 Australian HIV-positive gay men. Resilience was measured using the Connor-Davidson Resilience Scale. Higher levels of resilience were linked with experiencing low or no internalized HIV-related stigma, having no previous history of mental health problems, and a number of socioeconomic indicators. In addition to providing a more complete picture of the mental health of HIV-positive gay men, findings from this study can be used to inform strength-based approaches to mental health prevention and support.

Pharmacist's impact on acute pain management during trauma resuscitation.

PubMed

Montgomery, Kayla; Hall, A Brad; Keriazes, Georgia

2015-01-01

The timely administration of analgesics is crucial to the comprehensive management of trauma patients. When an emergency department (ED) pharmacist participates in trauma resuscitation, the pharmacist acts as a medication resource for trauma team members and facilitates the timely administration of analgesics. This study measured the impact of a pharmacist on time to first analgesic dose administered during trauma resuscitation. All adult (>18 years) patients who presented to this level II trauma center via activation of the trauma response system between January 1, 2009, and May 31, 2013, were screened for eligibility. For inclusion, patients must have received intravenous fentanyl, morphine, or hydromorphone in the trauma bay. The time to medication administration was defined as the elapsed time from ED arrival to administration of first analgesic. There were 1328 trauma response system activations during the study period; of which 340 patients were included. The most common analgesic administered was fentanyl (62% in both groups). When a pharmacist was participating, the mean time to first analgesic administered was decreased (17 vs 21 minutes; P = .03). Among the 78% of patients with documented pain scores, the overall mean reduction in pain scores from ED arrival to ED discharge was similar between the 2 groups. There was a 2.4 point reduction with a pharmacist versus 2.7 without a pharmacist, using a 0 to 10 numeric pain rating scale. The participation of a clinical pharmacist during trauma resuscitation significantly decreased the time to first analgesic administration in trauma patients. The results of this study supplement the literature supporting the integration of clinical ED pharmacists on trauma teams.

Characterization of Water and CO2 Adsorption by Stores 3A Desiccant Samples Using Thermal Gravimetric Analysis and Fourier Transform Infrared Spectroscopy

DOE Office of Scientific and Technical Information (OSTI.GOV)

RIVERA, DION A.; ALAM, M. KATHLEEN; MARTIN, LAURA

2003-02-01

Two lots of manufactured Type 3a zeolite samples were compared by TGA/IR analysis. The first lot, obtained from Davidson Chemical, a commercial vendor, was characterized during the previous study cycle for its water and water-plus-CO{sub 2} uptake in order to determine whether CO{sub 2} uptake prevented water adsorption by the zeolite. It was determined that CO{sub 2} did not hamper water adsorption using the Davidson zeolite. CO{sub 2} was found on the zeolite surface at dewpoints below -40 C, however it was found to be reversibly adsorbed. During the course of the previous studies, chemical analyses revealed that the Davidsonmore » 3a zeolite contained calcium in significant quantities, along with the traditional counterions potassium and sodium. Chemical analysis of a Type 3a zeolite sample retrieved from Kansas City (heretofore referred to as the ''Stores 3a'' sample) indicated that the Stores sample was a more traditional Type 3a zeolite, containing no calcium. TGA/IR studies this year focused on obtaining CO{sub 2} and water absorbance data from the Stores 3a zeolite. Within the Stores 3a sample, CO{sub 2} was found to be reversibly absorbed within the sample, but only at and below -60 C with 5% CO{sub 2} loading. The amount of CO{sub 2} observed eluting from the Stores zeolite at this condition was similar to what was observed from the Davidson zeolite sample but with a greater uncertainty in the measured value. The results of the Stores 3a studies are summarized within this report.« less

Epidemiology and risk factors of multiple-organ failure after multiple trauma: an analysis of 31,154 patients from the TraumaRegister DGU.

PubMed

Fröhlich, Matthias; Lefering, Rolf; Probst, Christian; Paffrath, Thomas; Schneider, Marco M; Maegele, Marc; Sakka, Samir G; Bouillon, Bertil; Wafaisade, Arasch

2014-04-01

In the severely injured who survive the early posttraumatic phase, multiple-organ failure (MOF) is the main cause of morbidity and mortality. An enhanced prediction of MOF might influence individual monitoring and therapy of severely injured patients. We performed a retrospective analysis of a nationwide prospective database, the TraumaRegister DGU of the German Trauma Society. Patients with complete data sets (2002-2011) and a relevant trauma load (Injury Severity Score [ISS] ≥ 16), who were admitted to an intensive care unit, were included. Of a total of 31,154 patients enclosed in this study, 10,201 (32.7%) developed an MOF according to the Sequential Organ Failure Assessment score. During the study period, mortality of all patients decreased from 18.1% in 2002 to 15.3% in 2011 (p < 0.001). Meanwhile, MOF occurred significantly more often (24.6% in 2002 vs. 31.5% in 2011, p < 0.001), but mortality of MOF patients decreased (42.6% vs. 33.3%, p < 0.001). MOF patients who died survived 2 days less (11 days in 2002 vs. 8.9 days in 2011, p < 0.001). Independent risk factors for the development of MOF following severe trauma were age, ISS, head Abbreviated Injury Scale (AIS) score of 3 or higher, thoracic AIS score of 3 or higher, male sex, Glasgow Coma Scale (GCS) score of 8 or less, mass transfusion, base excess of less than -3, systolic blood pressure less than 90 mm Hg at admission, and coagulopathy. Over one decade, we observed an ongoing decrease of mortality after multiple trauma, accompanied by decreasing mortality in the subgroup with MOF. However, incidence of MOF in the severely injured increased significantly. Thus, MOF after multiple trauma remains a challenge in intensive care. The risk factors from multivariate analysis could be instrumental in anticipating the early development of MOF. Furthermore, a reliable prediction model might be supportive for patient enrolment in trauma studies, in which MOF marks the primary end point. Epidemiologic study, level III.

The Compassion Fatigue Scale: Its Use With Social Workers Following Urban Disaster

PubMed Central

Adams, Richard E.; Figley, Charles R.; Boscarino, Joseph A.

2008-01-01

Objective The present study has two goals: to assess the difference between secondary trauma and job burnout and to examine the utility of secondary trauma in predicting psychological distress. Method The data come from a survey of social workers (N = 236) living in New York City 20 months following the September 11 terrorist attacks on the World Trade Center (WTC). Results Social workers’ involvement in WTC recovery efforts is related to secondary trauma but not burnout. Analyses also reveal that both secondary trauma and burnout are related to psychological distress after controlling for other risk factors. Conclusion This study supports the importance of compassion fatigue as a risk factor for social workers counseling traumatized clients and its association with psychological problems. PMID:18458750

Secondary traumatic stress and vicarious trauma: a validational study.

PubMed

Jenkins, Sharon Rae; Baird, Stephanie

2002-10-01

Vicarious trauma (VT) and secondary traumatic stress (STS) or compassion fatigue both describe effects of working with traumatized persons on therapists. Despite conceptual similarities, their emphases differ: cognitive schemas vs. posttraumatic symptoms and burnout, respectively. The TSI Belief Scale (TSI-BSL) measures VT; the Compassion Fatigue Self-Test (CFST) for Psychotherapists measures STS. Neither has substantial psychometric evidence yet, nor has their association been studied. Results for 99 sexual assault and domestic violence counselors show concurrent validity between TSI-BSL and CFST, moderate convergence with burnout but useful discrimination, and strong convergence with general distress, but adequate independent shared variance. Counselors with interpersonal trauma histories scored higher on CFST, but not TSI-BSL or burnout, consistent with the CFST's emphasis on trauma symptomatology.

Pediatric trauma BIG score: predicting mortality in children after military and civilian trauma.

PubMed

Borgman, Matthew A; Maegele, Marc; Wade, Charles E; Blackbourne, Lorne H; Spinella, Philip C

2011-04-01

To develop a validated mortality prediction score for children with traumatic injuries. We identified all children (<18 years of age) in the US military established Joint Theater Trauma Registry from 2002 to 2009 who were admitted to combat-support hospitals with traumatic injuries in Iraq and Afghanistan. We identified factors associated with mortality using univariate and then multivariate regression modeling. The developed mortality prediction score was then validated on a data set of pediatric patients (≤ 18 years of age) from the German Trauma Registry, 2002-2007. Admission base deficit, international normalized ratio, and Glasgow Coma Scale were independently associated with mortality in 707 patients from the derivation set and 1101 patients in the validation set. These variables were combined into the pediatric "BIG" score (base deficit + [2.5 × international normalized ratio] + [15 - Glasgow Coma Scale), which were each calculated to have an area under the curve of 0.89 (95% confidence interval: 0.83-0.95) and 0.89 (95% confidence interval: 0.87-0.92) on the derivation and validation sets, respectively. The pediatric trauma BIG score is a simple method that can be performed rapidly on admission to evaluate severity of illness and predict mortality in children with traumatic injuries. The score has been shown to be accurate in both penetrating-injury and blunt-injury populations and may have significant utility in comparing severity of injury in future pediatric trauma research and quality-assurance studies. In addition, this score may be used to determine inclusion criteria on admission for prospective studies when accurately estimating the mortality for sample size calculation is required.

Development of the Vicarious Resilience Scale (VRS): A measure of positive effects of working with trauma survivors.

PubMed

Killian, Kyle; Hernandez-Wolfe, Pilar; Engstrom, David; Gangsei, David

2017-01-01

Attending to the potential impacts, both positive and negative, of clinical work with trauma survivors on professionals themselves is a crucial aspect of clinical training and supervision. Vicarious resilience refers to unique, positive effects that transform therapists in response to witnessing trauma survivors' resilience and recovery process. This study describes the development and exploratory factor analysis of the first instrument to assess vicarious resilience. The Vicarious Resilience Scale (VRS) was developed and administered via electronic survey to 190 helping professionals from around the globe working with survivors of severe traumas, such as torture. Exploratory factor analysis yielded 7 factors: Changes in life goals and perspective, client-inspired hope, increased recognition of clients' spirituality as a therapeutic resource, increased capacity for resourcefulness, increased self-awareness and self-care practices, increased consciousness about power and privilege relative to clients' social location, and increased capacity for remaining present while listening to trauma narratives. The Cronbach's alpha reliability of the VRS was .92 and, as hypothesized, the VRS was moderately and positively correlated with posttraumatic growth and compassion satisfaction, indicating convergent validity. The VRS was not significantly correlated with compassion fatigue (CF) or burnout, indicating discriminant validity and that vicarious resilience is a unique construct that is not merely "the opposite" of CF or burnout. The VRS possesses sound psychometric properties and can be utilized in supervision and training contexts and for self-assessment by professionals working with trauma survivors to aid the recognition and cultivation of vicarious resilience. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Extracting Sexual Trauma Mentions from Electronic Medical Notes Using Natural Language Processing.

PubMed

Divita, Guy; Brignone, Emily; Carter, Marjorie E; Suo, Ying; Blais, Rebecca K; Samore, Matthew H; Fargo, Jamison D; Gundlapalli, Adi V

2017-01-01

Patient history of sexual trauma is of clinical relevance to healthcare providers as survivors face adverse health-related outcomes. This paper describes a method for identifying mentions of sexual trauma within the free text of electronic medical notes. A natural language processing pipeline for information extraction was developed and scaled to handle a large corpus of electronic medical notes used for this study from US Veterans Health Administration medical facilities. The tool was used to identify sexual trauma mentions and create snippets around every asserted mention based on a domain-specific lexicon developed for this purpose. All snippets were evaluated by trained human reviewers. An overall positive predictive value (PPV) of 0.90 for identifying sexual trauma mentions from the free text and a PPV of 0.71 at the patient level are reported. The metrics are superior for records from female patients.

Dissociation, childhood trauma, and ataque de nervios among Puerto Rican psychiatric outpatients.

PubMed

Lewis-Fernández, Roberto; Garrido-Castillo, Pedro; Bennasar, Mari Carmen; Parrilla, Elsie M; Laria, Amaro J; Ma, Guoguang; Petkova, Eva

2002-09-01

This study examined the relationships of dissociation and childhood trauma with ataque de nervios. Forty Puerto Rican psychiatric outpatients were evaluated for frequency of ataque de nervios, dissociative symptoms, exposure to trauma, and mood and anxiety psychopathology. Blind conditions were maintained across assessments. Data for 29 female patients were analyzed. Among these 29 patients, clinician-rated dissociative symptoms increased with frequency of ataque de nervios. Dissociative Experiences Scale scores and diagnoses of panic disorder and dissociative disorders were also associated with ataque frequency, before corrections were made for multiple comparisons. The rate of childhood trauma was uniformly high among the patients and showed no relationship to dissociative symptoms and disorder or number of ataques. Frequent ataques de nervios may, in part, be a marker for psychiatric disorders characterized by dissociative symptoms. Childhood trauma per se did not account for ataque status in this group of female outpatients.

Assessing post-traumatic stress disorder in South African adolescents: using the child and adolescent trauma survey (CATS) as a screening tool

PubMed Central

Suliman, S; Kaminer, D; Seedat, S; Stein, DJ

2005-01-01

Background Several studies have demonstrated that South African children and adolescents are exposed to high levels of violent trauma with a significant proportion developing PTSD, however, limited resources make it difficult to accurately identify traumatized children. Methods A clinical interview (K-SADS-PL, selected modules) and self-report scale (CATS) were compared to determine if these different methods of assessment elicit similar information with regards to trauma exposure and post-traumatic stress disorder (PTSD) in adolescents. Youth (n = 58) from 2 schools in Cape Town, South Africa participated. Results 91% of youth reported having been exposed to a traumatic event on self-report (CATS) and 38% reported symptoms severe enough to be classified as PTSD. On interview (K-SADS-PL), 86% reported exposure to a traumatic event and 19% were found to have PTSD. While there were significant differences in the rates of trauma exposure and PTSD on the K-SADS and CATS, a cut-off value of 15 on the CATS maximized both the number of true positives and true negatives with PTSD. The CATS also differentiated well between adolescents meeting DSM-IV PTSD symptom criteria from adolescents not meeting criteria. Conclusions Our results indicate that trauma exposure and PTSD are prevalent in South African youth and if appropriate cut-offs are used, self-report scales may be useful screening tools for PTSD. PMID:15845137

Relationship between cognitive emotion regulation, social support, resilience and acute stress responses in Chinese soldiers: Exploring multiple mediation model.

PubMed

Cai, Wen-Peng; Pan, Yu; Zhang, Shui-Miao; Wei, Cun; Dong, Wei; Deng, Guang-Hui

2017-10-01

The current study aimed to explore the association of cognitive emotion regulation, social support, resilience and acute stress responses in Chinese soldiers and to understand the multiple mediation effects of social support and resilience on the relationship between cognitive emotion regulation and acute stress responses. A total of 1477 male soldiers completed mental scales, including the cognitive emotion regulation questionnaire-Chinese version, the perceived social support scale, the Chinese version of the Connor-Davidson resilience scale, and the military acute stress scale. As hypothesized, physiological responses, psychological responses, and acute stress were associated with negative-focused cognitive emotion regulation, and negatively associated with positive-focused cognitive emotion regulation, social supports and resilience. Besides, positive-focused cognitive emotion regulation, social support, and resilience were significantly associated with one another, and negative-focused cognitive emotion regulation was negatively associated with social support. Regression analysis and bootstrap analysis showed that social support and resilience had partly mediating effects on negative strategies and acute stress, and fully mediating effects on positive strategies and acute stress. These results thus indicate that military acute stress is significantly associated with cognitive emotion regulation, social support, and resilience, and that social support and resilience have multiple mediation effects on the relationship between cognitive emotion regulation and acute stress responses. Copyright © 2017 Elsevier B.V. All rights reserved.

Stress Management and Resiliency Training (SMART) program among Department of Radiology faculty: a pilot randomized clinical trial.

PubMed

Sood, Amit; Sharma, Varun; Schroeder, Darrell R; Gorman, Brian

2014-01-01

To test the efficacy of a Stress Management and Resiliency Training (SMART) program for decreasing stress and anxiety and improving resilience and quality of life among Department of Radiology physicians. The study was approved by the institutional review board. A total of 26 Department of Radiology physicians were randomized in a single-blind trial to either the SMART program or a wait-list control arm for 12 weeks. The program involved a single 90-min group session in the SMART training with two follow-up phone calls. Primary outcomes measured at baseline and week 12 included the Perceived Stress Scale, Linear Analog Self-Assessment Scale, Mindful Attention Awareness Scale, and Connor-Davidson Resilience Scale. A total of 22 physicians completed the study. A statistically significant improvement in perceived stress, anxiety, quality of life, and mindfulness at 12 weeks was observed in the study arm compared to the wait-list control arm; resilience also improved in the active arm, but the changes were not statistically significant when compared to the control arm. A single session to decrease stress among radiologists using the SMART program is feasible. Furthermore, the intervention afforded statistically significant and clinically meaningful improvement in anxiety, stress, quality of life, and mindful attention. Further studies including larger sample size and longer follow-up are warranted. Copyright © 2014. Published by Elsevier Inc.

Community Resilience, Psychological Resilience, and Depressive Symptoms: An Examination of the Mississippi Gulf Coast 10 Years After Hurricane Katrina and 5 Years After the Deepwater Horizon Oil Spill.

PubMed

Lee, Joohee; Blackmon, Bret J; Cochran, David M; Kar, Bandana; Rehner, Timothy A; Gunnell, Mauri Stubbs

2018-04-01

This study examined the role of community resilience and psychological resilience on depressive symptoms in areas on the Mississippi Gulf Coast that have experienced multiple disasters. Survey administration took place in the spring of 2015 to a spatially stratified, random sample of households. This analysis included a total of 294 subjects who lived in 1 of the 3 counties of the Mississippi Gulf Coast at the time of both Hurricane Katrina in 2005 and the Deepwater Horizon oil spill in 2010. The survey included the Communities Advancing Resilience Toolkit (CART) scale, the Connor-Davidson Resilience Scale (CD-RISC 10), and the Center for Epidemiologic Studies Depression Scale (CES-D). There was a significant inverse relationship between psychological resilience and depressive symptoms and a significant positive relationship between community resilience and psychological resilience. The results also revealed that community resilience was indirectly related to depressive symptoms through the mediating variable of psychological resilience. These findings highlight the importance of psychological resilience in long-term disaster recovery and imply that long-term recovery efforts should address factors associated with both psychological and community resilience to improve mental health outcomes. (Disaster Med Public Health Preparedness. 2018;12:241-248).

Posttraumatic Maladaptive Beliefs Scale: Evolution of the Personal Beliefs and Reactions Scale

ERIC Educational Resources Information Center

Vogt, Dawne S.; Shipherd, Jillian C.; Resick, Patricia A.

2012-01-01

The Posttraumatic Maladaptive Beliefs Scale (PMBS) was developed to measure maladaptive beliefs about current life circumstances that may occur following trauma exposure. This scale assesses maladaptive beliefs within three domains: (a) Threat of Harm, (b) Self-Worth and Judgment, and (c) Reliability and Trustworthiness of Others. Items for the…

78 FR 8089 - Proposed Flood Elevation Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-05

... flooding sources Big Run, Little Loyalsock Creek, Loyalsock Creek, and Muncy Creek. DATES: Comments are to..., Pennsylvania (All Jurisdictions)'' addressed the flooding sources Big Run, Little Loyalsock Creek, Loyalsock... Sullivan County, Pennsylvania (All Jurisdictions) Big Run At the Muncy Creek +968 +965 Township of Davidson...

Directions in Rehabilitation Counseling, 2001.

ERIC Educational Resources Information Center

Flach, Frederic, Ed.

2001-01-01

This volume of 12 lessons provides expert information on a variety of medical and psychological issues in rehabilitative counseling. The lessons, which may be applied toward continuing education credits, are: (1) "Integration of Psychiatric Treatment and Rehabilitation" (Jeanne Steiner, Larry Davidson, Michael A. Hoge, and Selby Jacobs);…

40 CFR 62.10630 - Identification of sources.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Emissions from Commercial and Industrial Solid Waste Incineration (ciswi) Units-Section 111(d)/129 Plan § 62.10630 Identification of sources. The Plan applies to existing Commercial and Industrial Solid Waste Incineration Units that Commenced Construction On or Before November 30, 1999, in Nashville/Davidson County...

40 CFR 62.10630 - Identification of sources.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Emissions from Commercial and Industrial Solid Waste Incineration (ciswi) Units-Section 111(d)/129 Plan § 62.10630 Identification of sources. The Plan applies to existing Commercial and Industrial Solid Waste Incineration Units that Commenced Construction On or Before November 30, 1999, in Nashville/Davidson County...

A tale of two telescopes: North Queensland and the 1882 transit of Venus

NASA Astrophysics Data System (ADS)

Orchiston, Wayne; Darlington, Vicki

2017-08-01

The 1882 transit of Venus offered the final opportunity for astronomers to use these rare events to pin down the distance from the Earth to the Sun. A British party based itself in southern Queensland, but total cloud cover prevented any observations being made on the critical day. In this paper we trace the preparations of the British party, and then show how they laid the foundations for the development of astronomy in Queensland by selling their two 6-in Cooke refractors before returning to Britain. Both instruments were purchased by a Townsville amateur astronomer, Edwin Norris, and although he installed one in an observatory, he made little use of it. However, he subsequently sold the other telescope to J. Ewen Davidson of Mackay, who also erected an obser-vatory for it. Davidson then used his instrument for cometary astronomy, in the process discovering two new comets, one of which now bears his name. Unfortunately, recent attempts to track down the present whereabouts of the two telescopes have failed.

Bending space–time: a commentary on Dyson, Eddington and Davidson (1920) ‘A determination of the deflection of light by the Sun's gravitational field’

PubMed Central

Longair, Malcolm

2015-01-01

The famous eclipse expedition of 1919 to Sobral, Brazil, and the island of Principe, in the Gulf of Guinea, led by Dyson, Eddington and Davidson was a turning point in the history of relativity, not only because of its importance as a test of Einstein's General Theory of Relativity, but also because of the intense public interest which was aroused by the success of the expedition. The dramatic sequence of events which occurred is reviewed, as well as the long-term impact of its success. The gravitational bending of electromagnetic waves by massive bodies is a subject of the greatest importance for contemporary and future astronomy, astrophysics and cosmology. Examples of the potential impact of this key tool of modern observational astronomy are presented. This commentary was written to celebrate the 350th anniversary of the journal Philosophical Transactions of the Royal Society. PMID:25750149

Utilization of EREP data in geological evaluation, regional planning, forest management, and water management in North Carolina. [emphasizing Davidson and Durham Counties

NASA Technical Reports Server (NTRS)

Welby, C. W. (Principal Investigator)

1975-01-01

The author has identified the following significant results. Skylab imagery was evaluated, compiling vegetational and land use information in conjunction with a potential state park site fin along the Eno River in Durham County. Preliminary evaluation indicates that accuracy of identification was at the 90% level. Attempts at distinguishing between rock types in the Piedmont have proved generally unsuccessful, and recognition of linear features seems the best geologic use which the imagery can be put. The study concentrated on the High Rock Lake area of Davidson County. A study evaluating Skylab photographs for land use mapping in urban and rural areas of Piedmont North Carolina shows that S190A and S190B as well as U-2 imagery have almost the same accuracy when the interpretations are assessed with the square grid sampling method, even though the S190B imagery basically has a greater resolution.

The Compassion Fatigue Scale: Its Use with Social Workers Following Urban Disaster

ERIC Educational Resources Information Center

Adams, Richard E.; Figley, Charles R.; Boscarino, Joseph A.

2008-01-01

Objective: The present study has two goals: to assess the difference between secondary trauma and job burnout and to examine the utility of secondary trauma in predicting psychological distress. Method: The data come from a survey of social workers (N = 236) living in New York City 20 months following the September 11 terrorist attacks on the…

Tools to assess psychological trauma & its correlates in child sexual abuse: A review & current needs in Asia.

PubMed

Satapathy, Sujata; Choudhary, Vandana; Sagar, Rajesh

2017-02-01

Absence of visible physical symptoms and limited capacity to express trauma directly, pose significant challenges in assessment of its exact nature of trauma and its correlates in child sexual abuse. There are numerous assessment tools however, deciding upon the appropriateness is often challenging in Asian socio-cultural and health care set up. A review would provide a ready reference to the practioner regarding the exact clinically utility of the tools and also would guide them in the direction of culture specific modifications. Computerized databases namely Medline, PsycINFO, Health and Psychosocial Instruments, and Social Sciences Citation Index were used. 52 scales were obtained and analysed in terms of scale characteristics, reference to theory and DSM, and cultural competency. Despite of a wide variety of methods, and newer instruments, many of the traditionally used techniques of child's internal thinking and emotional assessment appear outdated while reviewing the recent theories of CSA related psychological trauma. An integrated format, incroporating child-parent-clinicain rating, with multiple domain speciafic items and verbal and non-verbal tasks, is the current need in the Asian region. Copyright © 2016 Elsevier B.V. All rights reserved.

The clinical significance of isolated loss of lordosis on cervical spine computed tomography in blunt trauma patients: a prospective evaluation of 1,007 patients.

PubMed

Mejaddam, Ali Y; Kaafarani, Haytham M A; Ramly, Elie P; Avery, Laura L; Yeh, Dante D; King, David R; de Moya, Marc A; Velmahos, George C

2015-11-01

A negative computed tomographic (CT) scan may be used to rule out cervical spine (c-spine) injury after trauma. Loss of lordosis (LOL) is frequently found as the only CT abnormality. We investigated whether LOL should preclude c-spine clearance. All adult trauma patients with isolated LOL at our Level I trauma center (February 1, 2011 to May 31, 2012) were prospectively evaluated. The primary outcome was clinically significant injury on magnetic resonance imaging (MRI), flexion-extension views, and/or repeat physical examination. Of 3,333 patients (40 ± 17 years, 60% men) with a c-spine CT, 1,007 (30%) had isolated LOL. Among 841 patients with a Glasgow Coma Scale score of 15, no abnormalities were found on MRI, flexion-extension views, and/or repeat examinations, and all collars were removed. Among 166 patients with Glasgow Coma Scale less than 15, 3 (.3%) had minor abnormal MRI findings but no clinically significant injury. Isolated LOL on c-spine CT is not associated with a clinically significant injury and should not preclude c-spine clearance. Copyright © 2015 Elsevier Inc. All rights reserved.

Assessment of the effects and limitations of the 1998 to 2008 Abbreviated Injury Scale map using a large population-based dataset.

