A strategy to identify opportunities for innovation in Romanian healthcare services

PubMed Central

Coculescu, BI; Purcărea, VL; Coculescu, EC

2015-01-01

In principle, the development of medicine (including the Romanian health system) is primarily dependent on the level of funding and the efficiency with which this funding is used, the structure of the population and socio-economic development of the geographical area concerned, and not least, the attitudes and expectations of patients, which in turn translate into care taking policies system. Unlike the other services, health services are accessed by a large number of people, which results into high health. As an economic principle, the fewer resources are used to achieve the expected results, the more effective the supplier. However, the introduction of new medical technologies, many of them more reliable yet more expensive, required a reassessment of the way resources are used at the suppliers’ level to produce the expected results, an evaluation based on cost-effectiveness per analysis (or per patient) criteria. Finally, medical services are the tools of the marketing strategy of any medical organizations without which the needs and motivations of the beneficiaries (patients) could not be satisfied. In essence, the entire marketing philosophy is based on the needs and wishes of the people and on concrete solutions to solve them. PMID:26351536

Who's distressed? A comparison of diabetes-related distress by type of diabetes and medication.

PubMed

Wardian, Jana L; Tate, Joshua; Folaron, Irene; Graybill, Sky; True, Mark; Sauerwein, Tom

2018-03-07

We hypothesized that diabetes-related distress would vary by type of diabetes and medication regimen [Type 1 diabetes (T1DM), Type 2 diabetes with insulin use (T2DM-i), Type 2 diabetes without insulin use (T2DM)]. Thus, the aim of this study was to identify groups with elevated diabetes-related distress. We administered the 17-item Diabetes-related Distress Scale (DDS-17) to 585 patients. We collected demographics, medications, and lab results from patient records. Patients were categorized by type of diabetes and medication: T1DM (n = 149); T2DM-i (n = 333); and T2DM (n = 103). ANOVA revealed significant differences in sample characteristics. ANCOVA were conducted on all four DDS-17 domains [Emotional Burden (EB); Physician-related Distress (PD); Regimen-related Distress (RD); and Interpersonal Distress (ID)]; covariates included in the models were sex, age, duration of diabetes, BMI, and HbA1c. EB was significantly lower in T1DM than T2DM-i, p < 0.05. In addition, RD was significantly lower in T1DM than either T2DM-i, p < 0.05 and T2DM, p < 0.05. EB and RD are higher for those with type 2 diabetes. Thus, interventions to reduce EB and RD need to be considered for patients with type 2 diabetes. DDS-17 is useful in identifying diabetes-related distress in patients with diabetes. Efforts need to be made to reduce EB and RD. Published by Elsevier B.V.

American Terms in the Romanian of Science and Technology.

ERIC Educational Resources Information Center

Berceanu, Vera

Historical conditions determined that the Romanian language developed independently of the other Romance languages; the language thus remains behind in its development. In the eighteenth century the activity of the Transylvanian School of philologists established the Romanian language's own linguistic bases for the assimilation of borrowings from…

Parent and child distress after war exposure.

PubMed

Lai, Betty S; Hadi, Fawzyiah; Llabre, Maria M

2014-09-01

The purpose of this study was to examine multiple distress symptoms (i.e., post-traumatic stress [PTS], anxiety, depression) among parents and children exposed to the Gulf Crisis in 1990-1991. Profiles of parent distress were identified, and the relationship between parent distress and specific child distress symptoms was examined. Parents and children were assessed at one time point. Participants included 151 children (Mage = 10.62 years; 51% female) and 140 parents (Mage = 40 years; 81% female). Utilizing latent profile analysis, three parallel profiles of parent distress were identified: low distress, moderate distress, and high distress. Parent distress was a risk factor for child depression, but it was not a risk factor for child PTS or anxiety. Findings support the importance of broadening the scope of research conducted after exposure to traumatic events to include the assessment of anxiety and depression, as well as PTS, among both parents and children. Additional implications for research and clinical work are discussed. Findings support the importance of screening for multiple distress symptoms among both children and parents after war exposure. Based on our findings, clinicians may want to consider including parents in therapy for children reporting psychological distress, especially depression symptoms, after exposure to traumatic events. This study was cross-sectional. Thus, we are not able to infer direction or causality. The generalizability of our study should be interpreted with caution, as findings will need to be replicated across other populations and other cultures. © 2014 The British Psychological Society.

A system model to integrate the “Green Manufacturing” concept in Romanian manufacturing organisation

NASA Astrophysics Data System (ADS)

Tilină, D. I.; Zapciu, M.; Mohora, C.

2015-11-01

In Romania, the large majorities of the manufacturing companies consume natural resources and energy in an unsustainable manner. Over the years, the emissions of greenhouse gases have led not only to many environmental problems but also to important social and economic problems. A real solution to help the Romanian manufacturing companies to adapt to the new legislative requirements is the green manufacturing implementation. Considering the current situation, the purpose of this paper is to present a model that will integrate the green manufacturing concept at the organizational level based on the practices identified in the Romanian manufacturing companies at the operational level in the context of sustainable development.

Distinguishing Between Spiritual Distress, General Distress, Spiritual Well-Being, and Spiritual Pain Among Cancer Patients During Oncology Treatment.

PubMed

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

2017-07-01

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

Relationships Among Financial Distress, Emotional Distress, and Overall Distress in Insured Patients With Cancer.

PubMed

Meeker, Caitlin R; Geynisman, Daniel M; Egleston, Brian