PubMed

Palmer, Cameron S; Franklyn, Melanie

2011-01-07

Trauma systems should consistently monitor a given trauma population over a period of time. The Abbreviated Injury Scale (AIS) and derived scores such as the Injury Severity Score (ISS) are commonly used to quantify injury severities in trauma registries. To reflect contemporary trauma management and treatment, the most recent version of the AIS (AIS08) contains many codes which differ in severity from their equivalents in the earlier 1998 version (AIS98). Consequently, the adoption of AIS08 may impede comparisons between data coded using different AIS versions. It may also affect the number of patients classified as major trauma. The entire AIS98-coded injury dataset of a large population based trauma registry was retrieved and mapped to AIS08 using the currently available AIS98-AIS08 dictionary map. The percentage of codes which had increased or decreased in severity, or could not be mapped, was examined in conjunction with the effect of these changes to the calculated ISS. The potential for free text information accompanying AIS coding to improve the quality of AIS mapping was explored. A total of 128280 AIS98-coded injuries were evaluated in 32134 patients, 15471 patients of whom were classified as major trauma. Although only 4.5% of dictionary codes decreased in severity from AIS98 to AIS08, this represented almost 13% of injuries in the registry. In 4.9% of patients, no injuries could be mapped. ISS was potentially unreliable in one-third of patients, as they had at least one AIS98 code which could not be mapped. Using AIS08, the number of patients classified as major trauma decreased by between 17.3% and 30.3%. Evaluation of free text descriptions for some injuries demonstrated the potential to improve mapping between AIS versions. Converting AIS98-coded data to AIS08 results in a significant decrease in the number of patients classified as major trauma. Many AIS98 codes are missing from the existing AIS map, and across a trauma population the AIS08 dataset estimates which it produces are of insufficient quality to be used in practice. However, it may be possible to improve AIS98 to AIS08 mapping to the point where it is useful to established registries.

Assessment of the effects and limitations of the 1998 to 2008 Abbreviated Injury Scale map using a large population-based dataset

PubMed Central

2011-01-01

Background Trauma systems should consistently monitor a given trauma population over a period of time. The Abbreviated Injury Scale (AIS) and derived scores such as the Injury Severity Score (ISS) are commonly used to quantify injury severities in trauma registries. To reflect contemporary trauma management and treatment, the most recent version of the AIS (AIS08) contains many codes which differ in severity from their equivalents in the earlier 1998 version (AIS98). Consequently, the adoption of AIS08 may impede comparisons between data coded using different AIS versions. It may also affect the number of patients classified as major trauma. Methods The entire AIS98-coded injury dataset of a large population based trauma registry was retrieved and mapped to AIS08 using the currently available AIS98-AIS08 dictionary map. The percentage of codes which had increased or decreased in severity, or could not be mapped, was examined in conjunction with the effect of these changes to the calculated ISS. The potential for free text information accompanying AIS coding to improve the quality of AIS mapping was explored. Results A total of 128280 AIS98-coded injuries were evaluated in 32134 patients, 15471 patients of whom were classified as major trauma. Although only 4.5% of dictionary codes decreased in severity from AIS98 to AIS08, this represented almost 13% of injuries in the registry. In 4.9% of patients, no injuries could be mapped. ISS was potentially unreliable in one-third of patients, as they had at least one AIS98 code which could not be mapped. Using AIS08, the number of patients classified as major trauma decreased by between 17.3% and 30.3%. Evaluation of free text descriptions for some injuries demonstrated the potential to improve mapping between AIS versions. Conclusions Converting AIS98-coded data to AIS08 results in a significant decrease in the number of patients classified as major trauma. Many AIS98 codes are missing from the existing AIS map, and across a trauma population the AIS08 dataset estimates which it produces are of insufficient quality to be used in practice. However, it may be possible to improve AIS98 to AIS08 mapping to the point where it is useful to established registries. PMID:21214906

Severe war-related trauma and personality pathology: a case-control study.

PubMed

Munjiza, Jasna; Britvic, Dolores; Radman, Maja; Crawford, Mike J

2017-03-21

Exposure to war-related trauma has long been recognised to have an adverse effect on mental health. We attempted to investigate whether people who have clinically significant personality-related problems 15 years after a war are more likely to have been exposed to severe war-related trauma than those who do not have significant personality difficulties. A case -control study was conducted in southern Croatia, fifteen years after the 1991-1995 war. We recruited 268 participants: 182 cases who scored positively on the International Personality Disorder Examination scale (IPDE), and 86 controls who were IPDE negative. Severity of war-related trauma was assessed according to the 17 items on the Harvard Trauma Questionnaire (HTQ) trauma event scale, which were considered to be of severe (catastrophic) nature based on the ICD-10 description of catastrophic trauma and the opinion of trauma experts. All participants also completed measures of mental health (depression, anxiety and PTSD), social functioning and current substance misuse. Cases (IPDE positive) were eight times more likely to report exposure to severe war-related trauma than controls. This association increased after adjustments for demographic factors (OR = 10.1, 95% CI 5.0 to 20.4). The types of severe trauma most frequently reported were either the participants'own life being in direct danger or witnessing extreme violence inflicted on others or the result of violence towards others (murder, torture, seeing burned or disfigured bodies). Prevalences of depression, anxiety and PTSD were high among IPDE positive participants 15 years after exposure to war trauma. Their level of interpersonal dysfunction was considerably higher than that in controls (OR = 10.39, 95% CI 3.51 to 30.75). Alcohol consumption in cases was significantly higher with a mean of 14.24 units per week (sd = 11.03) when compared to controls whose mean number of alcohol units was 9.24 (sd = 7.25), t (73) = 2.16, p < 0.05, mean difference 4.99 (95% CI = 0.39 to 9.60). Similarly, a significantly higher number of cases reported current substance misuse (8.2% vs. 0.0%) X 2 (1, n = 268) = 7.51, p < 0.05). Exposure to severe war-related trauma is a risk factor for interpersonal dysfunction15 years after people were exposed to an armed conflict. These findings have implications for assessing and meeting the long-term mental health needs of people in war-affected regions. Further research needs to be done to increase our understanding about the relationship between severe war trauma and personality related problems.

Risk factors for injury acute renal in patients with severe trauma and its effect on mortality.

PubMed

Baitello, André Luciano; Marcatto, Gustavo; Yagi, Roberto Kaoru

2013-01-01

The studies which associated acute kidney injury (AKI) and trauma emerged during the Second World War, and since then we have seen a progressive evolution of healthcare aiming at AKI prevention. However, establishing the risk factors for post-trauma AKI development remains crucial and may help reduce this complication. This study aims at identifying risk factors vis-à-vis the development of AKI in patients with severe trauma and its impact on mortality. This is a retrospective study of 75 patients with severe trauma. Six were taken off because they arrived at the hospital past the point of resuscitation. The variables considered were age, gender, trauma severity according to the Injury Severity Score (ISS) and the Glasgow Coma Scale (GCS), trauma mechanism, mean blood pressure upon admission, fluid replacement in the first 24 hours, serum creatinine levels, use of nephrotoxic antibiotics, length of hospital stay, need for ICU admission and mortality. The prevalence of AKI in severe trauma patients was 17.3%, and the factors associated with ARF in this sample were Head Injury and GCS < 10. Mortality, length of hospital stay and the need for ICU were significantly higher in patients who developed AKI. The identification of these risk factors is of paramount importance for the development of care strategies for patients suffering from severe trauma, for the prevention of acute kidney injury and the associated high mortality.

Psychological Effect of an Analogue Traumatic Event Reduced by Sleep Deprivation.

PubMed

Porcheret, Kate; Holmes, Emily A; Goodwin, Guy M; Foster, Russell G; Wulff, Katharina

2015-07-01

To examine the effect of sleep deprivation compared to sleep, immediately after experimental trauma stimuli on the development of intrusive memories to that trauma stimuli. Participants were exposed to a film with traumatic content (trauma film). The immediate response to the trauma film was assessed, followed by either total sleep deprivation (sleep deprived group, N = 20) or sleep as usual (sleep group, N = 22). Twelve hours after the film viewing the initial psychological effect of the trauma film was measured and for the subsequent 6 days intrusive emotional memories related to the trauma film were recorded in daily life. Academic sleep laboratory and participants' home environment. Healthy paid volunteers. On the first day after the trauma film, the psychological effect as assessed by the Impact of Event Scale - Revised was lower in the sleep deprived group compared to the sleep group. In addition, the sleep deprived group reported fewer intrusive emotional memories (mean 2.28, standard deviation [SD] 2.91) compared to the sleep group (mean 3.76, SD 3.35). Because habitual sleep/circadian patterns, psychological health, and immediate effect of the trauma film were similar at baseline for participants of both groups, the results cannot be accounted for by pre-existing inequalities between groups. Our findings suggest that sleep deprivation on one night, rather than sleeping, reduces emotional effect and intrusive memories following exposure to experimental trauma. © 2015 Associated Professional Sleep Societies, LLC.

Evaluation of a trauma-informed and gender-responsive intervention for women in drug treatment.

PubMed

Covington, Stephanie S; Burke, Cynthia; Keaton, Sandy; Norcott, Candice

2008-11-01

There is growing recognition of the complex needs of women with dual diagnoses of substance abuse and mental health disorders. Recent research indicates that 55% to 99% of women with co-occurring disorders have experienced trauma from abuse and that abused women tend to engage in self-destructive behaviors. These women often are not well served by the services found in their communities, which separate substance abuse and mental health programs, despite the fact that research shows that integrated, trauma-informed treatment services will increase the success of their recovery. A recent study examined the use of two gender-responsive, trauma-informed curricula presented in a residential facility for women, 55% of whom had criminal histories. Helping Women Recover and Beyond Trauma are both manualized programs founded on research and clinical practice and are grounded in the theories of addiction, trauma, and women's psychological development. This treatment model is named "Women's Integrated Treatment" (WIT). Women who successfully completed the programs were assessed at several points in time on several scales, including trauma symptomology, depression, and substance use before and after the programs. The findings indicated less substance use, less depression, and fewer trauma symptoms (p < or = .05)--including anxiety, sleep disturbances, and dissociation--after participation in the WIT curricula.

Measuring historical trauma in an American Indian community sample: contributions of substance dependence, affective disorder, conduct disorder and PTSD.

PubMed

Ehlers, Cindy L; Gizer, Ian R; Gilder, David A; Ellingson, Jarrod M; Yehuda, Rachel

2013-11-01

The American Indian experience of historical trauma is thought of as both a source of intergenerational trauma responses as well as a potential causative factor for long-term distress and substance abuse among communities. The aims of the present study were to evaluate the extent to which the frequency of thoughts of historical loss and associated symptoms are influenced by: current traumatic events, post traumatic stress disorder (PTSD), cultural identification, percent Native American Heritage, substance dependence, affective/anxiety disorders, and conduct disorder/antisocial personality disorder (ASPD). Participants were American Indians recruited from reservations that were assessed with the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA), The Historical Loss Scale and The Historical Loss Associated Symptoms Scale (to quantify frequency of thoughts and symptoms of historical loss) the Stressful-Life-Events Scale (to assess experiences of trauma) and the Orthogonal Cultural Identification Scale (OCIS). Three hundred and six (306) American Indian adults participated in the study. Over half of them indicated that they thought about historical losses at least occasionally, and that it caused them distress. Logistic regression revealed that significant increases in how often a person thought about historical losses were associated with: not being married, high degrees of Native Heritage, and high cultural identification. Additionally, anxiety/affective disorders and substance dependence were correlated with historical loss associated symptoms. In this American Indian community, thoughts about historical losses and their associated symptomatology are common and the presence of these thoughts are associated with Native American Heritage, cultural identification, and substance dependence. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Comparison of bedside screening methods for frailty assessment in older adult trauma patients in the emergency department.

PubMed

Shah, Sachita P; Penn, Kevin; Kaplan, Stephen J; Vrablik, Michael; Jablonowski, Karl; Pham, Tam N; Reed, May J

2018-04-14

Frailty is linked to poor outcomes in older patients. We prospectively compared the utility of the picture-based Clinical Frailty Scale (CFS9), clinical assessments, and ultrasound muscle measurements against the reference FRAIL scale in older adult trauma patients in the emergency department (ED). We recruited a convenience sample of adults 65 yrs. or older with blunt trauma and injury severity scores <9. We queried subjects (or surrogates) on the FRAIL scale, and compared this to: physician-based and subject/surrogate-based CFS9; mid-upper arm circumference (MUAC) and grip strength; and ultrasound (US) measures of muscle thickness (limbs and abdominal wall). We derived optimal diagnostic thresholds and calculated performance metrics for each comparison using sensitivity, specificity, predictive values, and area under receiver operating characteristic curves (AUROC). Fifteen of 65 patients were frail by FRAIL scale (23%). CFS9 performed well when assessed by subject/surrogate (AUROC 0.91 [95% CI 0.84-0.98] or physician (AUROC 0.77 [95% CI 0.63-0.91]. Optimal thresholds for both physician and subject/surrogate were CFS9 of 4 or greater. If both physician and subject/surrogate provided scores <4, sensitivity and negative predictive value were 90.0% (54.1-99.5%) and 95.0% (73.1-99.7%). Grip strength and MUAC were not predictors. US measures that combined biceps and quadriceps thickness showed an AUROC of 0.75 compared to the reference standard. The ED needs rapid, validated tools to screen for frailty. The CFS9 has excellent negative predictive value in ruling out frailty. Ultrasound of combined biceps and quadriceps has modest concordance as an alternative in trauma patients who cannot provide a history. Copyright © 2017 Elsevier Inc. All rights reserved.

Childhood Trauma Questionnaire (CTQ) correlations with prospective violence assessment in a longitudinal cohort.

PubMed

Liebschutz, Jane M; Buchanan-Howland, Kathryn; Chen, Clara A; Frank, Deborah A; Richardson, Mark A; Heeren, Timothy C; Cabral, Howard J; Rose-Jacobs, Ruth

2018-06-01

Retrospective recall-based measures administered to adults, like the Childhood Trauma Questionnaire (CTQ), are commonly used to determine experiences of childhood trauma in the home. However, the CTQ has not been compared with prospective measures of childhood violence exposure, whether at home or in the community. We evaluated the relationships between young adults' responses to the CTQ and their prospective self-reports of exposure to violence in childhood and adolescence. Participants were 127 (93% African American, 47% male) urban young adults in a longitudinal birth cohort study examining effects of prenatal substance exposure and environmental factors on development. Participants completed the Violence Exposure Scale for Children-Revised (VEX-R), a 21-item self-report measure of experience of/witness to interpersonal violence, administered face to face at 9, 10, and 11 years using cartoon pictures, and via audio-computer assisted self-interview at 12, 14, and 16 years. Participants also completed the CTQ, a 28-item, 5-scale screening measure, during a young-adult follow-up (ages 18-23). Using Pearson Correlation coefficients, VEX-R total scores significantly correlated with the sum of CTQ scales, r = .33, p < .01, and 3 (physical, emotional, and sexual abuse) of the 5 CTQ subscales, showing a moderate linear association. This study suggests that the CTQ serves as a reasonable retrospective assessment of prospectively ascertained childhood trauma exposure. The differences may be accounted for by disparities in domains assessed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Transgenerational transmission of trauma in families of Holocaust survivors: the consequences of extreme family functioning on resilience, sense of coherence, anxiety and depression.

PubMed

Fossion, Pierre; Leys, Christophe; Vandeleur, Caroline; Kempenaers, Chantal; Braun, Stéphanie; Verbanck, Paul; Linkowski, Paul

2015-01-15

The psychological transmission of the noxious effects of a major trauma from one generation to the next remains unclear. The present study aims to identify possible mechanisms explaining this transmission among families of Holocaust Survivors (HS). We hypothesized that the high level of depressive and anxiety disorders (DAD) among HS impairs family systems, which results in damaging coping strategies of their children (CHS) yielding a higher level of DAD. 49 CHS completed the Resilience Scale for Adults, the Hopkins Symptom Check List-25, the 13-Item Sense of Coherence (SOC) scale, and the Family Adaptability and Cohesion Scale. We test a mediation model with Family types as the predictor; coping strategies (i.e. Resilience or SOC) as the mediator; and DAD as the outcome variable. Results confirm that the CHS׳ family types are more often damaged than in general population. Moreover, growing in a damaged family seems to impede development of coping strategies and, therefore, enhances the occurrence of DAD. The present investigation is correlational and should be confirmed by other prospective investigations. At a theoretical level we propose a mechanism of transmission of the noxious effects of a major trauma from one generation to the next through family structure and coping strategies. At a clinical level, our results suggest to investigate the occurrence of trauma among parents of patients consulting for DAD and to reinforce their coping strategies. Copyright © 2014 Elsevier B.V. All rights reserved.

Depression, anxiety and loss of resilience after multiple traumas: an illustration of a mediated moderation model of sensitization in a group of children who survived the Nazi Holocaust.

PubMed

Fossion, Pierre; Leys, Christophe; Kempenaers, Chantal; Braun, Stephanie; Verbanck, Paul; Linkowski, Paul

2013-12-01

Depressive and anxiety disorders (DAD) have become a major public health problem. Multiple trauma is known to increase the risk of DAD through a sensitization mechanism. We investigate the hypothesis that resilience is a mediator of this mechanism. Former Hidden Children (FHC), the Jewish youths who spent World War II in various hideaway shelters across Nazi-occupied Europe, were compared with a control group. In each group, we measured the presence of multiple traumas, the resilience with the Resilience Scale for Adults, which has a six factors solution, and the DAD with the Hopkins Symptoms Checklist. We test a mediated moderation model with childhood trauma as the predictor; Later trauma as the moderator; Resilience as the mediator; and DAD as the outcome variable. Results are consistent with a sensitization model of DAD mediated by resilience: confrontation with a primary trauma during childhood followed by secondary trauma(s) after childhood damages resilience, which, in turn, results in higher level of DAD. We are unable to differentiate if the sensitization process is a consequence of the nature of the trauma endured by FHC (long-standing exposure to extreme external events) or a consequence of the fact that this first trauma occurred during childhood. Resilience construct is multi-factorial and a limited damaging of some of the factors is sufficient to lead to DAD even if other factors remain unaltered. Resilience can be altered by multiple traumas and, therefore, needs to be bolstered in therapy sessions. Copyright © 2013. Published by Elsevier B.V.

Trauma care at rural level III trauma centers in a state trauma system.

PubMed

Helling, Thomas S

2007-02-01

Although much has been written about the benefits of trauma center care, most experiences are urban with large numbers of patients. Little is known about the smaller, rural trauma centers and how they function both independently and as part of a larger trauma system. The state of Missouri has designated three levels of trauma care. The cornerstone of rural trauma care is the state-designated Level III trauma center. These centers are required to have the presence of a trauma team and trauma surgeon but do not require orthopedic or neurosurgical coverage. The purpose of this retrospective study was to determine how Level III trauma centers compared with Level I and Level II centers in the Missouri trauma system and, secondly, how trauma surgeon experience at these centers might shape future educational efforts to optimize rural trauma care. During a 2-year period in 2002 and 2003, the state trauma registry was queried on all trauma admissions for centers in the trauma system. Demographics and patient care outcomes were assessed by level of designation. Trauma admissions to the Level III centers were examined for acuity, severity, and type of injury. The experiences with chest, abdominal, and neurologic trauma were examined in detail. A total of 24,392 patients from 26 trauma centers were examined, including all eight Level III centers. Acuity and severity of injuries were higher at Level I and II centers. A total of 2,910 patients were seen at the 8 Level III centers. Overall deaths were significantly lower at Level III centers (Level I, 4% versus Level II, 4% versus Level III, 2%, p < 0.001). Numbers of patients dying within 24 hours were no different among levels of trauma care (Level I, 37% versus Level II, 30% versus Level III, 32%). Among Level III centers 45 (1.5%) patients were admitted in shock, and 48 (2%) had a Glasgow Coma Scale score <9. Twenty-six patients had a surgical head injury (7 epidural, 19 subdural hematomas). Twenty-eight patients (1%) needed a chest or abdominal operation. There were 15 spleen and 12 liver injuries with an Abbreviated Injury Score of 4 or 5. Level III trauma centers performed as expected in a state trauma system. Acuity and severity were less as was corresponding mortality. There were a paucity of life-threatening head, chest, and abdominal injuries, which provide a challenge to the rural trauma surgeon to maintain necessary skills in management of these critical injuries.

Enhancing Thinking through Cooperative Learning.

ERIC Educational Resources Information Center

Davidson, Neil, Ed.; Worsham, Toni, Ed.

This collection of papers provides a theoretical foundation on current practice in cooperative thinking. The papers offer many practical methods that can be applied to a full range of classroom settings. After an introduction, "HOTSICLE: Higher Order Thinking Skills in Cooperative Learning Environments" (Neil Davidson and Toni Worsham),…

36. Close view of the east elevation looking north to ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

36. Close view of the east elevation looking north to south beginning at the northeast corner to show square corner notches and protruding ceiling joists (duplicate of HABS no. TN-52-B-17) - The Hermitage, East Cabin, 4580 Rachel's Lane, Hermitage, Davidson County, TN

EEG Biofeedback: A Critical Evaluation of the Results and Underlying Rationale.

DTIC Science & Technology

1977-01-31

workers (Nowlia & Kamiya, 1970), improved delayed recall have published a series of studies evaluating the (Cannon 6 Sternbach , 1971), extrasensory ... perception role of the visuomotor system in the control of (Ifonorton , Davidson, 6 Bindier, 1971) , and decreased alpha activity (Mulholland 6 Runnals, 1962

Using Infographics in the Science Classroom

ERIC Educational Resources Information Center

Davidson, Rosemary

2014-01-01

As a chemistry teacher, Rosemary Davidson has found "infographics" (information graphics) successfully engage her students in science--not only in carrying out the research for classroom projects but also in presenting the results of their research to their peers. This article will help teachers integrate student-created infographics…

The Abbreviated Injury Scale and its correlation with preventable traumatic accidental deaths: a study from South Delhi.

PubMed

Rautji, R; Bhardwaj, D N; Dogra, T D

2006-04-01

Anatomic trauma scoring systems are fundamental to trauma research. The Abbreviated Injury Scale (AIS) and its derivative, the Injury Severity Score (ISS), are the most frequently used scales. In a prospective study, 400 autopsies of road traffic accident victims performed between January 2002 and December 2003 were coded according to the AIS and ISS methods. All the cases were classified into different injury groups according to the Injury Severity Scale. Fifty-eight cases (14.5%) were assigned an ISS value of <25; 244 (61%) cases were valued between 25-49; 38 cases (9.5%) were valued between 50-74 and 60 (15%) cases had a value of 75. On analysis of medical care, in cases with ISS<50, about 96% of the victims did not receive optimal care quickly enough with a lack of pre-hospital resuscitation measures and lengthy transportation time to hospital being of major importance.

Career Adapt-Abilities Scale--Brazilian Form: Psychometric Properties and Relationships to Personality

ERIC Educational Resources Information Center

Teixeira, Marco Antonio Pereira; Bardagi, Marucia Patta; Lassance, Maria Celia Pacheco; Magalhaes, Mauro de Oliveira; Duarte, Maria Eduarda

2012-01-01

The Career Adapt-Abilities Scale--Brazilian Form (CAASBrazil) consists of four scales which measure concern, control, curiosity, and confidence as psychosocial resources for managing occupational transitions, developmental tasks, and work traumas. Internal consistency estimates for the subscale and total scores ranged from good to excellent. The…

Rape myth acceptance, sexual trauma history, and posttraumatic stress disorder.

PubMed

Baugher, Shannon N; Elhai, Jon D; Monroe, James R; Gray, Matt J

2010-11-01

The prediction of false rape-related beliefs (rape myth acceptance [RMA]) was examined using the Illinois Rape Myth Acceptance Scale (Payne, Lonsway, & Fitzgerald, 1999) among a nonclinical sample of 258 male and female college students. Predictor variables included measures of attitudes toward women, gender role identity (GRI), sexual trauma history, and posttraumatic stress disorder (PTSD) symptom severity. Using linear regression and testing interaction effects, negative attitudes toward women significantly predicted greater RMA for individuals without a sexual trauma history. However, neither attitudes toward women nor GRI were significant predictors of RMA for individuals with a sexual trauma history. PTSD did not moderate RMA's relationship with attitudes toward women and GRI. This study has clinical implications for treatment as well as for the development of rape myth-dispelling programs.

Epidemiology of severe trauma.

PubMed

Alberdi, F; García, I; Atutxa, L; Zabarte, M

2014-12-01

Major injury is the sixth leading cause of death worldwide. Among those under 35 years of age, it is the leading cause of death and disability. Traffic accidents alone are the main cause, fundamentally in low- and middle-income countries. Patients over 65 years of age are an increasingly affected group. For similar levels of injury, these patients have twice the mortality rate of young individuals, due to the existence of important comorbidities and associated treatments, and are more likely to die of medical complications late during hospital admission. No worldwide, standardized definitions exist for documenting, reporting and comparing data on severely injured trauma patients. The most common trauma scores are the Abbreviated Injury Scale (AIS), the Injury Severity Score (ISS) and the Trauma and Injury severity Score (TRISS). Documenting the burden of injury also requires evaluation of the impact of post-trauma impairments, disabilities and handicaps. Trauma epidemiology helps define health service and research priorities, contributes to identify disadvantaged groups, and also facilitates the elaboration of comparable measures for outcome predictions. Copyright © 2014 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

The pathway to grandparenting stress: trauma, relational conflict, and emotional well-being.

PubMed

Sprang, Ginny; Choi, Moon; Eslinger, Jessica G; Whitt-Woosley, Adrienne L

2015-01-01

This paper examines the mediating effect of child-grandparent conflict on the relationship between child trauma exposure and grandparenting stress. Data was collected from a sample of custodial grandparents who participated in kinship care or relative caregiving programs (n = 251). Grandparenting stress was measured with Parenting Stress Scale (Berry & Jones, 1995 ) modified for grandparents. A series of regression models and structural equation models (SEM) were used to test the relationship between the number of different types of child trauma exposures and grandparenting stress, and to examine the mediating effect of child-grandparent conflicts on the relationship. Almost three-fourths (72%) of children had experienced at least one type of traumatic exposure. The SEM model shows that child's trauma exposure indirectly affected grandparenting stress, mediated by child-grandparenting conflicts though no direct path between the child's trauma exposure variable and grandparenting stress was found. A higher level of child-grandparent conflicts was also associated with a lower level of emotional well-being among custodial grandparents. Based on these findings, recommendations are made about how to tailor a trauma-informed approach to the needs of custodial grandparents.

Initial validation of the Spanish childhood trauma questionnaire-short form: factor structure, reliability and association with parenting.

PubMed

Hernandez, Ana; Gallardo-Pujol, David; Pereda, Noemí; Arntz, Arnoud; Bernstein, David P; Gaviria, Ana M; Labad, Antonio; Valero, Joaquín; Gutiérrez-Zotes, Jose Alfonso

2013-05-01

The present study examines the internal consistency and factor structure of the Spanish version of the Childhood Trauma Questionnaire-Short Form (CTQ-SF) and the association between the CTQ-SF subscales and parenting style. Cronbach's α and confirmatory factor analyses (CFA) were performed in a female clinical sample (n = 185). Kendall's ι correlations were calculated between the maltreatment and parenting scales in a subsample of 109 patients. The Spanish CTQ-SF showed adequate psychometric properties and a good fit of the 5-factor structure. The neglect and abuse scales were negatively associated with parental care and positively associated with overprotection scales. The results of this study provide initial support for the reliability and validity of the Spanish CTQ-SF.

Inclusion of 'minor' trauma cases provides a better estimate of the total burden of injury: Queensland Trauma Registry provides a unique perspective.

PubMed

Lang, Jacelle; Dallow, Natalie; Lang, Austin; Tetsworth, Kevin; Harvey, Kathy; Pollard, Cliff; Bellamy, Nicholas

2014-08-01

Injury is recognised as a frequent cause of preventable mortality and morbidity; however, incidence estimates focusing only on the extent of mortality and major trauma may seriously underestimate the magnitude of the total injury burden. There currently exists a paucity of information regarding minor trauma, and the aim of this study was to increase awareness of the contribution of minor trauma cases to the total burden of injury. The demographics, injury details, acute care factors and outcomes of both minor trauma cases and major trauma cases were evaluated using data from the state-wide trauma registry in Queensland, Australia, from 2005 to 2010. The impact of changes in Abbreviated Injury Scale (AIS) versions on the classification of minor and major injury cases was also assessed. Over the 6-year period, minor cases [Injury Severity Score (ISS) ≤ 12] accounted for almost 90% of all trauma included on the Queensland Trauma Registry (QTR). These cases utilised more than half a million acute care bed days, underwent more than 66,500 operations, and accounted for more than 48,000 patient transport episodes via road ambulance, fixed wing aircraft, or helicopter. Furthermore, more than 5800 minor trauma cases utilised in-hospital rehabilitation services; almost 3000 were admitted to an ICU; and more than 20,000 were admitted to hospital for greater than one week. When using the contemporary criteria for classifying trauma (AIS 08), the proportion of cases classified as minor trauma (87.7%) and major trauma (12.3%) were similar to the proportion using the traditional criteria for AIS90 (87.9% and 12.1%, respectively). This evaluation of minor trauma cases admitted to public hospitals in Queensland detected high levels of demand placed on trauma system resources in terms of acute care bed days, operations, ICU admissions, in-hospital rehabilitation services and patient transportation, and which are all associated with high cost. These data convincingly demonstrate the significant burden of injury imposed by minor trauma cases serious enough to be admitted to hospital. Copyright © 2014 Elsevier Ltd. All rights reserved.

Posttraumatic Stress Disorder, Health Problems, and Depression Among African American Women in Residential Substance Use Treatment.

PubMed

Meshberg-Cohen, Sarah; Presseau, Candice; Thacker, Leroy R; Hefner, Kathryn; Svikis, Dace

2016-07-01

Rates of posttraumatic stress disorder (PTSD) are high among women seeking treatment for substance use disorders (SUDs). Minority women, in particular, experience high rates of trauma and may be less likely to disclose trauma history. This article identifies items from pre-existing screening measures that can be used across settings to sensitively but noninvasively identify women with likely PTSD. For a sample of 104 African American women in residential SUD treatment who provided informed consent as a part of a larger randomized clinical trial, the prevalence of trauma and PTSD, as well as the relationships between trauma, health, depression, and distress, was examined. Measures included Posttraumatic Stress Diagnostic Scale (PDS), Center for Epidemiologic Studies-Depression Scale (CES-D), Pennebaker Inventory of Limbic Languidness (PILL), and Brief Symptom Inventory (BSI). Additional analyses were undertaken to determine if a subset of noninvasive items could serve to identify the presence of a probable PTSD diagnosis. Most women (94.2%) reported at least one lifetime trauma, with over half (51.0%) meeting DSM-IV criteria for PTSD. Women with greater trauma symptom severity reported more health problems and higher levels of depression and distress. Five BSI items and one CES-D item were significantly associated with a probable PTSD diagnosis with a sensitivity of 88.7%, a specificity of 66.7%, a positive predictive value of 73.4%, a negative predictive value of 85.0%, and an accuracy of 77.9%. Findings affirm that African American women with SUDs present for residential treatment with comorbid psychiatric and emotional conditions that warrant assessment and treatment. Results highlight potential benefits of brief screening with routine measures and coordinated access to ancillary psychiatric and medical services, in conjunction with substance treatment, such as in residential or primary care.

Trauma cognitions are related to symptoms up to 10 years after cognitive behavioral treatment for posttraumatic stress disorder.

PubMed

Scher, Christine D; Suvak, Michael K; Resick, Patricia A

2017-11-01

This study examined (a) relationships between trauma-related cognitions and posttraumatic stress disorder (PTSD) symptoms from pretreatment through a long-term period after cognitive-behavioral therapy (CBT) for PTSD and (b) whether these relationships were impacted by treatment type. Participants were 171 women randomized into treatment for PTSD after rape. Measures of self-reported trauma-related cognitions and interviewer-assessed PTSD symptoms (i.e., Posttraumatic Maladaptive Beliefs Scale, Trauma-Related Guilt Inventory, and Clinician-Administered PTSD Scale) were obtained at pretreatment, posttreatment, and 3-month, 9-month, and 5-10 year follow-ups. Multilevel regression analyses were used to examine relationships between trauma-related cognitions and PTSD symptoms throughout the study period and whether these relationships differed as a function of treatment type (i.e., Cognitive Processing Therapy or Prolonged Exposure). Initial multilevel regression analyses that examined mean within-participant associations suggested that beliefs regarding Reliability and Trustworthiness of Others, Self-Worth and Judgment, Threat of Harm, and Guilt were related to PTSD symptoms throughout follow-up. Growth curve modeling suggested that patterns of belief change throughout follow-up were similar to those previously observed in PTSD symptoms over the same time period. Finally, multilevel mediation analyses that incorporated time further suggested that change in beliefs was related to change in symptoms throughout follow-up. With 1 minor exception, relationships between beliefs and symptoms were not moderated by treatment type. These data suggest that trauma-related cognitions are a potential mechanism for long-term maintenance of treatment gains after CBT for PTSD. Moreover, these cognitions may be a common, rather than specific, treatment maintenance mechanism. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Emotion regulation in mothers and young children faced with trauma.

PubMed

Pat-Horenczyk, Ruth; Cohen, S; Ziv, Y; Achituv, M; Asulin-Peretz, L; Blanchard, T R; Schiff, M; Brom, D

2015-01-01

The present study investigated maternal emotion regulation as mediating the association between maternal posttraumatic stress symptoms and children's emotional dysregulation in a community sample of 431 Israeli mothers and children exposed to trauma. Little is known about the specific pathways through which maternal posttraumatic symptoms and deficits in emotion regulation contribute to emotional dysregulation. Inspired by the intergenerational process of relational posttraumatic stress disorder (PTSD), in which posttraumatic distress is transmitted from mothers to children, we suggest an analogous concept of relational emotion regulation, by which maternal emotion regulation problems may contribute to child emotion regulation deficits. Child emotion regulation problems were measured using the Child Behavior Checklist-Dysregulation Profile (CBCL-DP; T.M. Achenbach & I. Rescorla, 2000), which is comprised of three subscales of the CBCL: Attention, Aggression, and Anxiety/Depression. Maternal PTSD symptoms were assessed by the Posttraumatic Diagnostic Scale (E.B. Foa, L. Cashman, L. Jaycox, & K. Perry, 1997) and maternal emotion regulation by the Difficulties in Emotion Regulation Scale (K.L. Gratz & L. Roemer, 2004). Results showed that the child's emotion regulation problems were associated with both maternal posttraumatic symptoms and maternal emotion dysregulation. Further, maternal emotion regulation mediated the association between maternal posttraumatic symptoms and the child's regulation deficits. These findings highlight the central role of mothers' emotion regulation skills in the aftermath of trauma as it relates to children's emotion regulation skills. The degree of mothers' regulatory skills in the context of posttraumatic stress symptoms reflects a key process through which the intergenerational transmission of trauma may occur. Study results have critical implications for planning and developing clinical interventions geared toward the treatment of families in the aftermath of trauma and, in particular, the enhancement of mothers' emotion regulation skills after trauma. © 2015 Michigan Association for Infant Mental Health.

Pain intensity, temperament traits and social support as determinants of trauma symptoms in patients suffering from rheumatoid arthritis and low-back pain.

PubMed

Rzeszutek, Marcin; Oniszczenko, Włodzimierz; Schier, Katarzyna; Biernat-Kałuża, Edyta; Gasik, Robert

2016-04-01

The main goal of our study was to investigate the relationship between age, duration of pain, pain intensity, temperament traits as postulated by the Regulative Theory of Temperament (RTT), social support dimensions and the level of trauma symptoms, as appear in post-traumatic stress disorder (PTSD) in a sample of 300 patients suffering from chronic pain in two groups comprised of 150 patients with a clinical diagnosis of rheumatoid arthritis (RA) and 150 patients with a clinical diagnosis of low-back pain (LBP). They were analyzed together as a one group of 300 patients with chronic pain. Temperament was measured with the Formal Characteristics of Behaviour - Temperament Inventory (FCB-TI). Social support was tested with the Berlin Social Support Scales (BSSS). The Numerical Rating Scale (NRS-11) was used to measure pain intensity. The level of trauma symptoms was assessed with the Post-Traumatic Stress Disorder Factorial Version Inventory (PTSDF). The results of our study suggest that the intensity of pain, participants' age, Emotional Reactivity and Sensory Sensitivity as temperament traits, need for support, and actually received social support were related to the level of trauma symptoms. The sum of the squared semi-partial correlations showed that all six variables (age, pain intensity, Emotional Reactivity, Sensory Sensitivity, need for support and actually received support), account for 20% of the variance of general trauma symptoms level. The importance of temperament traits, social support and trauma symptoms should be taken into an account in psychotherapy accompanying pharmacotherapy for pain. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

Quality of life after multiple trauma: validation and population norm of the Polytrauma Outcome (POLO) chart.

PubMed

Lefering, R; Tecic, T; Schmidt, Y; Pirente, N; Bouillon, B; Neugebauer, E

2012-08-01

Due to an increasing number of survivors after multiple injuries in Western countries, the health-related quality of life (QoL) is considered to be an important outcome parameter. Up to now, measuring instruments used in this field lacked validity and comparability. Within 6 years, our working group developed a new modular instrument, called the Polytrauma Outcome (POLO) chart. This study documents the validation of the trauma-specific module specifically designed for trauma patients, the Trauma Outcome Profile (TOP). A total of 172 multiply injured patients (mean Injury Severity Score [ISS] 26.7) recruited from eight trauma centres participating in the German Trauma Registry were compared with 166 marginally injured patients (mean ISS 3.9). The mean follow-up was 24.2 and 26.4 months, respectively. The validation questionnaires used were the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), Impact of Event Scale-Revised (IES-R), Social Support Questionnaire (F-SOZU-K-22), Barthel Index of Activities of Daily Living (ADL) and the Short Form Health Survey (SF-36). The internal consistency of the different dimensions of QoL assessed with the TOP was good. Factor analysis provides evidence of the construct validity of the questionnaire. Correlation with external measures gives evidence of criterion validity for the various dimensions of QoL and similar exceedance of proposed cut-off points within TOP and external measures is verified. The TOP module is a reliable and valid instrument to assess health-related QoL in patients with multiple injuries. It can be used stand-alone or as part of the POLO chart together with the Glasgow Outcome Scale (GOS), the EuroQoL and the SF-36 as a regular systematic follow-up instrument.

Six-month Follow Up of the Injured Trauma Survivor Screen (ITSS): Clinical Implications and Future Directions.

PubMed

Hunt, Joshua C; Chesney, Samantha A; Brasel, Karen; deRoon-Cassini, Terri A

2018-04-17

The Injured Trauma Survivor Screen (ITSS) has been shown to predict PTSD and depression risk at one-month after traumatic injury. This study explored the ability of the ITSS to predict chronic distress after injury, as well as the impact of combining the ITSS with an additional screening measure. Patients were enrolled following admission to a Level 1 trauma center. Baseline measurements were collected during initial hospitalization, and follow-up measures were collected an average of 6.5 months after injury. Receiver Operating Characteristic (ROC) curve analyses were run to determine predictive accuracy, controlling for participants who had mental health intervention and for those who experienced additional potentially psychologically traumatic events since their injury event. Utilizing a cut score of 2, the ITSS PTSD scale had a sensitivity of 85.42%, specificity 67.35%, NPV 91.9% and PPV 51.4%. The Combined PTSD risk group (risk positive on the baseline ITSS and the PTSD Checklist for the DSM-5) had a sensitivity of 72.92%, specificity 81.63%, NPV 88.2% and PPV 61.6%. Also utilizing a cut score of 2, the ITSS Depression scale had a sensitivity of 72.50%, specificity 70.29%, NPV 91.1% and PPV 37.9%. The 9-item ITSS, which takes approximately five minutes to administer, is a stable screening tool for predicting those most at risk for PTSD and/or depression six-months after admission to a Level 1 trauma center following traumatic injury. The Combined PTSD risk group data provide evidence that symptom evaluation by a psychologist can improve specificity. These results further inform the recommendation of the American College of Surgeons Committee on Trauma regarding PTSD and depression screening in trauma centers. Prognostic study, Level III.

Leadership and Teamwork in Trauma and Resuscitation.

PubMed

Ford, Kelsey; Menchine, Michael; Burner, Elizabeth; Arora, Sanjay; Inaba, Kenji; Demetriades, Demetrios; Yersin, Bertrand

2016-09-01

Leadership skills are described by the American College of Surgeons' Advanced Trauma Life Support (ATLS) course as necessary to provide care for patients during resuscitations. However, leadership is a complex concept, and the tools used to assess the quality of leadership are poorly described, inadequately validated, and infrequently used. Despite its importance, dedicated leadership education is rarely part of physician training programs. The goals of this investigation were the following: 1. Describe how leadership and leadership style affect patient care; 2. Describe how effective leadership is measured; and 3. Describe how to train future physician leaders. We searched the PubMed database using the keywords "leadership" and then either "trauma" or "resuscitation" as title search terms, and an expert in emergency medicine and trauma then identified prospective observational and randomized controlled studies measuring leadership and teamwork quality. Study results were categorized as follows: 1) how leadership affects patient care; 2) which tools are available to measure leadership; and 3) methods to train physicians to become better leaders. We included 16 relevant studies in this review. Overall, these studies showed that strong leadership improves processes of care in trauma resuscitation including speed and completion of the primary and secondary surveys. The optimal style and structure of leadership are influenced by patient characteristics and team composition. Directive leadership is most effective when Injury Severity Score (ISS) is high or teams are inexperienced, while empowering leadership is most effective when ISS is low or teams more experienced. Many scales were employed to measure leadership. The Leader Behavior Description Questionnaire (LBDQ) was the only scale used in more than one study. Seven studies described methods for training leaders. Leadership training programs included didactic teaching followed by simulations. Although programs differed in length, intensity, and training level of participants, all programs demonstrated improved team performance. Despite the relative paucity of literature on leadership in resuscitations, this review found leadership improves processes of care in trauma and can be enhanced through dedicated training. Future research is needed to validate leadership assessment scales, develop optimal training mechanisms, and demonstrate leadership's effect on patient-level outcome.

Comparison of whole-body post mortem 3D CT and autopsy evaluation in accidental blunt force traumatic death using the abbreviated injury scale classification.

PubMed

Daly, Barry; Abboud, Samir; Ali, Zabiullah; Sliker, Clint; Fowler, David

2013-02-10

Although 3D CT imaging data are available on survivors of accidental blunt trauma, little similar data has been collected and classified on major injuries in victims of fatal injuries. This study compared the sensitivity of post mortem computed tomography (PMCT) with that of conventional autopsy for major trauma findings classified according to the trauma Abbreviated Injury Scale (AIS). Whole-body 3D PMCT imaging data and full autopsy findings were analyzed on 21 victims of accidental blunt force trauma death. All major injuries were classified on the AIS scale with ratings from 3 (serious) to 6 (unsurvivable). Agreement between sensitivity of autopsy and PMCT for major injuries was determined. A total of 195 major injuries were detected (mean per fatality, 9.3; range, 1-14). Skeletal injuries by AIS grade included 37 grade 3, 45 grade 4, 12 grade 5, and 2 grade 6 major findings. Soft tissue injuries included 10 grade 3, 68 grade 4, 16 grade 5, and 5 grade 6 major findings. Of these, PMCT detected 165 (88 skeletal, 77 soft tissue), and autopsy detected 127 (59 skeletal, 68 soft tissue). PMCT agreed with autopsy in 86% and 76% of skeletal and soft tissue injuries, respectively. PMCT detected an additional 37 skeletal and 31 soft tissue injuries that were not identified at autopsy. Autopsy detected 8 skeletal and 22 soft tissue injuries that were not detected by PMCT. PMCT was more sensitive for skeletal (P=0.05) and head and neck region injury (P=0.043) detection. PMCT showed a trend for greater sensitivity than autopsy, but this did not reach statistical significance (P=0.083). 3D PMCT detected significantly more skeletal injuries than autopsy and a similar number of soft tissue injuries to autopsy and promises to be a sensitive tool for detection and classification of skeletal injuries in fatal blunt force accidental trauma. Use of the AIS scale allows standardized categorization and quantification of injuries that contribute to death in such cases and allows more objective comparison between autopsy and PMCT. Copyright © 2012. Published by Elsevier Ireland Ltd.

Defining major trauma using the 2008 Abbreviated Injury Scale.

PubMed

Palmer, Cameron S; Gabbe, Belinda J; Cameron, Peter A

2016-01-01

The Injury Severity Score (ISS) is the most ubiquitous summary score derived from Abbreviated Injury Scale (AIS) data. It is frequently used to classify patients as 'major trauma' using a threshold of ISS >15. However, it is not known whether this is still appropriate, given the changes which have been made to the AIS codeset since this threshold was first used. This study aimed to identify appropriate ISS and New Injury Severity Score (NISS) thresholds for use with the 2008 AIS (AIS08) which predict mortality and in-hospital resource use comparably to ISS >15 using AIS98. Data from 37,760 patients in a state trauma registry were retrieved and reviewed. AIS data coded using the 1998 AIS (AIS98) were mapped to AIS08. ISS and NISS were calculated, and their effects on patient classification compared. The ability of selected ISS and NISS thresholds to predict mortality or high-level in-hospital resource use (the need for ICU or urgent surgery) was assessed. An ISS >12 using AIS08 was similar to an ISS >15 using AIS98 in terms of both the number of patients classified major trauma, and overall major trauma mortality. A 10% mortality level was only seen for ISS 25 or greater. A NISS >15 performed similarly to both of these ISS thresholds. However, the AIS08-based ISS >12 threshold correctly classified significantly more patients than a NISS >15 threshold for all three severity measures assessed. When coding injuries using AIS08, an ISS >12 appears to function similarly to an ISS >15 in AIS98 for the purposes of identifying a population with an elevated risk of death after injury. Where mortality is a primary outcome of trauma monitoring, an ISS >12 threshold could be adopted to identify major trauma patients. Level II evidence--diagnostic tests and criteria. Copyright © 2015 Elsevier Ltd. All rights reserved.

Predictive Utility of the Total Glasgow Coma Scale Versus the Motor Component of the Glasgow Coma Scale for Identification of Patients With Serious Traumatic Injuries.

PubMed

Chou, Roger; Totten, Annette M; Carney, Nancy; Dandy, Spencer; Fu, Rongwei; Grusing, Sara; Pappas, Miranda; Wasson, Ngoc; Newgard, Craig D

2017-08-01

The motor component of the Glasgow Coma Scale (mGCS) has been proposed as an easier-to-use alternative to the total GCS (tGCS) for field assessment of trauma patients by emergency medical services. We perform a systematic review and meta-analysis to compare the predictive utility of the tGCS versus the mGCS or Simplified Motor Scale in field triage of trauma for identifying patients with adverse outcomes (inhospital mortality or severe brain injury) or who underwent procedures (neurosurgical intervention or emergency intubation) indicating need for high-level trauma care. Ovid MEDLINE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Health and Psychosocial Instruments, and the Cochrane databases were searched through June 2016 for English-language cohort studies. We included studies that compared the area under the receiver operating characteristic curve (AUROC) of the tGCS versus the mGCS or Simplified Motor Scale assessed in the field or shortly after arrival in the emergency department for predicting the outcomes described above. Meta-analyses were performed with a random-effects model, and subgroup and sensitivity analyses were conducted. We included 18 head-to-head studies of predictive utility (n=1,703,388). For inhospital mortality, the tGCS was associated with slightly greater discrimination than the mGCS (pooled mean difference in [AUROC] 0.015; 95% confidence interval [CI] 0.009 to 0.022; I 2 =85%; 12 studies) or the Simplified Motor Scale (pooled mean difference in AUROC 0.030; 95% CI 0.024 to 0.036; I 2 =0%; 5 studies). The tGCS was also associated with greater discrimination than the mGCS or Simplified Motor Scale for nonmortality outcomes (differences in AUROC from 0.03 to 0.05). Findings were robust in subgroup and sensitivity analyses. The tGCS is associated with slightly greater discrimination than the mGCS or Simplified Motor Scale for identifying severe trauma. The small differences in discrimination are likely to be clinically unimportant and could be offset by factors such as convenience and ease of use. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Second Language Acquisition in a Study Abroad Context. Studies in Bilingualism 9.

ERIC Educational Resources Information Center

Freed, Barbara F., Ed.

The collection of essays on second language learning during study abroad includes: "Language Learning and Study Abroad" (Barbara F. Freed); "Predictors of Foreign Language Gain During Study Abroad" (Richard D. Brecht, Dan E. Davidson, Ralph B. Ginsberg); "A Canadian Interprovincial Exchange: Evaluating the Linguistic…

Interpreting Students' and Teachers' Discourse in Science Classes: An Underestimated Problem?

ERIC Educational Resources Information Center

Klaassen, C. W. J. M.; Lijnse, P. L.

1996-01-01

Deals with the problem of the proper interpretation of discourse between students and teachers in classrooms. Presents several interpretations of a concrete classroom protocol in terms of misconceptions. Draws on Davidson's principle of charity and distinguishes between belief and meaning to present an analysis that interprets the discourse…

Attitudes about Addiction: A National Study of Addiction Educators

ERIC Educational Resources Information Center

Broadus, Angela D.; Hartje, Joyce A.; Roget, Nancy A.; Cahoon, Kristy L.; Clinkinbeard, Samantha S.

2010-01-01

The following study, funded by the National Institute of Drug Abuse (NIDA), utilized the "Addiction Belief Inventory" (ABI; Luke, Ribisl, Walton, & Davidson, 2002) to examine addiction attitudes in a national sample of U.S. college/university faculty teaching addiction-specific courses (n = 215). Results suggest that addiction educators view…

NASA Pathways: Intern Employment Program Work Report Summer 2014

NASA Technical Reports Server (NTRS)

Davidson, Kyle B.

2014-01-01

This report documents the work experience and project involvement of Kyle Davidson during his tenure at Kennedy Space Center for the summer of 2014. Projects include the Nitrogen Oxygen Recharge System (NORS), Restore satellite servicing program, and mechanical handling operations for the SAGE III and Rapidscat payloads.

Examining the Relationship between Worry and Trait Anxiety

ERIC Educational Resources Information Center

Kelly, William E.

2004-01-01

It is commonly assumed that worry and anxiety are synonymous. However, there is growing evidence that anxiety and worry are separate, yet related, constructs (i.e., Davey, Hampton, Farrell, & Davidson, 1992; Davey, 1993; Gana, Martin, & Canouet, 2001 ). Worry, is generally defined as a stream of negative thoughts (Kelly & Miller,…

78 FR 63253 - Davidson Kempner Capital Management LLC; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-23

... employees of the Adviser other than the Contributor have any knowledge of the Contribution prior to its discovery by the Adviser on November 2, 2011. The Contribution was discovered by the Adviser's compliance... names of employees. After discovery of the Contribution, the Adviser and Contributor obtained the...

Speed Reader. MicroSIFT Courseware Evaluation.

ERIC Educational Resources Information Center

Northwest Regional Educational Lab., Portland, OR.

THE FOLLOWING IS THE FULL TEXT OF THIS DOCUMENT (Except for the Evaluation Summary Table): VERSION: Copyright 1981. PRODUCER: Davidson and Associates, 6069 Groveoak Place #12, Rancho Palos Verdes, CA 90274. EVALUATION COMPLETED: January, 1983 by the Oakland ISD of Pontiac, Michigan. COST: $70.00. ABILITY LEVEL: Secondary. SUBJECT: Reading. MEDIUM…

Inequity of Human Services: The Rural Tennessee Dilemma.

ERIC Educational Resources Information Center

Tennessee State Univ., Nashville.

Davidson, Williamson, Rutherford, and Cheatham counties of Tennessee were the setting for a study that sought to determine the types of health and social services provided to residents of rural areas and to assess the present status of the service delivery system. Interviews with both agency representatives and randomly selected household…

CAPSAS: Computer Assisted Program for the Selection of Appropriate Statistics.

ERIC Educational Resources Information Center

Shermis, Mark D.; Albert, Susan L.

A computer-assisted program has been developed for the selection of statistics or statistical techniques by both students and researchers. Based on Andrews, Klem, Davidson, O'Malley and Rodgers "A Guide for Selecting Statistical Techniques for Analyzing Social Science Data," this FORTRAN-compiled interactive computer program was…

Strategies for College and University Instructional Physical Activity Program (IPAP) Directors

ERIC Educational Resources Information Center

Melton, Bridget F.; Moore, Carrie Sampson; Hoffman, Brandi

2016-01-01

There is a growing trend to rely on part-time instructors including both adjunct faculty and graduate teaching assistants (GTAs) in higher education (Eney & Davidson, 2012). Most kinesiology departments depend on part-time instructors to teach instructional physical activity programs (IPAPs) to the general student population; this is…

The effect of paramedic training on pre-hospital trauma care (EPPTC-study): a study protocol for a prospective semi-qualitative observational trial

PubMed Central

2014-01-01

Background Accidents are the leading cause of death in adults prior to middle age. The care of severely injured patients is an interdisciplinary challenge. Limited evidence is available concerning pre-hospital trauma care training programs and the advantage of such programs for trauma patients. The effect on trauma care procedures or on the safety of emergency crews on the scene is limited; however, there is a high level of experience and expert opinion. Methods I – Video-recorded case studies are the basis of an assessment tool and checklist being developed to verify the results of programs to train participants in the care of seriously injured patients, also known as “objective structured clinical examination” (OSCE). The timing, completeness and quality of the individual measures are assessed using appropriate scales. The evaluation of team communication and interaction will be analyzed with qualitative methods and quantified and verified by existing instruments (e.g. the Clinical Team Scale). The developed assessment tool is validated by several experts in the fields of trauma care, trauma research and medical education. II a) In a German emergency medical service, the subjective assessment of paramedics of their pre-hospital care of trauma patients is evaluated at three time points, namely before, immediately after and one year after training. b) The effect of a standardized course concept on the quality of documentation in actual field operations is determined based on three items relevant to patient safety before and after the course. c) The assessment tool will be used to assess the effect of a standardized course concept on procedures and team communication in pre-hospital trauma care using scenario-based case studies. Discussion This study explores the effect of training on paramedics. After successful study completion, further multicenter studies are conceivable, which would evaluate emergency-physician staffed teams. The influence on the patients and prehospital measures should be assessed based on a retrospective analysis of the emergency room data. Trials registration German Clinical Trials Register, ID DRKS00004713. PMID:24528532

Comparison of risk and protective factors associated with smartphone addiction and Internet addiction.

PubMed

Choi, Sam-Wook; Kim, Dai-Jin; Choi, Jung-Seok; Ahn, Heejune; Choi, Eun-Jeung; Song, Won-Young; Kim, Seohee; Youn, Hyunchul

2015-12-01

Smartphone addiction is a recent concern that has resulted from the dramatic increase in worldwide smartphone use. This study assessed the risk and protective factors associated with smartphone addiction in college students and compared these factors to those linked to Internet addiction. College students (N = 448) in South Korea completed the Smartphone Addiction Scale, the Young's Internet Addiction Test, the Alcohol Use Disorders Identification Test, the Beck Depression Inventory I, the State-Trait Anxiety Inventory (Trait Version), the Character Strengths Test, and the Connor-Davidson Resilience Scale. The data were analyzed using multiple linear regression analyses. The risk factors for smartphone addiction were female gender, Internet use, alcohol use, and anxiety, while the protective factors were depression and temperance. In contrast, the risk factors for Internet addiction were male gender, smartphone use, anxiety, and wisdom/knowledge, while the protective factor was courage. Discussion These differences may result from unique features of smartphones, such as high availability and primary use as a tool for interpersonal relationships. Our findings will aid clinicians in distinguishing between predictive factors for smartphone and Internet addiction and can consequently be utilized in the prevention and treatment of smartphone addiction.

Resilience moderates the relationship between emotional intelligence and clinical communication ability among Chinese practice nursing students: A structural equation model analysis.

PubMed

Kong, Linghua; Liu, Yun; Li, Guopeng; Fang, Yueyan; Kang, Xiaofei; Li, Ping

2016-11-01

To examine the positive association between emotional intelligence and clinical communication ability among practice nursing students, and to determine whether resilience plays a moderating role in the relationship between emotional intelligence and clinical communication ability among Chinese practice nursing students. Three hundred and seventy-seven practice nursing students from three hospitals participated in this study. They completed questionnaires including the Emotional Intelligence Inventory (EII), Connor-Davidson Resilience Scale (CD-RISC-10), and Clinical Communication Ability Scale (CCAS). Structural equation modeling was used to analyze the relationships among emotional intelligence, resilience, and clinical communication ability. Emotional intelligence was positively associated with clinical communication ability (P<0.01). Resilience significantly affected clinical communication ability (P<0.01) and moderated the relationship between emotional intelligence and clinical communication ability (P<0.01). Emotional intelligence is positively related to clinical communication ability among Chinese practice nursing students, and resilience moderates the relationship between emotional intelligence and clinical communication ability, which may provide scientific evidence to aid in developing intervention strategies to improve clinical communication ability. Copyright © 2016 Elsevier Ltd. All rights reserved.

Relationship Between Resilience, Adjustment, and Psychological Functioning After Traumatic Brain Injury: A Preliminary Report.

PubMed

Lukow, Herman R; Godwin, Emilie E; Marwitz, Jennifer H; Mills, Ana; Hsu, Nancy H; Kreutzer, Jeffrey S

2015-01-01

To examine the relationship between resilience, psychological distress, adjustment, and community participation after traumatic brain injury (TBI). Large university health system. Adult survivors of mild to severe TBI (N = 96). Descriptive, preliminary. The Connor-Davidson Resilience Scale (10-item version) was used to assess resilience, the Brief Symptom Inventory (BSI-18) was used to characterize psychological distress, and the Mayo-Portland Adaptability Index (MPAI-4) was used to measure ability, adjustment, and participation. Resilience scores were substantially lower than those of the general population. Significant relationships were found between resilience, psychological distress, and adjustment. Partial correlations (adjusting for the other MPAI-4 indices) showed significant correlation (P < .05) between MPAI-4 Adjustment and resilience. Partial correlations (adjusting for the other BSI-18 scales) also showed significance for Depression (P < .01) and resilience. Resilience scores differed significantly (P < .001) between individuals meeting BSI-18 caseness criteria for psychological distress (n = 55) and those not meeting criteria (n = 41). Individuals with TBI are at risk for low resilience, which was found to correlate with psychological distress and psychosocial maladjustment. Developing interventions to strengthen resilience skills has the potential to improve postinjury psychosocial adjustment, an important area for future research.

Factors affecting the psychological functioning of Australian adults with chronic pain.

PubMed

Viggers, Lorna C; Caltabiano, Marie L

2012-12-01

The role of resilience, for adults facing ongoing adversity in the form of chronic medical conditions, has received little attention in the past. This research investigated the impact of resilience and coping strategies on the psychological functioning of 87 Australian adults with chronic pain, using a self-report questionnaire. It included the McGill Pain Questionnaire, the Connor-Davidson Resilience Scale, the Coping Strategies Questionnaire, the 36-item Short Form Health Survey, and the Depression, Anxiety and Stress Scale. Using hierarchical regression, after the effects of pain severity, catastrophizing, and ignoring the pain were controlled for, resilience was significantly associated with mental health-related quality of life (β = 0.18, P < 0.05), depression (β = -0.31, P < 0.01), and anxiety (β = -0.20, P < 0.05). In the final model for depression, resilience had a stronger association than pain severity. Resilience did not, however, influence individual's perceptions of their physical health-related quality of life. The link between resilience and mental health-related quality of life outcomes provides initial evidence for the potential application of resilience related interventions to pain management programs. © 2012 Wiley Publishing Asia Pty Ltd.

Barriers to compliance with evidence-based care in trauma.

PubMed

Rayan, Nadine; Barnes, Sunni; Fleming, Neil; Kudyakov, Rustam; Ballard, David; Gentilello, Larry M; Shafi, Shahid

2012-03-01

We have preciously demonstrated that trauma patients receive less than two-thirds of the care recommended by evidence-based medicine. The purpose of this study was to identify patients least likely to receive optimal care. Records of a random sample of 774 patients admitted to a Level I trauma center (2006-2008) with moderate to severe injuries (Abbreviated Injury Scale score ≥3) were reviewed for compliance with 25 trauma-specific processes of care (T-POC) endorsed by Advanced Trauma Life Support, Eastern Association for the Surgery of Trauma, the Brain Trauma Foundation, Surgical Care Improvement Project, and the Glue Grant Consortium based on evidence or consensus. These encompassed all aspects of trauma care, including initial evaluation, resuscitation, operative care, critical care, rehabilitation, and injury prevention. Multivariate logistic regression was used to identify patients likely to receive recommended care. Study patients were eligible for a total of 2,603 T-POC, of which only 1,515 (58%) were provided to the patient. Compliance was highest for T-POC involving resuscitation (83%) and was lowest for neurosurgical interventions (17%). Increasing severity of head injuries was associated with lower compliance, while intensive care unit stay was associated with higher compliance. There was no relationship between compliance and patient demographics, socioeconomic status, overall injury severity, or daily volume of trauma admissions. Little over half of recommended care was delivered to trauma patients with moderate to severe injuries. Patients with increasing severity of traumatic brain injuries were least likely to receive optimal care. However, differences among patient subgroups are small in relation to the overall gap between observed and recommended care. II.

History of sexual trauma moderates psychotherapy outcome for posttraumatic stress disorder.

PubMed

Markowitz, John C; Neria, Yuval; Lovell, Karina; Van Meter, Page E; Petkova, Eva

2017-08-01

Moderators of differential psychotherapy outcome for posttraumatic stress disorder (PTSD) are rare, yet have crucial clinical importance. We tested the moderating effects of trauma type for three psychotherapies in 110 unmedicated patients with chronic DSM-IV PTSD. Patients were randomized to 14 weeks of prolonged exposure (PE, N = 38), interpersonal psychotherapy (IPT, N = 40), or relaxation therapy (RT, N = 32). The Clinician-Administered PTSD Scale (CAPS) was the primary outcome measure. Moderator candidates were trauma type: interpersonal, sexual, physical. We fit a regression model for week 14 CAPS as a function of treatment (a three-level factor), an indicator of trauma type presence/absence, and their interactions, controlling for baseline CAPS, and evaluated potential confounds. Thirty-nine (35%) patients reported sexual, 68 (62%) physical, and 102 (93%) interpersonal trauma. Baseline CAPS scores did not differ by presence/absence of trauma types. Sexual trauma as PTSD criterion A significantly moderated treatment effect: whereas all therapies had similar efficacy among nonsexually-traumatized patients, IPT had greater efficacy among sexually traumatized patients (efficacy difference with and without sexual trauma: IPT vs. PE and IPT vs. RT P's < .05), specifically in PTSD symptom clusters B and D (P's < .05). Few studies have assessed effects of varying trauma types on effects of differing psychotherapies. In this exploratory study, sexual trauma moderated PTSD outcomes of three therapies: IPT showed greater benefit for sexually traumatized patients than PE or RT. The IPT focuses on affect to help patients determine trust in their current environments may particularly benefit patients who have suffered sexual assault. © 2017 Wiley Periodicals, Inc.

Gun trauma and ophthalmic outcomes.

PubMed

Chopra, N; Gervasio, K A; Kalosza, B; Wu, A Y

2018-04-01

PurposeThis retrospective cohort study assesses the visual outcomes of patients who survive gunshot wounds to the head.MethodsThe Elmhurst City Hospital Trauma Registry and Mount Sinai Data Warehouse were queried for gun trauma resulting in ocular injury over a 16-year period. Thirty-one patients over 16 years of age were found who suffered a gunshot wound to the head and resultant ocular trauma: orbital fracture, ruptured globe, foreign body, or optic nerve injury. Gun types included all firearms and air guns. Nine patients were excluded due to incorrect coding or unavailable charts. Statistical analysis was performed using a simple bivariate analysis (χ 2 ).ResultsOf the 915 victims of gun trauma to the head, 27 (3.0%) sustained ocular injuries. Of the 22 patients whose records were accessible, 18 survived. Eight of the 18 surviving patients (44%) suffered long-term visual damage, defined as permanent loss of vision in at least one eye to the level of counting fingers or worse. Neither location of injury (P=0.243), nor type of gun used (P=0.296), nor cause of gun trauma (P=0.348) predicted visual loss outcome. The Glasgow Coma Scale eye response score on arrival to the hospital also did not predict visual loss outcome (P=0.793).ConclusionThere has been a dearth of research into gun trauma and even less research on the visual outcomes following gun trauma. Our study finds that survivors of gun trauma to the head suffer long-term visual damage 44% of the time after injury.

PTSD prevalence among Polish World War II survivors.

PubMed

Lis-Turlejska, Maja; Łuszczyńska, Aleksandra; Szumiał, Szymon

2016-10-31

Over the past decade research has been published in several Western European countries on the prevalence of PTSD among World War II survivors, mostly civilians. Prevalence rates ranged from 1.9% to 10.8 %. The aim of the study was to measure the frequency of PTSD occurrence among Polish WWII survivors. Data from 96 persons: 59 women and 37 men, aged 70-96 were analyzed. All participants were born before 1945. They completed Polish adaptations of: Posttraumatic Diagnostic Scale (PDS), Impact of Events Scale (IES), Beck's Depression Inventory (BDI) and WWII trauma related questionnaire. Prevalence rate of potential PTSD was 32,3% Mean values of both number and severity of symptoms of PTSD were significantly higher for respondents with at least one war related trauma comparing to the participants who did note relate any such trauma. Comparing to other studies on WWII related PTSD the prevalence rate of possible PTSD was very high. Looking for possible explanation of such results seems to be an important challenge.

Classification of the severe trauma patient with the Abbreviated Injury Scale: degree of correlation between versions 98 and 2005 (2008 update).

PubMed

Abajas Bustillo, Rebeca; Leal Costa, César; Ortego Mate, María Del Carmen; Zonfrillo, Mark R; Seguí Gómez, María; Durá Ros, María Jesús

2018-02-01

To explore differences in severity classifications according to 2 versions of the Abbreviated Injury Scale (AIS): version 2005 (the 2008 update) and the earlier version 98. To determine whether possible differences might have an impact on identifying severe trauma patients. Descriptive study and cross-sectional analysis of a case series of patients admitted to two spanish hospitals with out-of-hospital injuries between February 2012 and February 2013. For each patient we calculated the Injury Severity Score (ISS), the New Injury Severity Score (NISS), and the AIS scores according to versions 98 and 2005. The sample included 699 cases. The mean Severity (SD) age of patients was 52.7 (29.2) years, and 388 (55.5%) were males. Version 98 of the AIS correlated more strongly with both the ISS (2.6%) and the NISS (2.9%). The 2008 update of the AIS (version 2005) classified fewer trauma patients than version 98 at the severity levels indicated by the ISS and NISS.

Stress management versus cognitive restructuring in trauma-affected refugees-A pragmatic randomised study.

PubMed

Carlsson, Jessica; Sonne, Charlotte; Vindbjerg, Erik; Mortensen, Erik Lykke

2018-05-24

The aim of this randomised trial was to compare the effectiveness of stress management (SM) versus cognitive restructuring (CR) in trauma-affected refugees. The intention-to-treat sample comprised 126 refugees with PTSD (SM = 62, CR = 64). The treatment consisted of 16 sessions of psychotherapy with manualised SM or CR in addition to 10 sessions with a medical doctor (psychoeducation and pharmacological treatment). The primary outcome was PTSD symptom severity (Harvard Trauma Questionnaire). Secondary outcomes were symptoms of depression and anxiety (Hopkins Symptom Checklist-25, Hamilton Depression and Anxiety Ratings), quality of life (WHO-5), functioning (Global Assessment of Functioning, Sheehan Disability Scale), pain (Visual Analogue Scale) and somatisation (Symptom Checklist). There was no difference in the primary outcome between groups. A significant group difference was found on the Hamilton Anxiety Rating with the SM group improving more than the CR group (effect size 0.46) indicating that methods in SM could potentially be helpful in this population. Copyright © 2018 Elsevier B.V. All rights reserved.

Long-term effects of conflict-related sexual violence compared with non-sexual war trauma in female World War II survivors: a matched pairs study.

PubMed

Kuwert, Philipp; Glaesmer, Heide; Eichhorn, Svenja; Grundke, Elena; Pietrzak, Robert H; Freyberger, Harald J; Klauer, Thomas

2014-08-01

The aim of the study was to compare the long-term effects of conflict-related sexual violence experienced at the end of World War II (WWII) with non-sexual WWII trauma (e.g., being exposed to shell shock or physical violence). A total of 27 elderly wartime rape survivors were compared to age- and gender-matched control subjects who were drawn from a larger sample of subjects over 70 years of age who had experienced WWII-related trauma. A modified version of the Posttraumatic Diagnostic Scale was used to assess trauma characteristics and posttraumatic stress disorder (PTSD) symptoms and the Brief Symptom Inventory-18 was used to assess current psychopathology. Additionally, measures of posttraumatic growth (Posttraumatic Growth Inventory) and social acknowledgement as a trauma survivor (Social Acknowledgement Questionnaire) were used to assess two mediating variables in post-trauma conditions of rape victims. Women exposed to conflict-related sexual violence reported greater severity of PTSD-related avoidance and hyperarousal symptoms, as well as anxiety, compared with female long-term survivors of non-sexual WWII trauma. The vast majority (80.9 %) of these women also reported severe sexual problems during their lifetimes relative to 19.0 % of women who experienced non-sexual war trauma. Women exposed to conflict-related sexual violence also reported greater posttraumatic growth, but less social acknowledgement as trauma survivors, compared to survivors of non-sexual war trauma. The results were consistent with emerging neurobiological research, which suggests that different traumas may be differentially associated with long-term posttraumatic sequelae in sexual assault survivors than in other survivor groups and highlights the need to treat (or better prevent) deleterious effects of conflict-related sexual violence in current worldwide crisis zones.

Surfing the net for medical information about psychological trauma: an empirical study of the quality and accuracy of trauma-related websites.

PubMed

Bremner, J Douglas; Quinn, John; Quinn, William; Veledar, Emir

2006-09-01

Psychological trauma is a major public-health problem, and trauma victims frequently turn to the Internet for medical information related to trauma. The Internet has many advantages for trauma victims, including low cost, privacy, use of access, and reduced direct social interactions. However, there are no regulations on what is posted on the Internet, or by whom, and little is known about the quality of information currently available related to the topic of psychological trauma. The purpose of this study was to evaluate the quality of Internet sites related to the topic of psychological trauma. The top 20 hits for searches on Google, AllTheWeb, and Yahoo were tabulated, using search words of 'psychological trauma', 'stress', 'PTSD', and 'trauma'. From these searches, a list of 94 unique unsponsored hits that represented accessible websites was generated. Fourteen sites were unrelated or only peripherally related, and eight were related but were not comprehensively evaluated because they represented brochures, online book sales, etc. Seventy-two websites underwent evaluation of the content, design, disclosure, ease of use, and other factors based on published guidelines for medical information sites. Forty-two per cent of sites had inaccurate information, 82% did not provide a source of their information, and 41% did not use a mental-health professional in the development of the content. Ratings of content (e.g. accuracy, reliability, etc.) were 4 (2 SD) on a scale of 1 - 10, with 10 being the best. There were similar ratings for the other variables assessed. These findings suggest that although abundant, websites providing information about psychological trauma are often not useful, and can sometimes provide inaccurate and potentially harmful information to consumers of medical information.

The Effects of Traumatic Stressors and HIV-Related Trauma Symptoms on Health and Health Related Quality of Life

PubMed Central

Sher, Tamara G.; Mattson, Melissa; Thilges, Sarah; Hansen, Nathan B.

2012-01-01

The study identified relations among traumatic stressors, HIV-related trauma symptoms, comorbid medical conditions, and health related quality of life (HRQL) in individuals with HIV. Participants (N = 118) completed a structured clinical interview on HIV as a traumatic stressor and other severe traumatic stressors and completed the Impact of Event Scale to assess HIV-related trauma symptoms and the Medical Outcomes Study 36-item Short Form (SF-36) to assess HRQL. Medical chart reviews determined comorbid conditions. Path analysis findings indicated participants with prior severe traumatic stressors experienced their HIV diagnosis as traumatic and in turn were more likely to have current HIV-related trauma symptoms which were negatively related to HRQL. HIV as a traumatic stressor was related to coronary artery diseases and HRQL. Traumatic stressors and HIV-related trauma symptoms impact health in individuals with HIV and highlight the need for psychological interventions prior to diagnosis and throughout treatment. PMID:21667297

Reliability and Validity of the Korean Version of the Symptom Checklist-Post-Traumatic Stress Disorder Scale

PubMed Central

2016-01-01

The Symptom Checklist - Post-Traumatic Stress Disorder Scale (SCL-PTSD), also known as Crime-Related PTSD Scale has been validated in survivors of interpersonal trauma in the general population. However, the psychometric properties have not been investigated in a clinical setting for patients with PTSD from diverse traumatic events. This study investigates the reliability and validity of the Korean version of the SCL-PTSD among 104 psychiatric outpatients with PTSD, caused by interpersonal (n = 50) or non-interpersonal trauma (n = 54). Self-report data of the SCL-PTSD, Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and Impact of Events Scale-Revised (IES-R) were gathered. The Korean version of the SCL-PTSD showed excellent internal consistency and moderate-to-good four-week temporal stability in both the interpersonal and non-interpersonal trauma groups. In comparison with other diagnostic groups, the scores of the SCL-PTSD were significantly higher compared to those of adjustment disorder, depression, other anxiety disorders, and schizophrenia, demonstrating its criteria-related validity. Convergent validity was confirmed because the scores of the SCL-PTSD were significantly correlated with BDI, SAI and TAI scores. Concurrent validity was demonstrated by significant correlation with the IES-R score. This study demonstrated the favorable psychometric prosperities of the Korean version of the SCL-PTSD, supporting its use in clinical research and practice. PMID:27134501

The Role of Computed Tomography in Blunt Abdominal Trauma.

PubMed

Karki, O B

2015-01-01

Blunt injury trauma is regularly encountered in the emergency department. Diagnostic tools that help in optimum management of blunt abdominal trauma include; Focussed Assessment Sonography for Trauma scan, Diagnostic peritoneal lavage and Computed Tomography scan. The aim of this study is to determine the validity of CT scan as an accurate diagnostic tool and its role in management of patients with blunt abdominal trauma. A prospective analysis of 80 patients of blunt abdomen trauma who were admitted in Manipal Teaching Hospital, Pokhara, Nepal within a span of 15 months was done. Demographic data, mechanism of trauma, management and outcomes were studied. Organ injuries were graded using the Organ Injury Scale guidelines. Most of the patients in our study were in the age group of 21-40 years with an M: F ratio of 2.3:1. Road traffic accident (47.5%) was the most common mechanism of injury. Spleen (27.5%) was the commonest organ injured. CT scan was superior to FAST scan and had sensitivity of 97.3% specificity 75% positive predictive value 98.6%. FAST scan had sensitivity of 78.9%, specificity 50%, positive predictive value 96% with p- value of 0.0034. 81% of patients were conservatively managed. In conjunction with close clinical monitoring, CT scan is reliable in the evaluation and management of blunt abdominal trauma patients. Our study also shows CT as a superior diagnostic modality compared to FAST scan.

IMPACT OF DENTAL TRAUMA AND ESTHETIC IMPAIRMENT ON THE QUALITY OF LIFE OF PRESCHOOL CHILDREN

PubMed Central

Gonçalves, Bruna Miroski; Dias, Loraine Fernandes; Pereira, Carla da Silva; Ponte, Marcos Ximenes; Konrath, Andréa Cristina; Bolan, Michele da Silva; Cardoso, Mariane

2017-01-01

ABSTRACT Objective: To evaluate the impact of dental trauma and impaired esthetics on the quality of life (QoL) of preschool children and their relatives. Methods: Study conducted with 192 children aged 2 to 5 years in 11 preschools in Florianópolis, Santa Catarina, South of Brazil. Parents/caregivers completed a questionnaire on quality of life (Brazilian version of the Early Childhood Oral Health Impact Scales - B-ECOHIS), a socioeconomic survey, and then answered specific questions related to dental trauma. The subjects were examined by three accordant examiners (Kappa>0.7). Dental trauma was evaluated on the basis of indexes adopted by the World Health Organization, and esthetic impairment was then classified. Data were descriptively analyzed and put to bivariate analysis by chi-square and Fisher tests, with significance level at 5%. Results: The prevalence of dental trauma was 62.5% with 15.6% of esthetic impairment. Almost 12% of parents reported impact on the quality of life of their children. Dental trauma was not significantly associated with gender, age or QoL. Crown color change by trauma was associated with esthetic impairment. Also esthetic impairment had a negative impact on QoL (p<0.05) and was associated with oral limitations (p<0.05). Conclusions: Esthetic impairment had a negative impact on children’s quality of life, while dental trauma was not associated to it. PMID:28977132

Dose reduction in whole-body computed tomography of multiple injuries (DoReMI): protocol for a prospective cohort study

PubMed Central

2014-01-01

Background Single-pass, contrast-enhanced whole body multidetector computed tomography (MDCT) emerged as the diagnostic standard for evaluating patients with major trauma. Modern iterative image algorithms showed high image quality at a much lower radiation dose in the non-trauma setting. This study aims at investigating whether the radiation dose can safely be reduced in trauma patients without compromising the diagnostic accuracy and image quality. Methods/Design Prospective observational study with two consecutive cohorts of patients. Setting: A high-volume, academic, supra-regional trauma centre in Germany. Study population: Consecutive male and female patients who 1. had been exposed to a high-velocity trauma mechanism, 2. present with clinical evidence or high suspicion of multiple trauma (predicted Injury Severity Score [ISS] ≥16) and 3. are scheduled for primary MDCT based on the decision of the trauma leader on call. Imaging protocols: In a before/after design, a consecutive series of 500 patients will undergo single-pass, whole-body 128-row multi-detector computed tomography (MDCT) with a standard, as low as possible radiation dose. This will be followed by a consecutive series of 500 patients undergoing an approved ultra-low dose MDCT protocol using an image processing algorithm. Data: Routine administrative data and electronic patient records, as well as digital images stored in a picture archiving and communications system will serve as the primary data source. The protocol was approved by the institutional review board. Main outcomes: (1) incidence of delayed diagnoses, (2) diagnostic accuracy, as correlated to the reference standard of a synopsis of all subsequent clinical, imaging, surgical and autopsy findings, (3) patients’ safety, (4) radiation exposure (e.g. effective dose), (5) subjective image quality (assessed independently radiologists and trauma surgeons on a 100-mm visual analogue scale), (6) objective image quality (e.g., contrast-to-noise ratio). Analysis: Multivariate regression will be employed to adjust and correct the findings for time and cohort effects. An exploratory interim analysis halfway after introduction of low-dose MDCT will be conducted to assess whether this protocol is clearly inferior or superior to the current standard. Discussion Although non-experimental, this study will generate first large-scale data on the utility of imaging-enhancing algorithms in whole-body MDCT for major blunt trauma. Trial registration Current Controlled Trials ISRCTN74557102. PMID:24589310

Etiology and clinical course of pseudoseizures. Relationship to trauma, depression, and dissociation.

PubMed

Bowman, E S

1993-01-01

Twenty-seven outpatients with video-EEG-documented pseudoseizures were interviewed by a psychiatrist to determine the historical course of seizures and diagnose the current presence of these DSM-III-R diagnoses: affective disorders (85%), dissociative disorders (85%), and posttraumatic stress disorder (33%). Their mean (26.7) and median (26.9) Dissociative Experiences Scale scores were elevated. Eighty-eight percent of subjects had sustained significant trauma, including sexual abuse/rape (77%) and physical abuse (70%). Four psychodynamic pathways to pseudoseizures were noted. Most commonly, pseudoseizures originated from dissociated personalities or ego states, were expressions of dissociated memories of child abuse, and were triggered by recent stresses or traumas.

Career Adapt-Abilities Scale--Netherlands Form: Psychometric Properties and Relationships to Ability, Personality, and Regulatory Focus

ERIC Educational Resources Information Center

van Vianen, Annelies E. M.; Klehe, Ute-Christine; Koen, Jessie; Dries, Nicky

2012-01-01

The Career Adapt-Abilities Scale (CAAS)--Netherlands Form consists of four scales, each with six items, which measure concern, control, curiosity, and confidence as psychosocial resources for managing occupational transitions, developmental tasks, and work traumas. Internal consistency estimates for the subscale and total scores ranged from…

Career Adapt-Abilities Scale-USA Form: Psychometric Properties and Relation to Vocational Identity

ERIC Educational Resources Information Center

Porfeli, Erik J.; Savickas, Mark L.

2012-01-01

This article reports construction and initial validation of the United States form of the Career Adapt-Abilities Scale (CAAS). The CAAS consists of four scales, each with six items, which measure concern, control, curiosity, and confidence as psychosocial resources for managing occupational transitions, developmental tasks, and work traumas.…

Career Adapt-Abilities Scale--Portugal Form: Psychometric Properties and Relationships to Employment Status

ERIC Educational Resources Information Center

Duarte, M. Eduarda; Soares, M. C.; Fraga, S.; Rafael, M.; Lima, M. R.; Paredes, I.; Agostinho, R.; Djalo, A.

2012-01-01

The Career-Adaptabilities Scale (CAAS)--Portugal Form consists of four scales, each with seven items, which measure concern, control, curiosity, and confidence as psychosocial resources for managing occupational transitions, developmental tasks, and work traumas. Internal consistency estimates for the subscale and total scores ranged from good to…

Career Adapt-Abilities Scale--Taiwan Form: Psychometric Properties and Construct Validity

ERIC Educational Resources Information Center

Tien, Hsiu-Lan Shelley; Wang, Yu-Chen; Chu, Hui-Chuang; Huang, Tsu-Lun

2012-01-01

The present study tested the reliability and validity of the Career Adapt-Ability Scale--Taiwan Form (CAAS-Taiwan Form). The CAAS consists of four scales, each with six items, which measure concern, control, curiosity, and confidence as psychosocial resources for managing occupational transitions, developmental tasks, and work traumas. Internal…

Is trauma in Switzerland any different? epidemiology and patterns of injury in major trauma - a 5-year review from a Swiss trauma centre.

PubMed

Heim, C; Bosisio, F; Roth, A; Bloch, J; Borens, O; Daniel, R T; Denys, A; Oddo, M; Pasquier, M; Schmidt, S; Schoettker, P; Zingg, T; Wasserfallen, J B

2014-01-01

Switzerland, the country with the highest health expenditure per capita, is lacking data on trauma care and system planning. Recently, 12 trauma centres were designated to be reassessed through a future national trauma registry by 2015. Lausanne University Hospital launched the first Swiss trauma registry in 2008, which contains the largest database on trauma activity nationwide. Prospective analysis of data from consecutively admitted shock room patients from 1 January 2008 to 31 December 2012. Shock room admission is based on physiology and mechanism of injury, assessed by prehospital physicians. Management follows a surgeon-led multidisciplinary approach. Injuries are coded by Association for the Advancement of Automotive Medicine (AAAM) certified coders. Over the 5 years, 1,599 trauma patients were admitted, predominantly males with a median age of 41.4 years and median injury severity score (ISS) of 13. Rate of ISS >15 was 42%. Principal mechanisms of injury were road traffic (40.4%) and falls (34.4%), with 91.5% blunt trauma. Principal patterns were brain (64.4%), chest (59.8%) and extremity/pelvic girdle (52.9%) injuries. Severe (abbreviated injury scale [AIS] score ≥ 3) orthopaedic injuries, defined as extremity and spine injuries together, accounted for 67.1%. Overall, 29.1% underwent immediate intervention, mainly by orthopaedics (27.3%), neurosurgeons (26.3 %) and visceral surgeons (13.9%); 43.8% underwent a surgical intervention within the first 24 hours and 59.1% during their hospitalisation. In-hospital mortality for patients with ISS >15 was 26.2%. This is the first 5-year report on trauma in Switzerland. Trauma workload was similar to other European countries. Despite high levels of healthcare, mortality exceeds published rates by >50%. Regardless of the importance of a multidisciplinary approach, trauma remains a surgical disease and needs dedicated surgical resources.

The mediation effect of PTSD, perceived job stress and resilience on the relationship between trauma exposure and the development of depression and alcohol use problems in Korean firefighters: A cross-sectional study.

PubMed

Kim, Johanna Inhyang; Park, Heyeon; Kim, Jeong-Hyun

2018-03-15

Firefighters constitute a high-risk group for depression and alcohol use disorders (AUDs) due to frequent exposure to trauma. Perceived job stress and resilience are powerful factors affecting the occurrence of depression and AUDs; however, research on this subject is scarce. We investigated the relationship of perceived job stress and resilience with depression or AUDs in firefighters. A total of 7151 Korean firefighters were included for analysis. Participants completed self-report scales, including a self-reported number of exposure to incident stressors, the Korean Occupational Stress Scale - Short Form, the Post-traumatic Stress Disorder (PTSD) Symptoms Checklist - Civilian version, the Patient Health Questionnaire 9, the Brief Resilience Scale, and the Alcohol Use Disorders Identification Test. Hierarchical multivariable linear regression analyses were performed to identify the relationship of perceived job stress and resilience with depression or AUDs. Path analyses were applied to investigate the mediation effects of PTSD, perceived job stress and resilience between trauma exposure and depression or AUDs. There were significant associations of perceived job stress and resilience with depression and AUDs, respectively, even after adjusting for demographic factors, number of traumatic events, and PTSD symptoms. The relationship between trauma exposure and depression/AUDs was mediated by PTSD symptoms, which had both direct and indirect effects on depression and AUDs; indirect effect was mediated by job stress and resilience. The findings in this study demonstrated that PTSD, perceived job stress and resilience can mediate the development of depression or AUDs following trauma exposure in firefighters. Efforts to prevent PTSD, reduce job stress and increase individual resilience could help prevent depression and AUDs. The cross-sectional study design and self-report nature of the assessment tools limit the current findings. Copyright © 2018 Elsevier B.V. All rights reserved.

Task Shifting: The Use of Laypersons for Acquisition of Vital Signs Data for Clinical Decision Making in the Emergency Room Following Traumatic Injury.

PubMed

Haac, Bryce E; Gallaher, Jared R; Mabedi, Charles; Geyer, Andrew J; Charles, Anthony G

2017-12-01

In resource-limited settings, identification of successful and sustainable task-shifting interventions is important for improving care. To determine whether the training of lay people to take vital signs as trauma clerks is an effective and sustainable method to increase availability of vital signs in the initial evaluation of trauma patients. We conducted a quasi-experimental study of patients presenting with traumatic injury pre- and post-intervention. The study was conducted at Kamuzu Central Hospital, a tertiary care referral hospital, in Lilongwe, Malawi. All adult (age ≥ 18 years) trauma patients presenting to emergency department over a six-month period from January to June prior to intervention (2011), immediately post-intervention (2012), 1 year post-intervention (2013) and 2 years post-intervention (2014). Lay people were trained to take and record vital signs. The number of patients with recorded vital signs pre- and post-intervention and sustainability of the intervention as determined by time-series analysis. Availability of vital signs on initial evaluation of trauma patients increased significantly post-intervention. The percentage of patients with at least one vital sign recorded increased from 23.5 to 92.1%, and the percentage of patients with all vital signs recorded increased from 4.1 to 91.4%. Availability of Glasgow Coma Scale also increased from 40.3 to 88.6%. Increased documentation of vital signs continued at 1 year and 2 years post-intervention. However, the percentage of documented vital signs did decrease slightly after the US-trained medical student and surgeon who trained the trauma clerks were no longer available in country, except for Glasgow Coma Scale. Patients who died during emergency department evaluation were significantly less likely to have vital signs recorded. The training of lay people to collect vital signs and Glasgow Coma Scale is an effective and sustainable method of task shifting in a resource-limited setting.

Brain-derived neurotrophic factor Val66met polymorphism and plasma levels in road traffic accident survivors.

PubMed

van den Heuvel, Leigh; Suliman, Sharain; Malan-Müller, Stefanie; Hemmings, Sian; Seedat, Soraya

2016-11-01

Alterations in brain-derived neurotrophic factor (BDNF) expression and release may play a role in the pathogenesis of post-traumatic stress disorder (PTSD). This study evaluated road traffic accident (RTA) survivors to determine whether PTSD and trauma-related factors were associated with plasma BDNF levels and BDNF Val66Met carrier status following RTA exposure. One hundred and twenty-three RTA survivors (mean age 33.2 years, SD = 10.6 years; 56.9% male) were assessed 10 (SD = 4.9) days after RTA exposure. Acute stress disorder (ASD), as assessed with the Acute Stress Disorder Scale, was present in 50 (42.0%) of the participants. Plasma BDNF levels were measured with enzyme-linked immunosorbent assay and BDNF Val66Met genotyping was performed. PTSD, as assessed with the Clinician-Administered PTSD Scale, was present in 10 (10.8%) participants at 6 months follow-up. Neither BDNF Val66Met genotype nor plasma BDNF was significantly associated with the presence or severity of ASD or PTSD. Plasma BDNF levels were, however, significantly correlated with the lifetime number of trauma exposures. In RTA survivors, plasma BDNF levels increased with increasing number of prior trauma exposures. Plasma BDNF may, therefore, be a marker of trauma load.

Prevalence and predictors of stress disorders following two earthquakes.

PubMed

Yuan, Kang Chuan; Ruo Yao, Zhao; Zhen Yu, Shi; Xu Dong, Zhao; Jian Zhong, Yang; Edwards, Jason Glen; Edwards, Glen David

2013-09-01

Studies about stress disorders following a disaster have mainly been based on single-event trauma with little emphasis on multiple traumas. This study investigated the prevalence and predictors of stress disorders following two earthquakes in China. Subjects were randomly sampled from 11 villages in rural China. A total of 624 subjects were administered with the 12-item General Health Questionnaire (GHQ-12), Symptom Checklist -90-R (SCL-90-R), Coping Style Scale and Social Support Rating Scale. This was followed by a structural clinical interview using the Chinese translation of the Structured Clinical Interview for Diagnostic and Statistical Manual (DSM)-IV-TR axis 1 disorders (SCID-I-P) for acute stress disorder (ASD) and post-traumatic stress disorder (PTSD). The prevalence of ASD and PTSD was 15% and 29%, respectively. Regression analysis indicated that high intensity of trauma exposure, lower educational level, subjective feeling of economic status and psychological stress after the first earthquake significantly predicted the outcome of PTSD. The study suggested that the prevalence of stress disorders in two earthquakes were higher than that experienced in a single disaster. The intensity of trauma exposure, low educational level, bad subjective feeling of economic status, and psychological stress after the first earthquake could be used to identify survivors at risk of developing PTSD in two earthquakes.

Pattern of maxillofacial fractures in severe multiple trauma patients: a 7-year prospective study.

PubMed

Alves, La-Salete; Aragão, Irene; Sousa, Maria-José Carneiro; Gomes, Ernestina

2014-01-01

The incidence of facial trauma is high. This study has the primary objective of documenting and cataloging maxillofacial fractures in polytrauma patients. From a total of 1229 multiple trauma cases treated at the Emergency Room of the Santo Antonio Hospital - Oporto Hospital Center, Portugal, between August 2001 and December 2007, 251 patients had facial wounds and 209 had maxillofacial fractures. Aged ranged form 13 to 86 years. The applied selective method was based on the presence of facial wound with Abbreviated Injury Scale ≥1. Men had a higher incidence of maxillofacial fractures among multiple trauma patients (86.6%) and road traffic accidents were the primary cause of injuries (69.38%). Nasoorbitoethmoid complex was the most affected region (67.46%) followed by the maxilla (57.42%). The pattern and presentation of maxillofacial fractures had been studied in many parts of the world with varying results. Severe multiple trauma patients had different patterns of maxillofacial injuries. The number of maxillofacial trauma is on the rise worldwide as well as the incidence of associated sequelae. Maxillofacial fractures on multiple trauma patients were more frequent among males and in road traffic crashes. Knowing such data is elementary. The society should have a key role in the awareness of individuals and in prevention of road traffic accidents.

Family Presence during Resuscitation after Trauma

PubMed Central

Leske, Jane S.; McAndrew, Natalie S.; Brasel, Karen J.; Feetham, Suzanne

2017-01-01

Purpose The primary aim was to examine the effects of family presence during resuscitation (FPDR) in patients who survived trauma from motor vehicle crashes (MVC) and gunshot wounds (GSW) in the emergency department. Background The ongoing controversy of FPDR, dearth of comparative designs, small sample sizes, and survey methods makes it difficult to come to a definitive conclusion about any benefits of FPDR. Methods The Resiliency Model guided the selection of variables. A multivariate, comparison, prospective design was used. A convenience sample of family members participated within three days of admission to critical care. Family strengths were measured by the Family Crisis Oriented Personal Scale, Family Inventory of Resources for Management, and Family Problem Solving Communication Index. Family outcomes were measured by the State anxiety portion of the State Trait Anxiety Inventory, Acute Stress Disorder Scale, Family Member Well-being Index, and Family Satisfaction in the Intensive Care Unit Scale. Results Family members of 140 trauma patients (MVC n=110; 79%; GSW n=30, 21%) participated. Family members ranged in age from 20–84 years (M=46, SD=15, Mdn=47). The majority were female (n=112, 80%) and related to the patient as spouse (n=46, 33%). Participating in the FPDR option reduced anxiety (t= −2.43, p=.04), reduced stress (t= −2.86, p=.005), and fostered well-being (t=3.46, p=.001) but was not significant for satisfaction with critical care (t= −.28, p=.78). Discussion Results demonstrate the positive initial effects of FPDR on family members of patients surviving trauma injury. Long term effects of FPDR remain unknown. PMID:28272181

Validity and reliability of the Spanish version of the 10-item CD-RISC in patients with fibromyalgia

PubMed Central

2014-01-01

Background No resilience scale has been validated in Spanish patients with fibromyalgia. The aim of this study was to evaluate the validity and reliability of the 10-item CD-RISC in a sample of Spanish patients with fibromyalgia. Methods Design: Observational prospective multicenter study. Sample: Patients with diagnoses of fibromyalgia recruited from primary care settings (N = 208). Instruments: In addition to sociodemographic data, the following questionnaires were administered: Pain Visual Analogue Scale (PVAS), the 10-item Connor-Davidson Resilience scale (10-item CD-RISC), the Fibromyalgia Impact Questionnaire (FIQ), the Hospital Anxiety and Depression Scale (HADS), the Pain Catastrophizing Scale (PCS), the Chronic Pain Acceptance Questionnaire (CPAQ), and the Mindful Attention Awareness Scale (MAAS). Results Regarding construct validity, the factor solution in the Principal Component Analysis (PCA) was considered adequate, so the KMO test had a value of 0.91, and the Barlett’s test of sphericity was significant (χ2 = 852.8; gl = 45; p < 0.001). Only one factor showed an eigenvalue greater than 1, and it explained 50.4% of the variance. PCA and Confirmatory Factor Analysis (CFA) results did not show significant differences between groups. The 10-item CD-RISC scale demonstrated good internal consistency (Cronbach’s alpha = 0.88) and test-retest reliability (r = 0.89 for a six-week interval). The 10-item CD-RISC score was significantly correlated with all of the other psychometric instruments in the expected direction, except for the PVAS (−0.115; p = 0.113). Conclusions Our study confirms that the Spanish version of the 10-item CD-RISC shows, in patients with fibromyalgia, acceptable psychometric properties, with a high level of reliability and validity. PMID:24484847

Self-resilience as a protective factor against development of post-traumatic stress disorder symptoms in police officers.

PubMed

Lee, Jong-Ku; Choi, Hyeon-Gyeong; Kim, Jae-Yeop; Nam, Juhyun; Kang, Hee-Tae; Koh, Sang-Baek; Oh, Sung-Soo

2016-01-01

This study was conducted to check whether self-resilience, one of the characteristics known to affect the occurrence of post-traumatic stress disorder (PTSD) symptoms after experiencing traumatic events, could serve as a protective factor for police officers whose occupational factors are corrected. We conducted a cross-sectional study in which 112 male police officers in Gangwon Province participated. They visited the Wonju Severance Christian Hospital Occupational Environment Center for medical check-ups from June to December 2015. Their general characteristics were identified using structured questionnaires, and they were asked to fill in the Korean Occupational Stress Scale-Short Form (KOSS-SF). Further, the Center for Epidemiologic Studies-Depression Scale (CES-D), Connor-Davidson Resilience Scale-Korean (CD-RI-K), and Impact of Event Scale-Revised-Korean version (IES-R-K) were used to evaluate their job stress, depression, self-resilience, and PTSD symptoms. Logistic regression analysis was conducted to correct their personal, occupational, and psychological factors to analyze the relationship between self-resilience and PTSD symptoms. Among 112 respondents who experienced a traumatic event, those with low self-resilience had significantly higher rate of PTSD symptoms than those with high self-resilience even after correcting for the covariate of general, occupational, and psychological characteristics (odds ratio [OR] 3.51; 95 % CI: 1.06-19.23). Despite several limitations, these results suggest that a high degree of self-resilience may protect police officers from critical incident-related PTSD symptoms.

Is the dissociative adult suggestible? A test of the trauma and fantasy models of dissociation.

PubMed

Kluemper, Nicole S; Dalenberg, Constance

2014-01-01

Psychologists have long assumed a connection between traumatic experience and psychological dissociation. This hypothesis is referred to as the trauma model of dissociation. In the past decade, a series of papers have been published that question this traditional causal link, proposing an alternative fantasy model of dissociation. In the present research, the relationship among dissociation, suggestibility, and fantasy proneness was examined. Suggestibility was measured through the Gudjonsson Scale of Interrogative Suggestibility (GSS) as well as an autobiographically based version of this measure based on the events of September 11, 2001. Consistent with prior research and with the trauma model, dissociation correlated positively with trauma severity (r = .32, p < .01) and fantasy proneness (r = .60, p < .01). Inconsistent with the fantasy model, dissociation did not correlate with the neutral form of the GSS and correlated negatively (r = -.24, p < .05) with the trauma-focused form of this suggestibility measure. Although some participants did become quite emotional during the procedure, the risk/benefit ratio was perceived by almost all participants to be positive, with more reactive individuals evaluating the procedure more positively. The results consistently support the trauma model of dissociation and fail to support the fantasy model of dissociation.

Workshop Report: Early-Career Anthropologists: Vocation and Occupation

ERIC Educational Resources Information Center

Follis, Karolina S.; Rogler, Christian R.

2015-01-01

Casualisation takes different forms in different academic contexts, from the "adjunctification" of teaching in the U.S.A. to precarious grant-funded postdoc positions common in Europe and the U.K. and the efforts to introduce other forms of temporary academic employment in New Zealand (Shore and Davidson 2014) and Australia (Barcan…

75 FR 57396 - List of Nonconforming Vehicles Decided To Be Eligible for Importation

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-21

... environment, public health or safety, or State, local, or Tribal governments or communities; (2) Create a..., health, or safety risk that NHTSA has reason to believe may have a disproportionate effect on children. L... (MC) FX, FL, XL Series..... 1986-1997 202 ...... ...... Harley Davidson (MC) FX, FL, XL & VR Series...

Undergraduate Quality Management Project: Motorcycle Manufacturer Vendor Rating System

ERIC Educational Resources Information Center

Baker, James; McHaney, Roger

2009-01-01

A major motorcycle vendor, based in the U.S. Midwest, is the world's largest custom V-Twin motorcycle manufacturer and domestically the second largest motorcycle manufacturer behind Harley-Davidson. This project describes the process used used by a K-State undergraduate distance learning student to design and develop the initial version of a…

NASHVILLE, EXPERIMENT IN URBAN SCHOOL CONSOLIDATION.

ERIC Educational Resources Information Center

EGERTON, JOHN; LEESON, JIM

THE BIGGEST CHANGE WHICH RESULTED FROM THE CONSOLIDATION OF NASHVILLE AND DAVIDSON COUNTY, TENNESSEE, INTO ONE GOVERNMENTAL UNIT WAS THE CREATION OF A UNIFIED SCHOOL SYSTEM. NOW, ALL BUT ONE MEMBER OF THE NEW METRO BOARD OF EDUCATION ARE NEW APPOINTEES, AS IS THE DIRECTOR OF THE SCHOOL SYSTEM. UNDER THIS NEW LEADERSHIP BROAD CHANGES IN THE…

76 FR 10926 - Self-Regulatory Organizations; Municipal Securities Rulemaking Board; Notice of Filing of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-28

..., Chief Financial Officer dated September 8, 2010 (``Georgetown, Texas Letter''); and Portland Letter... the financial advisor are separate, adversarial roles and cannot be provided by the same party.'' One..., President and Chief Executive Officer dated September 29, 2010 (``D.A. Davidson Letter''); and J.J.B...

76 FR 23854 - Reclassification of Motorcycles (Two and Three Wheeled Vehicles) in the Guide to Reporting...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-28

... and the unintended consequences of misclassification. Harley Davidson Motor Company (HDMC) stated that... concerns about the administrative, logistical and financial burdens of providing information based on the... estimated that the cost of updating their computers to process the information included in the new guidance...

Track 1.5/2 Security Dialogues with China: Nuclear Lessons Learned

DTIC Science & Technology

2014-09-01

Montville, “Foreign Policy According to Freud ,” Foreign Policy 45 (Winter, 1981-1982): 153. 10 Montville and Davidson took this as their starting...D., and Joseph V. Montville. “Foreign Policy According to Freud .” Foreign Policy 45 (Winter, 1981−1982):145−157. English-Chinese Chinese-English

A Theory of Direct Discourse: Its Semantics and Pragmatics

ERIC Educational Resources Information Center

Matsusaka, Youichi

2013-01-01

The dissertation presents a new account of how direct discourse works in natural language. After presenting preliminary discussions of the views of quotation given by Tarski, Quine, and Davidson in Chapter 1, Chapter 2 is devoted to historical investigations into Frege's theory of quotation and direct discourse. Although Frege's theory is often…

Sustainability and Higher Education: From Arborescent to Rhizomatic Thinking

ERIC Educational Resources Information Center

Le Grange, Lesley Lionel Leonard

2011-01-01

Currently, global society is delicately poised on a civilisational threshold similar to that of the feudal era. This is a time when outmoded institutions, values, and systems of thought and their associated dogmas are ripe for transcendence by more relevant systems of organization and knowledge (Davidson, 2000). The foundations of the modern era…

FORUM: Instructional Communication and Millennial Students: Teaching Communication to Emerging Adults

ERIC Educational Resources Information Center

Tompkins, Paula S.

2016-01-01

The new developmental stage of emerging adulthood (age 18-25) offers a framework for thinking about younger millennials in our classrooms. Smith, Christoffersen, Davidson, and Herzog's (2011) profile of emerging adults, based on longitudinal study of over 3200 emerging adults and culminating in 230 in-depth interviews, parallels research of the…

Academic Orientation, Academic Achievement, and Noctcaelador: Does Interest in Night-Sky Watching Correlate with Students' Approach to the Academic Environment?

ERIC Educational Resources Information Center

Kelly, William E.; Daughtry, Don

2007-01-01

This study explored the relationship between academic orientation, academic achievement, and interest in night-sky watching (noctcaelador). Participants included 117 students enrolled in undergraduate psychology classes who completed the Survey of Academic Orientations (SAO; Davidson, Beck, & Silver, 1999), Noctcaelador Inventory (NI; Kelly,…

Digital Portfolios and Learning: The Students' Voices

ERIC Educational Resources Information Center

Donnelly, Brian Francis

2010-01-01

The convergence of innovations in digital technologies and expanding global internet connectivity has given rise to an emerging field of study identified as Digital Media and Learning (DML). (Davidson and Goldberg, 2009; Gee, 2009; Ito, Horst and Bittanti, 2008; Jenkins and Purushotma, 2008). In describing his work for the MacArthur Foundation's…

Mood as Embodied Action: A Phenomenological Study of Interaction between Self and the Environment

ERIC Educational Resources Information Center

Manley, Dolores R.

2009-01-01

This phenomenological study explored the interaction between the affective phenomenon of mood (Davidson, et al., 2003) and embodied action (Varela, et al., 1993) experienced during interaction between self and the environment. Exploring the complementarity of mood and embodied action for organizations, teams, or individuals provided insightful…

76 FR 5078 - Approval and Promulgation of Air Quality Implementation Plans: Tennessee; Approval of Section 110...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-28

...) Maintenance Plan for the 1997 8-Hour Ozone Standards for the Nashville, TN, Area AGENCY: Environmental... Tennessee State Implementation Plan (SIP) concerning the maintenance plan addressing the 1997 8-hour ozone standards for the Nashville, Tennessee 1997 8-hour ozone maintenance area, which is comprised of Davidson...

Self-Nurturing of Precocious Youth

ERIC Educational Resources Information Center

Feldhusen, John F.

2005-01-01

In their new book, "Genius Denied" (2004), Jan and Bob Davidson paint a bleak picture of the educational scene for gifted and talented children in the United States. They also do a thorough job of presenting and describing the many school programs and services available and the good research bases for those programs and services. What…

Hardy: A Collection of Critical Essays. Twentieth Century Views Series.

ERIC Educational Resources Information Center

Guerard, Albert J., Ed.

One of a series of works aimed at presenting contemporary critical opinion on major authors, this collection includes essays by Albert Guerard, Donald Davidson, Morton Dauwen Zabel, D. H. Lawrence, John Hollowan, Dorothy Van Ghent, John Paterson, A. Alvarez, Delmore Schwartz, W. H. Auden, David Perkins, and Samuel Hynes--all dealing with the…

Hospitalization Cost Offset of a Hostility Intervention for Coronary Heart Disease Patients

ERIC Educational Resources Information Center

Davidson, Karina W.; Gidron, Yori; Mostofsky, Elizabeth; Trudeau, Kimberlee J.

2007-01-01

The authors evaluated hospitalization cost offset of hostility management group therapy for patients with coronary heart disease (CHD) from a previously published randomized controlled trial (Y. Gidron, K. Davidson, & I. Bata, 1999). Twenty-six male patients with myocardial infarction or unstable angina were randomized to either 2 months of…

North Carolina's Higher Education System: Success or Failure?

ERIC Educational Resources Information Center

Gillen, Andrew; Vedder, Richard

2008-01-01

North Carolina has long prided itself on what many perceive to be one of the finest systems of higher education in the country. Aside from having a number of nationally recognized private schools of distinction (e.g., Duke, Wake Forest, Davidson), the state has invested aggressively with public funds. State government appropriations for higher…

The Effects of Railroads on the Emergence of Operational Art During the American Civil War, 1861-1865

DTIC Science & Technology

2013-05-23

L&N Railroad in the Civil War: A Vital North–South Link and the Struggle to Control It. Jefferson: McFarland & Company, 2011. Lord, Francis A...Battlefield 1861-1863. Amherst: Prometheus Books, 2008. Reynolds, Paul Davidson. A Primer in Theory Construction. Boston: Allyn and Bacon Classics

Merger in Higher Education: Learning from Experiences

ERIC Educational Resources Information Center

Drowley, Melinda J.; Lewis, Duncan; Brooks, Simon

2013-01-01

Political pressure to reduce the number of higher education institutions in Wales has been sustained for over a decade by three successive ministers for education, two of whom, Jane Davidson and the current incumbent, Leighton Andrews, have left the Welsh sector in no doubt about the strength of their personal commitment to the policy of…

Contemporary Reflections on Speech-Based Language Learning

ERIC Educational Resources Information Center

Gustafson, Marianne

2009-01-01

In "The Relation of Language to Mental Development and of Speech to Language Teaching," S.G. Davidson displayed several timeless insights into the role of speech in developing language and reasons for using speech as the basis for instruction for children who are deaf and hard of hearing. His understanding that speech includes more than merely…

Predictors of Intrathoracic Injury after Blunt Torso Trauma in Children Presenting to an Emergency Department as Trauma Activations.

PubMed

McNamara, Caitlin; Mironova, Irina; Lehman, Erik; Olympia, Robert P

2017-06-01

Thoracic injuries are a major cause of death associated with blunt trauma in children. Screening for injury with chest x-ray study, compared with chest computed tomography (CT) scan, has been controversial, weighing the benefits of specificity with the detriment of radiation exposure. To identify predictors of thoracic injury in children presenting as trauma activations to a Level I trauma center after blunt torso trauma, and to compare these predictors with those previously reported in the literature. We performed a retrospective chart review of pediatric patients (<18 years of age) who presented to the Emergency Department of a Level I trauma center between June 2010 and June 2013 as a trauma activation after sustaining a blunt torso trauma and who received diagnostic imaging of the chest as part of their initial evaluation. Data analysis was performed on 166 patients. There were 33 patients (20%) with 45 abnormalities detected on diagnostic imaging of the chest, with the most common abnormalities being lung contusion (36%), pneumothorax (22%), and rib fracture (13%). Statistically significant predictors of abnormal diagnostic imaging of the chest included Glasgow Coma Scale score (GCS) < 15 (27% with abnormality vs. 13% without abnormality), hypoxia (22% vs. 5%), syncope/loss of consciousness (55% vs. 35%), cervical spine tenderness (12% vs. 3%), thoraco-lumbar-sacral spine tenderness (41% vs. 17%), and abdominal/pelvic tenderness (12% vs. 3%). Based on our data, predictors of thoracic injury in children after blunt torso trauma include GCS < 15, hypoxia, syncope/dizziness, cervical spine tenderness, thoraco-lumbar-sacral spine tenderness, and abdominal/pelvic tenderness. Copyright © 2016 Elsevier Inc. All rights reserved.

[Post-traumatic stress reaction in a sample of bank employees victims of robbery in the workplace: the role of pre-trauma and peri-trauma factors].

PubMed

Converso, Daniela; Viotti, Sara

2014-07-24

Robberies are traumatizing events for workers. Consequently, a number of health problems can arise. In the short term, a common reaction is post-traumatic stress (including intrusion, avoidance, and hyperarousal symptoms). The aim of the present study was to identify, among pre-trauma factors (personal characteristics: gender, age, educational level, and prior exposure to robberies) and peri-trauma factors (kind of weapon, duration of the event, number of robbers, and numbers of colleagues and clients involved), those that were most likely to cause post-traumatic symptoms in a sample of bank employees who were victims of a robbery. One-hundred-seventy-two employees at two banks in northwest Italy were involved in the research. A month after a robbery, the employees completed a self-report questionnaire including the Impact of Event Scale-Revised (IES-R) by Weiss and Marmar (39). Analyses found one pre-trauma factor (prior exposure to robbery/ies, and one peri-trauma factor, number of robbers) as significant predictors of intrusion. Two peri-trauma factors (number of robbers and duration of robbery) were identified as predictors of avoidance. Finally, one pre-trauma factor (prior exposure to robbery/ies) and two peri-trauma factors (number of robbers and number of colleagues involved in the robbery) were found to be predictors of hyperarousal. The results showed that several peri-trauma factors can increase the risk of workers developing post-traumatic stress reaction and suggest that these factors should be kept in mind when planning intervention programmes aimed at preventing and contrasting psychological consequences of robbery.

Moving from "optimal resources" to "optimal care" at trauma centers.

PubMed

Shafi, Shahid; Rayan, Nadine; Barnes, Sunni; Fleming, Neil; Gentilello, Larry M; Ballard, David

2012-04-01

The Trauma Quality Improvement Program has shown that risk-adjusted mortality rates at some centers are nearly 50% higher than at others. This "quality gap" may be due to different clinical practices or processes of care. We have previously shown that adoption of processes called core measures by the Joint Commission and Centers for Medicare and Medicaid Services does not improve outcomes of trauma patients. We hypothesized that improved compliance with trauma-specific clinical processes of care (POC) is associated with reduced in-hospital mortality. Records of a random sample of 1,000 patients admitted to a Level I trauma center who met Trauma Quality Improvement Program criteria (age ≥ 16 years and Abbreviated Injury Scale score 3) were retrospectively reviewed for compliance with 25 trauma-specific POC (T-POC) that were evidence-based or expert consensus panel recommendations. Multivariate regression was used to determine the relationship between T-POC compliance and in-hospital mortality, adjusted for age, gender, injury type, and severity. Median age was 41 years, 65% were men, 88% sustained a blunt injury, and mortality was 12%. Of these, 77% were eligible for at least one T-POC and 58% were eligible for two or more. There was wide variation in T-POC compliance. Every 10% increase in compliance was associated with a 14% reduction in risk-adjusted in-hospital mortality. Unlike adoption of core measures, compliance with T-POC is associated with reduced mortality in trauma patients. Trauma centers with excess in-hospital mortality may improve patient outcomes by consistently applying T-POC. These processes should be explored for potential use as Core Trauma Center Performance Measures.

Interaction Between FKBP5 and Childhood Trauma and Risk of Aggressive Behavior

PubMed Central

Bevilacqua, Laura; Carli, Vladimir; Sarchiapone, Marco; George, Danielle K.; Goldman, David; Roy, Alec; Enoch, Mary-Anne

2012-01-01

Context Childhood trauma may predispose individuals to aggressive behavior, and both childhood trauma and aggressive behavior are associated with hypothalamicpituitary-adrenal axis dysregulation. Objective To determine whether there would be an interaction between genetic variation in FKBP5 and childhood trauma in predicting aggressive behavior. Design Cross-sectional study. Four FKBP5 single-nucleotide polymorphisms used in previous studies (rs3800373, rs9296158, rs1360780, and rs9470080) were genotyped. Three diplotypes were derived from 2 major putatively functional haplotypes regulating protein expression that were previously associated with glucocorticoid receptor sensitivity. Setting Penitentiary District of Abruzzo-Molise in central Italy. Participants A population of 583 male Italian prisoners recruited between 2005 and 2008. Main Outcome Measures A comprehensive analysis of aggression and impulsivity was undertaken using the Brown-Goodwin Lifetime History of Aggression (BGHA) questionnaire, the Buss-Durkee Hostility Inventory (BDHI), and the Barratt Impulsiveness Scale (BIS). A history of childhood trauma was investigated with the Childhood Trauma Questionnaire. The interaction between the FKBP5 diplotypes and childhood trauma on measures of aggression was analyzed. Analyses were replicated with a second behavioral measure of aggression: violent behavior in jail. Individual single-nucleotide polymorphism analysis was performed. Results Childhood trauma had a significant effect on BGHA and BDHI scores but not on BIS scores. We observed a significant influence of the FKBP5 high-expression diplotype on both a lifetime history of aggressive behavior (BGHA) (P = .012) and violent behavior in jail (P = .025) but only in individuals exposed to childhood trauma, in particular to physical abuse. No main effect of the FKBP5 diplotypes was observed. Conclusion These data suggest that childhood trauma and variants in the FKBP5 gene may interact to increase the risk of overt aggressive behavior. PMID:22213790

A review of the management of blunt splenic trauma in England and Wales: have regional trauma networks influenced management strategies and outcomes?

PubMed

Yiannoullou, P; Hall, C; Newton, K; Pearce, L; Bouamra, O; Jenks, T; Scrimshire, A B; Hughes, J; Lecky, F; Macdonald, Adh

2017-01-01

INTRODUCTION The spleen remains one of the most frequently injured organs following blunt abdominal trauma. In 2012, regional trauma networks were launched across England and Wales with the aim of improving outcomes following trauma. This retrospective cohort study investigated the management and outcomes of blunt splenic injuries before and after the establishment of regional trauma networks. METHODS A dataset was drawn from the Trauma Audit Research Network database of all splenic injuries admitted to English and Welsh hospitals from 1 April 2010 to 31 March 2014. Demographic data, injury severity, treatment modalities and outcomes were collected. Management and outcomes were compared before and after the launch of regional trauma networks. RESULTS There were 1457 blunt splenic injuries: 575 between 2010 and 2012 and 882 in 2012-14. Following the introduction of the regional trauma networks, use of splenic artery embolotherapy increased from 3.5% to 7.6% (P = 0.001) and splenectomy rates decreased from 20% to 14.85% (P = 0.012). Significantly more patients with polytrauma and blunt splenic injury were treated with splenic embolotherapy following 2012 (61.2% vs. 30%, P < 0.0001). Increasing age, injury severity score, polytrauma and Charlson Comorbidity Index above 10 were predictors of increased mortality (P < 0.001). Increasing systolic blood pressure (odds ratio, OR, 0.757, 95% confidence interval, CI, 0.716-0.8) and Glasgow Coma Scale (OR 0.988, 95% CI 0.982-0.995) were protective. CONCLUSIONS This study demonstrates a reduction in splenectomy rate and an increased use of splenic artery embolotherapy since the introduction of the regional trauma networks. This may have resulted from improved access to specialist services and reduced practice variation since the establishment of these networks.

Should air medical patients be transferred on helipad or trauma bay?

PubMed

Lehrfeld, David; Gemignani, Robert; Shiroff, Adam; Kuhlmann, Sarah; Ohman-Strickland, Pamela; Merlin, Mark A

2013-01-01

Helicopter emergency medical services (HEMS) are widely used in regional trauma care and present unique challenges in the patient handoff process. In particular, the practice of patient handoff on the landing zone versus the trauma bay does not exist in ground emergency medical services. We hypothesized that patients handed off on the landing zone versus the trauma bay would have different patient characteristics and outcomes. A retrospective review identified 305 HEMS trauma patients received at our level 1 trauma center over a 3-year period. Patients were sorted on the basis of the handoff location, (landing zone vs. trauma bay) and assessed for predictors of injury severity including the Revised Trauma Score, the Injury Severity Score, the Trauma and Injury Severity Score, and other outcomes, primarily mortality. Of the 305 patients, 235 (77%) were handed off in the bay, and 70 (23%) were not. Regarding the characteristics of patients who were handed off in the bay, they were more likely to have hypotension (100% vs. 73%), have a lower O(2) saturation level (97.9 vs. 99.4), and a lower Glasgow Coma Scale at the scene (10.9 vs. 13.9.). When controlling for injury severity, the odds of survival for patients who were handed off in the bay were 11.06 times the odds for patients who were not handed off in the bay. In this limited study, we found that HEMS did identify the sickest patients and brought them to the trauma bay. Despite their greater injury severity, the patients handed off in the bay fared better than those handed off on the landing zone. Copyright © 2013 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

A Delphi study on research priorities for trauma nursing.

PubMed

Bayley, E W; Richmond, T; Noroian, E L; Allen, L R

1994-05-01

To identify and prioritize research questions of importance to trauma patient care and of interest to trauma nurses. A three-round Delphi technique was used to solicit, identify, and prioritize problems for trauma nursing research. In round 1, experienced trauma nurses (N = 208) generated 513 problems, which were analyzed, categorized, and collapsed into 111 items for subsequent rounds. Round 2 participants rated each research question on a 1 to 7 scale on two criteria: impact on patient welfare and value for practicing nurses. Group median scores provided by 166 round 2 respondents and respondents' individual round 2 scores were indicated on the round 3 questionnaire. Subjects rated the questions again on the same criteria and indicated whether nurses, independently or in collaboration with other health professionals, should assume responsibility for that research. Median and mean scores and rank order were determined for each item. Respondents who completed all three rounds (n = 137) had a mean of 8.3 years of trauma experience. Nine research questions ranked within the top 20 on both criteria. The two research questions that ranked highest on both criteria were: What are the most effective nursing interventions in the prevention of pulmonary and circulatory complications in trauma patients? and What are the most effective methods for preventing aspiration in trauma patients during the postoperative phase? The third-ranked question regarding patient welfare was: What psychological and lifestyle changes result from traumatic injury? Regarding value for practicing nurses, What are the most effective educational methods to prepare and maintain proficiency in trauma care providers? ranked third. These research priorities provide impetus and direction for nursing and collaborative investigation in trauma care.

Resilience, self-esteem and self-compassion in adults with spina bifida.

PubMed

Hayter, M R; Dorstyn, D S

2014-02-01

Cross-sectional survey. To examine factors that may enhance and promote resilience in adults with spina bifida. Community-based disability organisations within Australia. Ninety-seven adults with a diagnosis of spina bifida (SB) completed a survey comprising of demographic questions in addition to standardised self-report measures of physical functioning (Craig Handicap Assessment and Reporting Technique), resilience (Connor-Davidson Resilience Scale, 10 item), self-esteem (Rosenberg Self-esteem Scale), self-compassion (Self-compassion Scale) and psychological distress (Depression Anxiety Stress Scales, 21 item). The majority (66%) of respondents reported moderate to high resilience. Physical disability impacted on coping, with greater CD-RISC 10 scores reported by individuals who were functionally independent in addition to those who experienced less medical co-morbidities. Significant correlations between resilience and psychological traits (self-esteem r=0.36, P<0.01; self-compassion r=0.40, P<0.01) were also noted. However, the combined contribution of these variables only accounted for 23% of the total variance in resilience scores (R(2)=0.227, F(5,94)=5.23, P<0.01). These findings extend current understanding of the concept of resilience in adults with a congenital physical disability. The suggestion is that resilience involves a complex interplay between physical determinants of health and psychological characteristics, such as self-esteem and self-compassion. It follows that cognitive behavioural strategies with a focus on self-management may, in part, contribute to the process of resilience in this group. Further large-scale and longitudinal research will help to confirm these findings.

Neurobehavioural and cognitive function is linked to childhood trauma in homeless adults.

PubMed

Pluck, Graham; Lee, Kwang-Hyuk; David, Rajan; Macleod, Diana C; Spence, Sean A; Parks, Randolph W

2011-03-01

To describe levels of traumatic childhood events in a sample of homeless individuals and to assess the contribution of traumatic events to neurobehavioural traits (measured with the Frontal Systems Behaviour Scale, FrSBe) and general cognitive function (IQ). A sample of 55 homeless adults was recruited from homeless services in the city of Sheffield, UK. All were interviewed to acquire substance misuse information, record experiences of childhood trauma, and assess cognitive and neurobehavioural traits. Experiences of abuse and neglect were assessed with the Childhood Trauma Questionnaire. Participants also completed the Wechsler Abbreviated Scale of Intelligence and the FrSBe, which was completed with respect to current behaviour and conduct prior to homelessness. Around three-quarters of the sample scored in the clinically significant range for current neurobehavioural impairment. They also reported high levels of impairment when rating retrospectively for the period before they were homeless. The mean group IQ was below average at 88. Abuse or neglect during their upbringing was reported by 89% of the sample. Emotional abuse, emotional neglect, and physical neglect were all positively correlated with total FrSBe scores. Sexual abuse, emotional neglect, and physical neglect were all negatively correlated with IQ. The associations between trauma and IQ and neurobehavioural traits appear generally unrelated to the presence of substance misuse in the sample. Our homeless sample displayed relatively low IQ with high levels of neurobehavioural impairment. Our evidence suggests that these neuropsychological factors may, in part, constitute a long-term consequence of childhood trauma. ©2010 The British Psychological Society.

Comparing shame in clinical and nonclinical populations: Preliminary findings.

PubMed

Dyer, Kevin F W; Dorahy, Martin J; Corry, Mary; Black, Rebecca; Matheson, Laura; Coles, Holly; Curran, David; Seager, Lenaire; Middleton, Warwick

2017-03-01

To conduct a preliminary study comparing different trauma and clinical populations on types of shame coping style and levels of state shame and guilt. A mixed independent groups/correlational design was employed. Participants were recruited by convenience sampling of 3 clinical populations-complex trauma (n = 65), dissociative identity disorder (DID; n = 20), and general mental health (n = 41)-and a control group of healthy volunteers (n = 125). All participants were given (a) the Compass of Shame Scale, which measures the four common shame coping behaviors/styles of "withdrawal," "attack self," "attack other," and "avoidance," and (b) the State Shame and Guilt Scale, which assesses state shame, guilt, and pride. The DID group exhibited significantly higher levels of "attack self," "withdrawal," and "avoidance" relative to the other groups. The complex trauma and general mental health groups did not differ on any shame variable. All three clinical groups had significantly greater levels of the "withdrawal" coping style and significantly impaired shame/guilt/pride relative to the healthy volunteers. "Attack self" emerged as a significant predictor of increased state shame in the complex trauma, general mental health, and healthy volunteer groups, whereas "withdrawal" was the sole predictor of state shame in the DID group. DID emerged as having a different profile of shame processes compared to the other clinical groups, whereas the complex trauma and general mental health groups had comparable shame levels and variable relationships. These differential profiles of shame coping and state shame are discussed with reference to assessment and treatment. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Childhood trauma and dissociation among women with genito-pelvic pain/penetration disorder

PubMed Central

Özen, Beliz; Özdemir, Y Özay; Beştepe, E Emrem

2018-01-01

Objective Causes such as childhood trauma, negative attitude about sexuality, inadequate sexual knowledge and education, relationship problems, and unconscious motivation are reported about psychosexual development in the etiology of genito-pelvic pain/penetration disorder (GPP/PD). There are few studies that focus directly on research etiology of GPP/PD and use structured scales. The aim of this study was to research childhood trauma and dissociation forms among women with GPP/PD. Patients and methods Fifty-five women with GPP/PD according to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders and 61 healthy women with no complaints of sexual function as a control group, in the age range of 18–60 years, were included in this study. Sociodemographic data form, Childhood Trauma Questionnaire (CTQ-28), Dissociative Experiences Scale (DES), and Somatoform Dissociation Questionnaire (SDQ-20) were administered to all participants. Results Sexual abuse, emotional abuse, and emotional neglect scores, which comprise the subgroups of CTQ, were found high among women with GPP/PD compared with the control group (p=0.003, p=0.006, p=0.001). While a significant difference between the two groups’ SDQ scores was obtained (p=0.000), no significant difference was detected between the two groups’ DES scores (p=0.392). Discussion The results evoke the question are genitopelvic pain conditions, vaginismus and dyspareunia, that cannot be explained with a medical cause and that cause penetration disorder, a kind of dissociative symptom prone to develop in some women with childhood psychogenic trauma. PMID:29503548

Development and Validation of the Five-by-Five Resilience Scale.

PubMed

DeSimone, Justin A; Harms, P D; Vanhove, Adam J; Herian, Mitchel N

2017-09-01

This article introduces a new measure of resilience and five related protective factors. The Five-by-Five Resilience Scale (5×5RS) is developed on the basis of theoretical and empirical considerations. Two samples ( N = 475 and N = 613) are used to assess the factor structure, reliability, convergent validity, and criterion-related validity of the 5×5RS. Confirmatory factor analysis supports a bifactor model. The 5×5RS demonstrates adequate internal consistency as evidenced by Cronbach's alpha and empirical reliability estimates. The 5×5RS correlates positively with the Connor-Davidson Resilience Scale (CD-RISC), a commonly used measure of resilience. The 5×5RS exhibits similar criterion-related validity to the CD-RISC as evidenced by positive correlations with satisfaction with life, meaning in life, and secure attachment style as well as negative correlations with rumination and anxious or avoidant attachment styles. 5×5RS scores are positively correlated with healthy behaviors such as exercise and negatively correlated with sleep difficulty and symptomology of anxiety and depression. The 5×5RS incrementally explains variance in some criteria above and beyond the CD-RISC. Item responses are modeled using the graded response model. Information estimates demonstrate the ability of the 5×5RS to assess individuals within at least one standard deviation of the mean on relevant latent traits.

Are severely injured trauma victims in Norway offered advanced pre-hospital care? National, retrospective, observational cohort.

PubMed

Wisborg, T; Ellensen, E N; Svege, I; Dehli, T

2017-08-01

Studies of severely injured patients suggest that advanced pre-hospital care and/or rapid transportation provides a survival benefit. This benefit depends on the disposition of resources to patients with the greatest need. Norway has 19 Emergency Helicopters (HEMS) staffed by anaesthesiologists on duty 24/7/365. National regulations describe indications for their use, and the use of the national emergency medical dispatch guideline is recommended. We assessed whether severely injured patients had been treated or transported by advanced resources on a national scale. A national survey was conducted collecting data for 2013 from local trauma registries at all hospitals caring for severely injured patients. Patients were analysed according to hospital level; trauma centres or acute care hospitals with trauma functions. Patients with an Injury Severity Score (ISS) > 15 were considered severely injured. Three trauma centres (75%) and 17 acute care hospitals (53%) had data for trauma patients from 2013, a total of 3535 trauma registry entries (primary admissions only), including 604 victims with an ISS > 15. Of these 604 victims, advanced resources were treating and/or transporting 51%. Sixty percent of the severely injured admitted directly to trauma centres received advanced services, while only 37% of the severely injured admitted primarily to acute care hospitals received these services. A highly developed and widely distributed HEMS system reached only half of severely injured trauma victims in Norway in 2013. © 2017 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

Trauma-related emotions and radical acceptance in dialectical behavior therapy for posttraumatic stress disorder after childhood sexual abuse.

PubMed

Görg, Nora; Priebe, Kathlen; Böhnke, Jan R; Steil, Regina; Dyer, Anne S; Kleindienst, Nikolaus

2017-01-01

Posttraumatic Stress Disorder (PTSD) related to childhood sexual abuse (CSA) is often associated with a wide range of trauma-related aversive emotions such as fear, disgust, sadness, shame, guilt, and anger. Intense experience of aversive emotions in particular has been linked to higher psychopathology in trauma survivors. Most established psychosocial treatments aim to reduce avoidance of trauma-related memories and associated emotions. Interventions based on Dialectical Behavior Therapy (DBT) also foster radical acceptance of the traumatic event. This study compares individual ratings of trauma-related emotions and radical acceptance between the start and the end of DBT for PTSD (DBT-PTSD) related to CSA. We expected a decrease in trauma-related emotions and an increase in acceptance. In addition, we tested whether therapy response according to the Clinician Administered PTSD-Scale (CAPS) for the DSM-IV was associated with changes in trauma-related emotions and acceptance. The data was collected within a randomized controlled trial testing the efficacy of DBT-PTSD, and a subsample of 23 women was included in this secondary data analysis. In a multilevel model, shame, guilt, disgust, distress, and fear decreased significantly from the start to the end of the therapy whereas radical acceptance increased. Therapy response measured with the CAPS was associated with change in trauma-related emotions. Trauma-related emotions and radical acceptance showed significant changes from the start to the end of DBT-PTSD. Future studies with larger sample sizes and control group designs are needed to test whether these changes are due to the treatment. ClinicalTrials.gov, number NCT00481000.

Evaluation of Military Trauma System Practices Related to Complications After Injury

DTIC Science & Technology

2012-01-01

and ventilator- associated pneumonia (VAP).3Y5 This current analysis illustrates three key examples of trauma system PI initiatives related to...the Abbreviated Injury Scale (AIS) body re- gion of 7 (upper extremity) or 8 (lower extremity). Compartment syndrome patients were identified in the...queried met the inclusion criteria for the VAP evaluation study. Of the total study popu- lation, 1.7% of patients (n = 107) acquired VAP, whereas

[The use of enerion in the treatment of asthenic disorders in patients after mild cranio-cerebral trauma].

PubMed

Levin, O S; Slizkova, Iu B

2007-01-01

Asthenia is a key symptom of posttraumatic disorders (postcommotion syndrom). The dynamics of the symptom developing after mild cranio-cerebral trauma was studied during the treatment of 36 patients with enerion (20 patients) and piracetam (16 patients - control group). The authors present the results of the complex study, which includes neuropsychological tests and scales. It was shown that enerion was more effective as compared with paracetam.

The Danieli Inventory of Multigenerational Legacies of Trauma, Part II: Reparative Adaptational Impacts.

PubMed

Danieli, Yael; Norris, Fran H; Lindert, Jutta; Paisner, Vera; Kronenberg, Sefi; Engdahl, Brian; Richter, Julia

2015-05-01

The impacts of the Holocaust on children of survivors have been widely investigated. However, consensus is limited, and no validated measures have been tailored with or to them. We aimed to develop and validate a scale that measures these specific impacts (Part II of the Danieli Inventory of Multigenerational Legacies of Trauma). We studied 484 adult children of survivors who participated in a cross-sectional web-based survey in English or Hebrew; of these, 191 participated in a clinical interview. Exploratory factor analyses of 58 items to reduce and refine the measure yielded a 36-item scale, Reparative Adaptational Impacts, that had excellent internal consistency (α = .91) and congruence between English and Hebrew versions (φ ≥ .95). Associations between impacts and SCID-based diagnoses of major depressive episode, posttraumatic stress disorder, and generalized anxiety disorder were moderate to strong (ds = 0.48-0.89). Strong associations also emerged between severity of offspring's reparative adaptational impacts and intensity of their parents' posttrauma adaptational styles (Multiple R = .72), with intensity of victim style, especially the mother's, having the strongest effect (β = .31-.33). Having both research and clinical relevance for assessing Holocaust survivors' offspring, future studies might investigate the scale's generalizability to other populations affected by mass trauma. (c) 2015 APA, all rights reserved).

Negative and positive effects of traumatic experiences in a group of emergency service workers --the role of personal and social resources.

PubMed

Ogińska-Bulik, Nina

2013-01-01

The purpose of the research is to investigate the role of personal (spirituality) and social (social support in the workplace) resources in both negative (post-traumatic stress disorder - PTSD symptoms) and positive (post-traumatic growth) effects of experienced trauma in a group of emergency service workers. Data of 116 workers representing emergency service (37.1% firefighters, 37.1%, police officers and 25.8% medical rescue workers) who have experienced traumatic events in their worksite were analyzed. The range of age of the participants was 21-57 years (M = 35.27; SD = 8.13). Polish versions of the Impact of Events Scale - Revised and the Post-traumatic Growth Inventory were used to assess the negative and positive effects of experienced events. Spirituality was assessed by self-report questionnaire and social support in the workplace scale was measured by the scale What support you can count on. The results revealed that support from supervisors reduces the severity of PTSD symptoms, and spirituality and support from co-workers promote the growth after trauma. Personal resources in the form of spirituality, compared with the social resources, play more important role in gaining benefits from trauma than in protecting against the harmful effects of the experienced traumatic event.

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

PubMed

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.

Validation of the Center for Epidemiological Studies Depression Scale among Korean Adolescents.

PubMed

Heo, Eun-Hye; Choi, Kyeong-Sook; Yu, Je-Chun; Nam, Ji-Ae

2018-02-01

The Center for Epidemiological Studies Depression Scale (CES-D) is designed to measure the current level of depressive symptomatology in the general population. However, no review has examined whether the scale is reliable and valid among children and adolescents in Korea. The purpose of this study was to test whether the Korean form of the CES-D is valid in adolescents. Data were obtained from 1,884 adolescents attending grades 1-3 in Korean middle schools. Reliability was evaluated by internal consistency (Cronbach's alpha). Concurrent validity was evaluated by a correlation analysis between the CES-D and other scales. Construct validity was evaluated by exploratory factor and confirmatory factor analyses. The internal consistency coefficient for the entire group was 0.88. The CES-D was positively correlated with scales that measure negative psychological constructs, such as the State Anxiety Inventory for Children, the Korean Social Anxiety Scale for Children and Adolescents, and the Reynold Suicidal Ideation Questionnaire, but it was negatively correlated with scales that measure positive psychological constructs, such as the Korean version of the Rosenberg Self-Esteem Scale and the Connor-Davidson Resilience Scale-2. The CES-D was examined by three-dimensional exploratory factor analysis, and the three-factor structure of the scale explained 53.165% of the total variance. The variance explained by factor I was 24.836%, that explained by factor II was 15.988%, and that explained by factor III was 12.341%. The construct validity of the CES-D was tested by confirmatory factor analysis, and we applied the entire group's data using a three-factor hierarchical model. The fit index showed a level similar to those of other countries' adolescent samples. The CES-D has high internal consistency and addresses psychological constructs similar to those addressed by other scales. The CES-D showed a three-factor structure in an exploratory factor analysis. The present findings suggest that the CES-D is a useful and reliable tool for measuring depression in Korean adolescents.

Towards an accurate representation of electrostatics in classical force fields: Efficient implementation of multipolar interactions in biomolecular simulations

NASA Astrophysics Data System (ADS)

Sagui, Celeste; Pedersen, Lee G.; Darden, Thomas A.

2004-01-01

The accurate simulation of biologically active macromolecules faces serious limitations that originate in the treatment of electrostatics in the empirical force fields. The current use of "partial charges" is a significant source of errors, since these vary widely with different conformations. By contrast, the molecular electrostatic potential (MEP) obtained through the use of a distributed multipole moment description, has been shown to converge to the quantum MEP outside the van der Waals surface, when higher order multipoles are used. However, in spite of the considerable improvement to the representation of the electronic cloud, higher order multipoles are not part of current classical biomolecular force fields due to the excessive computational cost. In this paper we present an efficient formalism for the treatment of higher order multipoles in Cartesian tensor formalism. The Ewald "direct sum" is evaluated through a McMurchie-Davidson formalism [L. McMurchie and E. Davidson, J. Comput. Phys. 26, 218 (1978)]. The "reciprocal sum" has been implemented in three different ways: using an Ewald scheme, a particle mesh Ewald (PME) method, and a multigrid-based approach. We find that even though the use of the McMurchie-Davidson formalism considerably reduces the cost of the calculation with respect to the standard matrix implementation of multipole interactions, the calculation in direct space remains expensive. When most of the calculation is moved to reciprocal space via the PME method, the cost of a calculation where all multipolar interactions (up to hexadecapole-hexadecapole) are included is only about 8.5 times more expensive than a regular AMBER 7 [D. A. Pearlman et al., Comput. Phys. Commun. 91, 1 (1995)] implementation with only charge-charge interactions. The multigrid implementation is slower but shows very promising results for parallelization. It provides a natural way to interface with continuous, Gaussian-based electrostatics in the future. It is hoped that this new formalism will facilitate the systematic implementation of higher order multipoles in classical biomolecular force fields.

Childhood trauma and adulthood physical health in Mexico.

PubMed

Baker, Charlene K; Norris, Fran H; Jones, Eric C; Murphy, Arthur D

2009-06-01

The present study examined the effect of childhood trauma on adulthood physical health among a randomly selected sample of adults (N = 2,177) in urban Mexico. Adults were interviewed about their experiences of trauma, post-traumatic stress disorder, depression, and physical health symptoms using Module K of the Composite International Diagnostic Interview, the Center for Epidemiologic Studies Depression Scale, and the Physical Symptoms Checklist. Trauma was prevalent, with 35% reporting a traumatic event in childhood. In general, men reported more childhood trauma than women, with the exception of childhood sexual violence where women reported more exposure. For men, childhood sexual violence was related to total and all physical health symptom subscales. For women, childhood sexual violence was related to total, muscular-skeletal, and gastrointestinal-urinary symptoms; hazards/accidents in childhood were related to total, muscular-skeletal, cardio-pulmonary, and nose-throat symptom subscales. Depression mediated the relationship between childhood sexual violence and physical health symptoms for men and women. Among women only, PTSD mediated the relationship between childhood sexual violence and total, muscular-skeletal, and gastrointestinal-urinary symptoms. PTSD also mediated the relationship between hazards/accidents in childhood and total, muscular-skeletal, cardio-pulmonary, and nose-throat symptoms. These findings can be used to increase awareness among general practitioners, as well as community stakeholders, about the prevalence of childhood trauma in Mexican communities and its impact on subsequent physical health outcomes. With this awareness, screening practices could be developed to identify those with trauma histories in order to increase positive health outcomes among trauma survivors.

Comparing the responsiveness of functional outcome assessment measures for trauma registries.

PubMed

Williamson, Owen D; Gabbe, Belinda J; Sutherland, Ann M; Wolfe, Rory; Forbes, Andrew B; Cameron, Peter A

2011-07-01

Measuring long-term disability and functional outcomes after major trauma is not standardized across trauma registries. An ideal measure would be responsive to change but not have significant ceiling effects. The aim of this study was to compare the responsiveness of the Glasgow Outcome Scale (GOS), GOS-Extended (GOSE), Functional Independence Measure (FIM), and modified FIM in major trauma patients, with and without significant head injuries. Patients admitted to two adult Level I trauma centers in Victoria, Australia, who survived to discharge from hospital, were aged 15 years to 80 years with a blunt mechanism of injury, and had an estimated Injury Severity Score >15 on admission, were recruited for this prospective study. The instruments were administered at baseline (hospital discharge) and by telephone interview 6 months after injury. Measures of responsiveness, including effect sizes, were calculated. Bootstrapping techniques, and floor and ceiling effects, were used to compare the measures. Two hundred forty-three patients participated, of which 234 patients (96%) completed the study. The GOSE and GOS were the most responsive instruments in this major trauma population with effect sizes of 5.3 and 4.4, respectively. The GOSE had the lowest ceiling effect (17%). The GOSE was the instrument with greatest responsiveness and the lowest ceiling effect in a major trauma population with and without significant head injuries and is recommended for use by trauma registries for monitoring functional outcomes and benchmarking care. The results of this study do not support the use of the modified FIM for this purpose.

[Comparative efficiency of nootropic drugs in complex treatment of patients with remote consequences of closed craniocereberal trauma].

PubMed

Hliebova, O S; Tkachenko, O V

2008-01-01

Main data of the research were data obtained after a complex treatment of 120 persons with late consequences of closed craniocereberal trauma (CCRCT). The treatment included administration of one of nootropic agents (noophen, aminolon or entropil), magnesium sulfate, group B vitamins. All patients have passed a complex examination: specially developed questionnaire, anamnesis gathering, neurologic status, neuropsychological status with the use of multiple-aspect scales and questionnaires, examination of fundus of eye, rheoencephalography, echoencephalography, brain MRT. Results of a complex examination proved positive effect of the use of nootropic agents, in particular noophen, entropil and aminolon in complex treatment of late consequences of closed craniocereberal trauma. For optimisation of the use of nootropic agents in the treatment of late consequences of closed craniocereberal trauma it is recommended to consider features of influence of nootropic agents on certain clinical aspects of the disease.

Management of colorectal trauma: a review.

PubMed

Cheong, Ju Yong; Keshava, Anil

2017-07-01

Traumatic colorectal injuries are common during times of military conflict, and major improvements in their care have arisen in such periods. Since World War II, many classification systems for colorectal trauma have been proposed, including (i) Flint Grading System; (ii) Penetrating Abdominal Trauma Index; (iii) Colonic/Rectal Injury Scale; and (iv) destructive/non-destructive colonic injuries. The primary goal of these classifications was to aid surgical management and, more particularly, to determine whether a primary repair or faecal diversion should be performed. Primary repair is now the preferred surgical option. Patients who have been identified as having destructive injuries have been found to have higher anastomotic leak rates after a primary repair. Damage control principles need to be adhered to in surgical decision-making. In this review, we discuss the mechanisms of injury, classifications, clinical presentation and current recommendations for the management of colorectal trauma. © 2017 Royal Australasian College of Surgeons.

The safety and efficacy of the administration of recombinant activated factor VII in major surgery and trauma patients.

PubMed

Wilson, Stephen J; Bellamy, Mark C; Giannoudis, Peter V

2005-05-01

Recombinant activated Factor VII (rFVIIa) has been successfully used in the treatment of haemophilia A and B with associated inhibitors for some years. Activated Factor VII binds to activated platelets independently of tissue factor. The resulting stimulation of an exaggerated early thrombin burst at sites of vascular injury makes it an attractive potential treatment for massive, uncontrolled bleeding associated with surgery and trauma. This article describes the evidence relating to surgery and trauma. The lack of large, controlled trials of rFVIIa means that a definitive recommendation regarding its use cannot be made at present. However, in the context of clearly defined protocols and balanced treatment strategies, rFVIIa may have a role in traumatic bleeding. Large scale, randomised controlled trials in trauma are required, as is further work on the safety profile of rFVIIa with an independent international safety monitoring committee.

The impact of self-efficacy, alexithymia and multiple traumas on posttraumatic stress disorder and psychiatric co-morbidity following epileptic seizures: a moderated mediation analysis.

PubMed

Chung, Man Cheung; Allen, Rachel D; Dennis, Ian

2013-12-30

This study investigated the incidence of posttraumatic stress disorder (PTSD) and psychiatric co-morbidity following epileptic seizure, whether alexithymia mediated the relationship between self-efficacy and psychiatric outcomes, and whether the mediational effect was moderated by the severity of PTSD from other traumas. Seventy-one (M=31, F=40) people with a diagnosis of epilepsy recruited from support groups in the United Kingdom completed the Posttraumatic Stress Diagnostic Scale, the Hospital Anxiety and Depression Scale, the Toronto Alexithymia Scale-20 and the Generalized Self-Efficacy Scale. They were compared with 71 people (M=29, F=42) without epilepsy. For people with epilepsy, 51% and 22% met the diagnostic criteria for post-epileptic seizure PTSD and for PTSD following one other traumatic life event respectively. For the control group, 24% met the diagnostic criteria for PTSD following other traumatic life events. The epilepsy group reported significantly more anxiety and depression than the control. Partial least squares (PLS) analysis showed that self-efficacy was significantly correlated with alexithymia, post-epileptic seizure PTSD and psychiatric co-morbidity. Alexithymia was also significantly correlated with post-epileptic seizure PTSD and psychiatric co-morbidity. Mediation analyses confirmed that alexithymia mediated the path between self-efficacy and post-epileptic seizure PTSD and psychiatric co-morbidity. Moderated mediation also confirmed that self-efficacy and PTSD from one other trauma moderated the effect of alexithymia on outcomes. To conclude, people can develop posttraumatic stress disorder symptoms and psychiatric co-morbidity following epileptic seizure. These psychiatric outcomes are closely linked with their belief in personal competence to deal with stressful situations and regulate their own functioning, to process rather than defend against distressing emotions, and with the degree of PTSD from other traumas. © 2013 Elsevier Ireland Ltd. All rights reserved.

Abusive Head Trauma and Mortality-An Analysis From an International Comparative Effectiveness Study of Children With Severe Traumatic Brain Injury.

PubMed

Miller Ferguson, Nikki; Sarnaik, Ajit; Miles, Darryl; Shafi, Nadeem; Peters, Mark J; Truemper, Edward; Vavilala, Monica S; Bell, Michael J; Wisniewski, Stephen R; Luther, James F; Hartman, Adam L; Kochanek, Patrick M

2017-08-01

Small series have suggested that outcomes after abusive head trauma are less favorable than after other injury mechanisms. We sought to determine the impact of abusive head trauma on mortality and identify factors that differentiate children with abusive head trauma from those with traumatic brain injury from other mechanisms. First 200 subjects from the Approaches and Decisions in Acute Pediatric Traumatic Brain Injury Trial-a comparative effectiveness study using an observational, cohort study design. PICUs in tertiary children's hospitals in United States and abroad. Consecutive children (age < 18 yr) with severe traumatic brain injury (Glasgow Coma Scale ≤ 8; intracranial pressure monitoring). None. Demographics, injury-related scores, prehospital, and resuscitation events were analyzed. Children were dichotomized based on likelihood of abusive head trauma. A total of 190 children were included (n = 35 with abusive head trauma). Abusive head trauma subjects were younger (1.87 ± 0.32 vs 9.23 ± 0.39 yr; p < 0.001) and a greater proportion were female (54.3% vs 34.8%; p = 0.032). Abusive head trauma were more likely to 1) be transported from home (60.0% vs 33.5%; p < 0.001), 2) have apnea (34.3% vs 12.3%; p = 0.002), and 3) have seizures (28.6% vs 7.7%; p < 0.001) during prehospital care. Abusive head trauma had a higher prevalence of seizures during resuscitation (31.4 vs 9.7%; p = 0.002). After adjusting for covariates, there was no difference in mortality (abusive head trauma, 25.7% vs nonabusive head trauma, 18.7%; hazard ratio, 1.758; p = 0.60). A similar proportion died due to refractory intracranial hypertension in each group (abusive head trauma, 66.7% vs nonabusive head trauma, 69.0%). In this large, multicenter series, children with abusive head trauma had differences in prehospital and in-hospital secondary injuries which could have therapeutic implications. Unlike other traumatic brain injury populations in children, female predominance was seen in abusive head trauma in our cohort. Similar mortality rates and refractory intracranial pressure deaths suggest that children with severe abusive head trauma may benefit from therapies including invasive monitoring and adherence to evidence-based guidelines.

The Dissociative Subtype of PTSD Scale (DSPS): Initial Evaluation in a National Sample of Trauma-Exposed Veterans

PubMed Central

Wolf, Erika J.; Mitchell, Karen S.; Sadeh, Naomi; Hein, Christina; Fuhrman, Isaac; Pietrzak, Robert H.; Miller, Mark W.

2015-01-01

The fifth edition of the Diagnostic and Statistical Manual (DSM-5) includes a dissociative subtype of posttraumatic stress disorder (PTSD), but no existing measures specifically assess it. This paper describes the initial evaluation of a 15-item self-report measure of the subtype called the Dissociative Subtype of PTSD Scale (DSPS) in an on-line survey of 697 trauma-exposed military veterans representative of the US veteran population. Exploratory factor analyses of the lifetime DSPS items supported the intended structure of the measure consisting of three factors reflecting derealization/depersonalization, loss of awareness, and psychogenic amnesia. Consistent with prior research, latent profile analyses assigned 8.3% of the sample to a highly dissociative class distinguished by pronounced symptoms of derealization and depersonalization. Overall, results provide initial psychometric support for the lifetime DSPS scales; additional research in clinical and community samples is needed to further validate the measure. PMID:26603115

The Dissociative Subtype of PTSD Scale: Initial Evaluation in a National Sample of Trauma-Exposed Veterans.

PubMed

Wolf, Erika J; Mitchell, Karen S; Sadeh, Naomi; Hein, Christina; Fuhrman, Isaac; Pietrzak, Robert H; Miller, Mark W

2017-06-01

The fifth edition of the Diagnostic and Statistical Manual includes a dissociative subtype of posttraumatic stress disorder, but no existing measures specifically assess it. This article describes the initial evaluation of a 15-item self-report measure of the subtype called the Dissociative Subtype of Posttraumatic Stress Disorder Scale (DSPS) in an online survey of 697 trauma-exposed military veterans representative of the U.S. veteran population. Exploratory factor analyses of the lifetime DSPS items supported the intended structure of the measure consisting of three factors reflecting derealization/depersonalization, loss of awareness, and psychogenic amnesia. Consistent with prior research, latent profile analyses assigned 8.3% of the sample to a highly dissociative class distinguished by pronounced symptoms of derealization and depersonalization. Overall, results provide initial psychometric support for the lifetime DSPS scales; additional research in clinical and community samples is needed to further validate the measure.

RMG An Open Source Electronic Structure Code for Multi-Petaflops Calculations

NASA Astrophysics Data System (ADS)

Briggs, Emil; Lu, Wenchang; Hodak, Miroslav; Bernholc, Jerzy

RMG (Real-space Multigrid) is an open source, density functional theory code for quantum simulations of materials. It solves the Kohn-Sham equations on real-space grids, which allows for natural parallelization via domain decomposition. Either subspace or Davidson diagonalization, coupled with multigrid methods, are used to accelerate convergence. RMG is a cross platform open source package which has been used in the study of a wide range of systems, including semiconductors, biomolecules, and nanoscale electronic devices. It can optionally use GPU accelerators to improve performance on systems where they are available. The recently released versions (>2.0) support multiple GPU's per compute node, have improved performance and scalability, enhanced accuracy and support for additional hardware platforms. New versions of the code are regularly released at http://www.rmgdft.org. The releases include binaries for Linux, Windows and MacIntosh systems, automated builds for clusters using cmake, as well as versions adapted to the major supercomputing installations and platforms. Several recent, large-scale applications of RMG will be discussed.

Prevalence, type, and correlates of trauma exposure among adolescent men and women in Soweto, South Africa: implications for HIV prevention.

PubMed

Closson, Kalysha; Dietrich, Janan Janine; Nkala, Busi; Musuku, Addy; Cui, Zishan; Chia, Jason; Gray, Glenda; Lachowsky, Nathan J; Hogg, Robert S; Miller, Cari L; Kaida, Angela

2016-11-25

Youth trauma exposure is associated with syndemic HIV risk. We measured lifetime prevalence, type, and correlates of trauma experience by gender among adolescents living in the HIV hyper-endemic setting of Soweto, South Africa. Using data from the Botsha Bophelo Adolescent Health Survey (BBAHS), prevalence of "ever" experiencing a traumatic event among adolescents (aged 14-19) was assessed using a modified Traumatic Event Screening Inventory-Child (TESI-C) scale (19 items, study alpha = 0.63). We assessed self-reported number of potentially traumatic events (PTEs) experienced overall and by gender. Gender-stratified multivariable logistic regression models assessed independent correlates of 'high PTE score' (≥7 PTEs). Overall, 767/830 (92%) participants were included (58% adolescent women). Nearly all (99.7%) reported experiencing at least one PTE. Median PTE was 7 [Q1,Q3: 5-9], with no gender differences (p = 0.19). Adolescent men reported more violent PTEs (e.g., "seen an act of violence in the community") whereas women reported more non-violent HIV/AIDS-related PTEs (e.g., "family member or someone close died of HIV/AIDS"). High PTE score was independently associated with high food insecurity among adolescent men and women (aOR = 2.63, 95%CI = 1.36-5.09; aOR = 2.57, 95%CI = 1.55-4.26, respectively). For men, high PTE score was also associated with older age (aOR = 1.40/year, 95%CI = 1.21-1.63); and recently moving to Soweto (aOR = 2.78, 95%CI = 1.14-6.76). Among women, high PTE score was associated with depression using the CES-D scale (aOR = 2.00, 95%CI = 1.31-3.03,) and inconsistent condom use vs. no sexual experience (aOR = 2.69, 95%CI = 1.66-4.37). Nearly all adolescents in this study experienced trauma, with gendered differences in PTE types and correlates, but not prevalence. Exposure to PTEs were distributed along social and gendered axes. Among adolescent women, associations with depression and inconsistent condom use suggest pathways for HIV risk. HIV prevention interventions targeting adolescents must address the syndemics of trauma and HIV through the scale-up of gender-transformative, youth-centred, trauma-informed integrated HIV and mental health services.

Pediatric trauma BIG score: Predicting mortality in polytraumatized pediatric patients.

PubMed

El-Gamasy, Mohamed Abd El-Aziz; Elezz, Ahmed Abd El Basset Abo; Basuni, Ahmed Sobhy Mohamed; Elrazek, Mohamed El Sayed Ali Abd

2016-11-01

Trauma is a worldwide health problem and the major cause of death and disability, particularly affecting the young population. It is important to remember that pediatric trauma care has made a significant improvement in the outcomes of these injured children. This study aimed at evaluation of pediatric trauma BIG score in comparison with New Injury Severity Score (NISS) and Pediatric Trauma Score (PTS) in Tanta University Emergency Hospital. The study was conducted in Tanta University Emergency Hospital to all multiple trauma pediatric patients attended to the Emergency Department for 1 year. Pediatric trauma BIG score, PTS, and NISS scores were calculated and results compared to each other and to observed mortality. BIG score ≥12.7 has sensitivity 86.7% and specificity 71.4%, whereas PTS at value ≤3.5 has sensitivity 63.3% and specificity 68.6% and NISS at value ≥39.5 has sensitivity 53.3% and specificity 54.3%. There was a significant positive correlation between BIG score value and mortality rate. The pediatric BIG score is a reliable mortality-prediction score for children with traumatic injuries; it uses international normalization ratio (INR), Base Excess (BE), and Glasgow Coma Scale (GCS) values that can be measured within a few minutes of sampling, so it can be readily applied in the Pediatric Emergency Department, but it cannot be applied on patients with chronic diseases that affect INR, BE, or GCS.

Childhood maltreatment increases the risk of suicide attempt in schizophrenia.

PubMed

Hassan, Ahmed N; Stuart, Elizabeth A; De Luca, Vincenzo

2016-10-01

In this study, we evaluated the effect of several types of childhood trauma on lifetime suicide attempt in patients with schizophrenia spectrum disorders. We interviewed 361 participants with schizophrenia. Childhood trauma was collected using the Childhood Trauma Questionnaire (CTQ). Suicidal attempts were confirmed using subjective and objective validated scales. We applied an observational study design using propensity scores to match individuals with history of childhood trauma to those without past history of trauma. We used logistic regression models to estimate the effect of each type of childhood maltreatment on suicidal attempts controlling for demographics and known suicidal risk factors. In our sample, 39.1% of the subjects had lifetime suicide attempt. After matching the two groups and controlling for demographics and clinical confounders, total trauma score and the majority of childhood maltreatment subtypes predicted suicide attempt (odds ratios ranged from 1.74 to 2.49 with p-values ranging from 0.001 to 0.02). Physical neglect was not significantly associated with suicide attempt in our sample (p=0.94). Childhood maltreatment is confirmed to be a strong independent risk factor for suicidal attempts in schizophrenia. The risk is probably aggravated by the development of depressive symptoms and feeling of hopelessness in the adult life. Early screening and modified psychosocial treatment are recommended for psychotic individuals with trauma history. Copyright © 2016 Elsevier B.V. All rights reserved.

Is the relationship between affective temperament and resilience different in depression cases with and without childhood trauma?

PubMed

Gündoğar, Duru; Kesebir, Sermin; Demirkan, Arda Kazim; Yaylaci, Elif Tatlidil

2014-05-01

The aim of this study was to investigate if the relationship between affective temperament and resilience in major depression is different in cases with and without childhood trauma. For this purpose 100 cases with major depressive disorder (MDD) diagnosis according to DSM-IV were evaluated consecutively in their regular outpatient clinic follow-up interviews. Diagnostic interviews were done with SCID-I, affective temperament was evaluated with TEMPS-A (Evaluation of Temperament Memphis, Pisa, Paris and SanDiego-Autoquestionnaire) Temperament Questionnaire, resilience was evaluated with The Resilience Scale for Adults (RSA)-Turkish version. The presence of childhood trauma (CT) was determined by Early Trauma Inventory. In MDD cases without CT a correlation was present between psychological resilience and hyperthymic temperament, while there was a correlation between psychological resilience and depressive temperament in cases with CT. The relationship between depressive temperament and psychological resilience in cases with CT was observed in the perception of self, family cohesion, and social resources dimensions of psychological resilience. In depression cases with and without childhood trauma, the relationship between temperament and resilience appears to be different. According to our results psychological resilience was associated with hyperthymic temperament in depressive cases without childhood trauma, while it was associated with depressive temperament in depressive cases with childhood trauma. Copyright © 2014 Elsevier Inc. All rights reserved.

F7. SEX DIFFERENCES IN THE ASSOCIATION BETWEEN SELF-REPORTS OF CHILDHOOD ADVERSITIES AND SCHIZOTYPAL PERSONALITY TRAITS

PubMed Central

Toutountzidis, Diamantis; Gale, Tim; Irvine, Karen; Sharma, Shivani; Laws, Keith

2018-01-01

Abstract Background While it has been repeatedly documented that people with schizophrenia report higher levels of adverse events in childhood (emotional, physical and sexual abuse), this has not been extensively examined in healthy individuals who score highly on schizotypal personality traits. The continuum hypothesis of psychosis and schizophrenia suggests it is important to assess the relationship in those who are healthy but who experience some psychotic-like symptoms. Of course, it is problematic to rely upon the veracity of events that anyone might recall from their childhood, but this is likely to be compounded by the presence of well-documented memory and executive problems, as well as symptoms such as delusional thinking, in some adults with psychosis. One advantage of examining healthy participants is that recall is not affected by the condition itself or memory- and executive-function problems. As there is evidence that the expression of psychotic disorders differ between males and females, the etiological mechanisms and pathways to the development and experience of psychotic symptoms may equally differ. Indeed, sex differences in the association between childhood trauma and psychotic symptoms have been noted. The aim of this present study was to investigate any links between childhood trauma and psychotic-like symptoms in healthy individuals. Based on previous research the expectation is that associations will be found between self-reports of childhood trauma and schizotypal personality traits. These associations would be expected to differ between males and females. Methods The sample consisted of 320 participants (221 females, 99 males) with a mean age of 28.24 (SD 12.76). Childhood traumatic events were assessed by three sub-scales (Physical Punishment; Emotional Abuse; and Sexual Events) of the Early Trauma Inventory Self Report-Short Form (ETISR-SF; Bremner et al., 2007). Schizotypal personality traits were assessed using the Five Factor Schizotypal Inventory (FFSI; Edmundson et al., 2011). This consists of nine subscales (Interpersonal Suspiciousness; Social Anhedonia; Social Isolation and Withdrawal; Physical Anhedonia; Social Anxiousness; Social Discomfort; Odd and Eccentric; Aberrant Ideas; and Aberrant Perceptions) which were constructed as schizotypic variants of respective facets of the five factor personality model. Results The relationship between childhood trauma and schizotypy was examined using Spearman’s bivariate correlation analyses. Males showed significant positive correlations (ranging from .28 to .39) between Emotional Abuse and seven out of nine schizotypal sub-scales. The other two childhood trauma scales were not associated with any schizotypal sub-scales in males. Females showed significant positive correlations (ranging from .19 to .34) between Physical Punishment and eight out of nine schizotypal sub-scales. Additionally, females showed significant positive correlations (ranging from .26 to .35) between Emotional Abuse and all schizotypal sub-scales. Sexual Events positively correlated with two schizotypal sub-scales (Aberrant Ideas and Aberrant Perceptions) in females. Discussion From the results of this study it appears that emotional abuse was linked to the expression of psychotic-like symptoms in both sexes across a wide array of symptomatology. Therefore, any effect of emotional abuse should not be considered sex or symptom specific. By contrast, physical abuse appeared to be sex specific – affecting only females – but not symptom specific. Finally, sexual abuse appeared to have a specific link with disorganized thoughts and hallucination-like experiences in females.

Toward a unified theory of childhood trauma and psychosis: A comprehensive review of epidemiological, clinical, neuropsychological and biological findings.

PubMed

Misiak, Błażej; Krefft, Maja; Bielawski, Tomasz; Moustafa, Ahmed A; Sąsiadek, Maria M; Frydecka, Dorota

2017-04-01

There is a growing body of research focused on the relationship between childhood trauma and the risk of developing psychosis. Numerous studies, including many large-scale population-based studies, controlling for possible mediating variables, provide persuasive evidence of a dose-response association and are indicative of a causal relationship. Existing evidence supports the specificity model, showing differential associations between particular adversities and clinical symptoms, with cumulative adversity causing less favorable clinical and functional outcomes in psychotic patients. To date, several psychological and biological models have been proposed to search for underlying developmental trajectories leading to the onset of psychosis, influencing psychopathological manifestation and negative functional outcomes due to a history of childhood trauma. In this article, we provide a unified review on the relationship between childhood trauma and psychosis by integrating results of epidemiological, clinical, neuropsychological and biological studies. The question whether psychosis with a positive history of childhood trauma should be considered as a new psychotic phenotype, requiring specific therapeutic interventions, warrants further investigation. Copyright © 2017 Elsevier Ltd. All rights reserved.

A preliminary RCT of a mind body skills based intervention addressing mood and coping strategies in patients with acute orthopaedic trauma.

PubMed

Vranceanu, Ana-Maria; Hageman, Michiel; Strooker, Joost; ter Meulen, Dirk; Vrahas, Mark; Ring, David

2015-04-01

To test the acceptability and feasibility of a mind body skills-based intervention (RRCB) and estimate its preliminary effect in reducing disability and pain intensity as compared to standard care (SC) in patients with acute musculoskeletal trauma. Randomised controlled trial. Level I trauma centre. Adult patients with acute fractures at risk for chronic pain and disability based on scores on two coping with pain measures who presented to an orthopedic trauma center and met inclusion and exclusion criteria. Participants were randomied to either RRCB with SC or SC alone. Disability (short musculoskeletal functional assessment, SMFA) and pain (Numerical Analogue Scale). coping strategies (Pain Catastrophizing Scale, PCS and Pain Anxiety Scale, PAS) and mood (CESD Depression and PTSD checklist). Among the 50 patients consented, two did not complete the initial assessment. Of these, the first four received the intervention as part of an open pilot and the next 44 were randomised (24 RRCBT and 20 UC) and completed initial assessment. We combined the patients who received RRCB into one group, N=28. Of the entire sample, 34 completed time two assessments (24 RRCBT and 10 SC). The RRCB proved to be feasible and accepted (86% retention, 28 out of 24 completers). Analyses of covariance ANCOVA showed a significant (p<05) improvement and large effect sizes for all time two main study variables (.2-.5) except pain with activity where the effect size was medium (.08). Improvement for pain at rest was not significantly higher in the RRCB as compared to the control, for a small effect size (.03). The RRCB is feasible, acceptable and potentially efficacious. Level 1 prognostic. Copyright © 2014 Elsevier Ltd. All rights reserved.

Assessing the academic and professional needs of trauma nurse practitioners and physician assistants.

PubMed

Wilson, Laurie N; Wainwright, Gail A; Stehly, Christy D; Stoltzfus, Jill; Hoff, William S

2013-01-01

Because of multiple changes in the health care environment, the use of services of physician assistants (PAs) and nurse practitioners (NPs) in trauma and critical care has expanded. Appropriate training and ongoing professional development for these providers are essential to optimize clinical outcomes. This study offers a baseline assessment of the academic and professional needs of the contemporary trauma PAs/NPs in the United States. A 14-question electronic survey, using SurveyMonkey, was distributed to PAs/NPs at trauma centers identified through the American College of Surgeons Web site and other online resources. Demographic questions included trauma center level, provider type, level of education, and professional affiliations. Likert scale questions were incorporated to assess level of mentorship, comfort level with training, and individual perceived needs for academic and professional development. There were 120 survey respondents: 60 NPs and 60 PAs. Sixty-two respondents (52%) worked at level I trauma centers and 95 (79%) were hospital-employed. Nearly half (49%) reported working in trauma centers for 3 years or less. One hundred nineteen respondents (99%) acknowledged the importance of trauma-specific education; 98 (82%) were required by their institution to obtain such training. Thirty-five respondents (32%) reported receiving $1000 per year or less as a continuing medical education benefit. Insufficient mentorship, professional development, and academic development were identified by 22 (18%), 16 (13%), and 30 (25%) respondents, respectively. Opportunities to network with trauma PAs/NPs outside their home institution were identified as insufficient by 79 (66%). While PAs/NPs in trauma centers recognize the importance of continued contemporary trauma care and evidence-based practices, attending trauma-related education is not universally required by their employers. Financial restrictions may pose an additional impediment to academic development. Therefore, resource-efficient opportunities should be a prime consideration for advanced practitioners education, especially since half of the reported workforce has 3 years or less experience. The Eastern Association of Trauma and other organizations can provide an ideal venue for mentorship, academic development, and networking that is vital to PA/NP professional development and, ultimately, quality patient care.

Risk Factors for Venous Thromboembolism in Pediatric Trauma Patients and Validation of a Novel Scoring System: The Risk of Clots in Kids with Trauma (ROCKIT score)

PubMed Central

Yen, Jennifer; Van Arendonk, Kyle J.; Streiff, Michael B.; McNamara, LeAnn; Stewart, F. Dylan; Conner G, Kim G; Thompson, Richard E.; Haut, Elliott R.; Takemoto, Clifford M.

2017-01-01

OBJECTIVES Identify risk factors for venous thromboembolism (VTE) and develop a VTE risk assessment model for pediatric trauma patients. DESIGN, SETTING, AND PATIENTS We performed a retrospective review of patients 21 years and younger who were hospitalized following traumatic injuries at the John Hopkins level 1 adult and pediatric trauma center (1987-2011). The clinical characteristics of patients with and without VTE were compared, and multivariable logistic regression analysis was used to identify independent risk factors for VTE. Weighted risk assessment scoring systems were developed based on these and previously identified factors from patients in the National Trauma Data Bank (NTDB 2008-2010); the scoring systems were validated in this cohort from Johns Hopkins as well as a cohort of pediatric admissions from the NTDB (2011-2012). MAIN RESULTS Forty-nine of 17,366 pediatric trauma patients (0.28%) were diagnosed with VTE after admission to our trauma center. After adjusting for potential confounders, VTE was independently associated with older age, surgery, blood transfusion, higher Injury Severity Score (ISS), and lower Glasgow Coma Scale (GCS) score. These and additional factors were identified in 402,329 pediatric patients from the NTDB from 2008-2010; independent risk factors from the logistic regression analysis of this NTDB cohort were selected and incorporated into weighted risk assessment scoring systems. Two models were developed and were cross-validated in 2 separate pediatric trauma cohorts: 1) 282,535 patients in the NTDB from 2011 to 2012 2) 17,366 patients from Johns Hopkins. The receiver operator curve using these models in the validation cohorts had area under the curves that ranged 90% to 94%. CONCLUSIONS VTE is infrequent after trauma in pediatric patients. We developed weighted scoring systems to stratify pediatric trauma patients at risk for VTE. These systems may have potential to guide risk-appropriate VTE prophylaxis in children after trauma. PMID:26963757

An Index of Trauma Severity Based on Multiattribute Utility: An Illustration of Complex Utility Modeling.

DTIC Science & Technology

1981-10-01

measure for Central Nervus System is the Glasgow Cons Score (GCS), a scale of brain and spinal cord injury (Langfitt [1978]), and is itself an additive...concerns directly relating to the injury itself were identified. These were: 1. Ventilation Severity 2 Circulation Severity 3. Central Nervous System ...interacting system within which these concerns represent interacting parts. Most trauma involves only one of these systems , but more than one may be

Career Adapt-Abilities Scale--Italian Form: Psychometric Properties and Relationships to Breadth of Interests, Quality of Life, and Perceived Barriers

ERIC Educational Resources Information Center

Soresi, Salvatore; Nota, Laura; Ferrari, Lea

2012-01-01

The Career Adapt-Abilities Scale (CAAS)-Italian Form consists of four 6-item scales, which measure concern, control, curiosity, and confidence as psychosocial resources for managing occupational transitions, developmental tasks, and work traumas. The 24-item CAAS-Italian Form is identical to the International Form 2.0. The factor structure was…

Childhood neglect predicts disorganization in schizophrenia through grey matter decrease in dorsolateral prefrontal cortex.

PubMed

Cancel, A; Comte, M; Truillet, R; Boukezzi, S; Rousseau, P-F; Zendjidjian, X Y; Sage, T; Lazerges, P-E; Guedj, E; Khalfa, S; Azorin, J-M; Blin, O; Fakra, E

2015-10-01

Psychosocial trauma during childhood is associated with schizophrenia vulnerability. The pattern of grey matter decrease is similar to brain alterations seen in schizophrenia. Our objective was to explore the links between childhood trauma, brain morphology and schizophrenia symptoms. Twenty-one patients with schizophrenia stabilized with atypical antipsychotic monotherapy and 30 healthy control subjects completed the study. Anatomical MRI images were analysed using optimized voxel-based morphometry (VBM). Childhood trauma was assessed with the Childhood Trauma Questionnaire, and symptoms were rated on the Scale for the Assessment of Negative Symptoms (SANS) and Scale for the Assessment of Positive Symptoms (SAPS) (disorganization, positive and negative symptoms). In the schizophrenia group, we used structural equation modelling in a path analysis. Total grey matter volume was negatively associated with emotional neglect (EN) in patients with schizophrenia. Whole-brain VBM analyses of grey matter in the schizophrenia group revealed a specific inversed association between EN and the right dorsolateral prefrontal cortex (DLPFC). Path analyses identified a well-fitted model in which EN predicted grey matter density in DLPFC, which in turn predicted the disorganization score. Our findings suggest that EN during childhood could have an impact on psychopathology in schizophrenia, which would be mediated by developmental effects on brain regions such as the DLPFC. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The role of attachment in recovery after a school-shooting trauma.

PubMed

Turunen, Tuija; Haravuori, Henna; Punamäki, Raija-Leena; Suomalainen, Laura; Marttunen, Mauri

2014-01-01

Survivors of life-endangering trauma use varying resources that help them to recover. Attachment system activates in the times of distress, and is expected to associate with stress responses, arousal regulation, and mental health. We examined the associations of attachment style with posttraumatic stress disorders (PTSD) symptoms and dissociative symptoms, and posttraumatic growth (PTG) among students exposed to a school shooting in Finland in a three-wave follow-up setting. Participants were students (M age=24.9 years; 95% female) who were followed 4 (T1, N=236), 16 (T2, N=180), and 28 months (T3, N=137) after the shooting. The assessments included the Attachment Style Questionnaire, the Impact of Event Scale, part of the Adolescent Dissociative Experiences Scale and the Posttraumatic Growth Inventory. Securely attached survivors had lower levels of posttraumatic stress and dissociative symptoms than preoccupied at T1 and T2 as hypothesized. At T3 survivors with avoidant attachment style had higher levels of intrusive and hyperarousal symptoms than those with secure style. Concerning PTG, survivors with avoidant attachment style scored lower in PTG at T3 than survivors with both secure and preoccupied style. Secure attachment style was beneficial in trauma recovery. A challenge to the health care systems is to acknowledge that survivors with preoccupied and avoidant attachment styles react uniquely to trauma, and thus need help in different doses, modalities, and timings.

The severity of Internet addiction risk and its relationship with the severity of borderline personality features, childhood traumas, dissociative experiences, depression and anxiety symptoms among Turkish university students.

PubMed

Dalbudak, Ercan; Evren, Cuneyt; Aldemir, Secil; Evren, Bilge

2014-11-30

The aim of this study was to investigate the relationship of Internet addiction (IA) risk with the severity of borderline personality features, childhood traumas, dissociative experiences, depression and anxiety symptoms among Turkish university students. A total of 271 Turkish university students participated in this study. The students were assessed through the Internet Addiction Scale (IAS), the Borderline Personality Inventory (BPI), the Dissociative Experiences Scale (DES), the Childhood Trauma Questionnaire (CTQ-28), the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). The rates of students were 19.9% (n=54) in the high IA risk group, 38.7% (n=105) in the mild IA risk group and 41.3% (n=112) in the group without IA risk. Correlation analyses revealed that the severity of IA risk was related with BPI, DES, emotional abuse, CTQ-28, depression and anxiety scores. Univariate covariance analysis (ANCOVA) indicated that the severity of borderline personality features, emotional abuse, depression and anxiety symptoms were the predictors of IAS score, while gender had no effect on IAS score. Among childhood trauma types, emotional abuse seems to be the main predictor of IA risk severity. Borderline personality features predicted the severity of IA risk together with emotional abuse, depression and anxiety symptoms among Turkish university students. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Classification of comorbidity in trauma: the reliability of pre-injury ASA physical status classification.

PubMed

Ringdal, Kjetil G; Skaga, Nils Oddvar; Steen, Petter Andreas; Hestnes, Morten; Laake, Petter; Jones, J Mary; Lossius, Hans Morten

2013-01-01

Pre-injury comorbidities can influence the outcomes of severely injured patients. Pre-injury comorbidity status, graded according to the American Society of Anesthesiologists Physical Status (ASA-PS) classification system, is an independent predictor of survival in trauma patients and is recommended as a comorbidity score in the Utstein Trauma Template for Uniform Reporting of Data. Little is known about the reliability of pre-injury ASA-PS scores. The objective of this study was to examine whether the pre-injury ASA-PS system was a reliable scale for grading comorbidity in trauma patients. Nineteen Norwegian trauma registry coders were invited to participate in a reliability study in which 50 real but anonymised patient medical records were distributed. Reliability was analysed using quadratic weighted kappa (κ(w)) analysis with 95% CI as the primary outcome measure and unweighted kappa (κ) analysis, which included unknown values, as a secondary outcome measure. Fifteen of the invitees responded to the invitation, and ten participated. We found moderate (κ(w)=0.77 [95% CI: 0.64-0.87]) to substantial (κ(w)=0.95 [95% CI: 0.89-0.99]) rater-against-reference standard reliability using κ(w) and fair (κ=0.46 [95% CI: 0.29-0.64]) to substantial (κ=0.83 [95% CI: 0.68-0.94]) reliability using κ. The inter-rater reliability ranged from moderate (κ(w)=0.66 [95% CI: 0.45-0.81]) to substantial (κ(w)=0.96 [95% CI: 0.88-1.00]) for κ(w) and from slight (κ=0.36 [95% CI: 0.21-0.54]) to moderate (κ=0.75 [95% CI: 0.62-0.89]) for κ. The rater-against-reference standard reliability varied from moderate to substantial for the primary outcome measure and from fair to substantial for the secondary outcome measure. The study findings indicate that the pre-injury ASA-PS scale is a reliable score for classifying comorbidity in trauma patients. Copyright © 2012 Elsevier Ltd. All rights reserved.

An Integrated Model of Emotional Problems, Beta Power of Electroencephalography, and Low Frequency of Heart Rate Variability after Childhood Trauma in a Non-Clinical Sample: A Path Analysis Study.

PubMed

Jin, Min Jin; Kim, Ji Sun; Kim, Sungkean; Hyun, Myoung Ho; Lee, Seung-Hwan

2017-01-01

Childhood trauma is known to be related to emotional problems, quantitative electroencephalography (EEG) indices, and heart rate variability (HRV) indices in adulthood, whereas directions among these factors have not been reported yet. This study aimed to evaluate pathway models in young and healthy adults: (1) one with physiological factors first and emotional problems later in adulthood as results of childhood trauma and (2) one with emotional problems first and physiological factors later. A total of 103 non-clinical volunteers were included. Self-reported psychological scales, including the Childhood Trauma Questionnaire (CTQ), State-Trait Anxiety Inventory, Beck Depression Inventory, and Affective Lability Scale were administered. For physiological evaluation, EEG record was performed during resting eyes closed condition in addition to the resting-state HRV, and the quantitative power analyses of eight EEG bands and three HRV components were calculated in the frequency domain. After a normality test, Pearson's correlation analysis to make path models and path analyses to examine them were conducted. The CTQ score was significantly correlated with depression, state and trait anxiety, affective lability, and HRV low-frequency (LF) power. LF power was associated with beta2 (18-22 Hz) power that was related to affective lability. Affective lability was associated with state anxiety, trait anxiety, and depression. Based on the correlation and the hypothesis, two models were composed: a model with pathways from CTQ score to affective lability, and a model with pathways from CTQ score to LF power. The second model showed significantly better fit than the first model (AIC model1  = 63.403 > AIC model2  = 46.003), which revealed that child trauma could affect emotion, and then physiology. The specific directions of relationships among emotions, the EEG, and HRV in adulthood after childhood trauma was discussed.

Blunt hepatic and splenic trauma. A single Center experience using a multidisciplinary protocol.

PubMed

Ruscelli, Paolo; Buccoliero, Farncesco; Mazzocato, Susanna; Belfiori, Giulio; Rabuini, Claudio; Sperti, Pierluigi; Rimini, Massimiliano

2017-01-01

The aim of this retrospective study was to describe more than 10 years experience of a single Trauma Center about non operative management of abdominal organ injuries in hemodynamically stable patients MATERIAL OF STUDY: Between January 2001 and December 2014 ,732 consecutive patients were admitted with blunt abdominal trauma, involving liver and/or spleen and/or kidney, at the Bufalini Cesena Hospital .Management of patients included a specific institutional developed protocol :hemodynamic stability was evaluated in shock room according to the patients response to fluid challenge and the patients were classified into three categories A,B,and C. Form 732 Trauma, 356(48.6%) of patients were submitted to a surgical procedure, all the other patient 376(51.4%) underwent an non operative management .Overall mortality was 9.8% (72), mortality in the surgery group was 15.4% eheras in the non operative group was 4.5%; the relative risk of mortality, measured by the odds ratio waith a 95% confidence interval, was 3.417(2.023-5.772) for rhe surgery group; patient over 40 years old has a statistically significant higher mortality. In our series the overall mortality rate of non operative management group was 4.5%, instead in unstable patients, the surgery group, the mortality was 15.3%; the overall mortality mortality rate after the application of our protocol is 9.8%, Although surgery continues to be the standard for hemodically unstable patients with blunt hepatic and splenic trauma. In our experience AAST Organ Injury Scale was useless for the therapeutic decision making process after the CT scan if a source of bleeding was detected and immediate angiography was performed in order to control and solve it. In our experience the AAST Organ Injury Scale was useless for the therapeutic decision making process, The results suggest that the only criteria of choice for therapeutici strategy was the hemodynamic stability, Nonoperative managem,ent can be applied only following strict institutional criteria KEY WORDS: Hemodynmic stability, Nonoperative management, Trauma.

An Integrated Model of Emotional Problems, Beta Power of Electroencephalography, and Low Frequency of Heart Rate Variability after Childhood Trauma in a Non-Clinical Sample: A Path Analysis Study

PubMed Central

Jin, Min Jin; Kim, Ji Sun; Kim, Sungkean; Hyun, Myoung Ho; Lee, Seung-Hwan

2018-01-01

Childhood trauma is known to be related to emotional problems, quantitative electroencephalography (EEG) indices, and heart rate variability (HRV) indices in adulthood, whereas directions among these factors have not been reported yet. This study aimed to evaluate pathway models in young and healthy adults: (1) one with physiological factors first and emotional problems later in adulthood as results of childhood trauma and (2) one with emotional problems first and physiological factors later. A total of 103 non-clinical volunteers were included. Self-reported psychological scales, including the Childhood Trauma Questionnaire (CTQ), State–Trait Anxiety Inventory, Beck Depression Inventory, and Affective Lability Scale were administered. For physiological evaluation, EEG record was performed during resting eyes closed condition in addition to the resting-state HRV, and the quantitative power analyses of eight EEG bands and three HRV components were calculated in the frequency domain. After a normality test, Pearson’s correlation analysis to make path models and path analyses to examine them were conducted. The CTQ score was significantly correlated with depression, state and trait anxiety, affective lability, and HRV low-frequency (LF) power. LF power was associated with beta2 (18–22 Hz) power that was related to affective lability. Affective lability was associated with state anxiety, trait anxiety, and depression. Based on the correlation and the hypothesis, two models were composed: a model with pathways from CTQ score to affective lability, and a model with pathways from CTQ score to LF power. The second model showed significantly better fit than the first model (AICmodel1 = 63.403 > AICmodel2 = 46.003), which revealed that child trauma could affect emotion, and then physiology. The specific directions of relationships among emotions, the EEG, and HRV in adulthood after childhood trauma was discussed. PMID:29403401

Childhood trauma and factors associated with depression among inpatients with cardiovascular disease

PubMed Central

Barreto, Felipe José Nascimento; Garcia, Frederico Duarte; Prado, Paulo Henrique Teixeira; Rocha, Paulo Marcos Brasil; Las Casas, Nádia Souza; Vallt, Felipe Barbosa; Correa, Humberto; Neves, Maila Castro Lourenço

2017-01-01

AIM To identify factors associated with depressive symptoms among inpatients with cardiovascular disease (CVD). METHODS This is a cross-sectional study performed in a subsample of a large cross-sectional research that investigated affective disorders and suicide behaviour among inpatients hospitalized in non-surgical wards of the University Hospital of the Federal University of Minas Gerais from November 2013 to October 2015. Sociodemographic and clinical data were obtained through a structured interview and medical record review. Depression was assessed by the depression subscale of the Hospital Anxiety and Depression Scale, with scores ≥ 8 considered as positive screening for depression. We used the Fageström Test for Nicotine Dependence to characterize nicotine dependence. For assessing resilience and early-life trauma, we used the raw scores of the Wagnild and Young Resilience Scale and Childhood Trauma Questionnaire, respectively. RESULTS At endpoint, we included 137 subjects. Thirty-eight (27.7%) subjects presented depressive symptoms and nine (23.7%) of those were receiving antidepressant treatment during hospitalization. The female sex; a lower mean educational level; a greater prevalence of previous suicide attempts; a higher level of pain; a higher prevalence of family antecedents of mental disorders; a lower resilience score; and higher childhood trauma score were the factors significantly associated with screening positive for major depression (P < 0.05). Multivariate analysis demonstrated that the factors independently associated with the depressive symptoms were a higher childhood trauma severity (OR = 1.06; P = 0.004); moderate to severe nicotine dependence (OR = 8.58; P = 0.008); and the number of previous hospital admissions (OR = 1.11; P = 0.034). The obtained logistic model was considered valid, indicating that the three factors together distinguished between having or not depressive symptoms, and correctly classified 74.6% of individuals in the sample. CONCLUSION Our results demonstrate that inpatients presenting both CVD and a positive screening for depression are more prone to have antecedents of childhood trauma, nicotine dependence and a higher number of previous hospitalizations. PMID:28713688

The Advanced Trauma Operative Management course in a Canadian residency program

PubMed Central

Ali, Jameel; Ahmed, Najma; Jacobs, Lenworth M.; Luk, Stephen S.

2008-01-01

Background The Advanced Trauma Operative Management (ATOM) course was first introduced into Canada in 2003 at the University of Toronto, with senior general surgery residents being the primary focus. We present an assessment of the course in this Canadian general surgery residency program. Methods We compared trainees' pre-and postcourse self-efficacy scores and multiple choice question (MCQ) examination results, using paired t tests and resident (n = 24) and faculty (n = 7) course ratings made according to a 10-item, 5-point Likert scale. Faculty were previously trained as ATOM instructors. Results Mean pre-and postcourse self-efficacy scores were 68.9 (standard deviation [SD] 24.0) and 101.4 (SD 14.8), respectively (p < 0.001). Mean pre-and post-MCQ scores were 16.4 (SD 3.2) and 18.8 (SD 2.7), respectively (p = 0.006). On the Likert scale (1 = strongly disagree, 5 = strongly agree), all faculty and residents rated the following items as 4–5: objectives were met; knowledge, skills, clinical training, judgment and confidence improved; the live animal is a useful representation of clinical trauma; and the course should be continued but would be more appropriate for the fourth rather than the fifth year of residency. Residents rated as 1–2 the item that the human cadaver would be preferable for learning the surgical skills. Of 24 residents, 20 rated as 3 or less the item stating that the course prepares them for trauma management more adequately than their regular training program. Conclusion Self-efficacy, trauma knowledge and skills improved significantly with ATOM training. Preference was expressed for the live animal versus cadaver model, for ATOM training in the fourth rather than fifth year of residency and for the view that it complements general surgery trauma training. The data suggest that including ATOM training in Canadian general surgical residency should be considered. PMID:18682791

Identifying dissociative identity disorder: a self-report and projective study.

PubMed

Scroppo, J C; Drob, S L; Weinberger, J L; Eagle, P

1998-05-01

This study compared 21 female adult psychiatric patients diagnosed with dissociative identity disorder (DID) with 21 female adult nondissociative psychiatric patients to determine whether DID patients exhibit a distinguishing set of clinical features, and perceptual, attentional, and cognitive processes. Participants were assessed with the Dissociative Disorders Interview Schedule to assess diagnostic status. Group scores on the Dissociative Experiences Scale, Tellegen Absorption Scale, Childhood Trauma Questionnaire, Brief Symptom Inventory, and the Rorschach test were compared. DID participants reported earlier and more severe childhood trauma, more dissociative symptoms, and a greater propensity for altered states of consciousness. The DID participants also exhibited increased projective and imaginative activity, a diminished ability to integrate mental contents, a complex and driven cognitive style, and a highly unconventional view of reality.

More Vision than Renaissance: Arabic as a Language of Science in the UAE

ERIC Educational Resources Information Center

Cook, William Robert Amilan

2017-01-01

Since its unification in 1971, the United Arab Emirates has experienced tremendous growth. Wealth generated by the oil industry has helped the country rapidly develop all levels of the educational system along with the economy (Davidson in "After the Sheikhs: the coming collapse of the Gulf monarchies," Hurst, London, 2013). English has…

Truth and the Capability of Learning

ERIC Educational Resources Information Center

Hinchliffe, Geoffrey

2007-01-01

This paper examines learning as a capability, taking as its starting point the work of Amartya Sen and Martha Nussbaum. The paper is concerned to highlight the relation between learning and truth, and it does so by examining the idea of a genealogy of truth and also Donald Davidson's coherence theory. Thus the notion of truth is understood to be…

Developmentally Regulated Ribosomal rDNA Genes in Plasmodium vivax: Biological Implications and Practical Applications

DTIC Science & Technology

1994-08-10

R. A" Moore, P. B. , Schlessinger, D., Warner, J. R., eds. American Society for Microbiology , Washington, D. C. pp. 73-92. Nomura, M., Morgan, E...HEIFFER, M. H. , DAVIDSON, D. E., JR" AND KORTE, D. W., JR. 1984. Preclinical TeSiing . In " Handbook of Experimental Pharmacology" (W. Peters and

Demystifying a Q-Matrix for Making Diagnostic Inferences about L2 Reading Skills: The Author Responds

ERIC Educational Resources Information Center

Jang, Eunice Eunhee

2010-01-01

This article presents the author's response to the commentary essays by Charles Alderson and Fred Davidson on "Demystifying a Q-matrix for making diagnostic inferences about L2 reading skills" (Jang, 2009). The author stresses that their commentaries provides vital perspectives on the challenges to pushing the boundaries of current testing…

Integrated Bow Waterjet for Amphibious Vehicles.

DTIC Science & Technology

1983-01-01

8217 Davidson Laboratory Report 2276, October 1982. 3. J. D. van Manen , "Open-Water Test Series with Propellers in Nozzles," International Shipbuilding Progress...Volume 1, No. 2, 1954, pg. 99. 4. W.P.A. van Lammeren, J. D. van Manen and M.W.C. Oosterveld, "The Wageningen B-Screw Series," Trans. SNAME 1969, pg

75 FR 74145 - Receipt of Petition for Decision That Nonconforming 2010 Harley Davidson FL Series Motorcycles...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-30

... reflex reflector; (d) rear turn signal lamps; (e) stoplamp; (f) taillamp; and (g) license plate lamp.... Privacy Act: Anyone is able to search the electronic form of all comments received into any of our dockets... submit late comments. Accordingly, we recommend that you periodically search the Docket for new material...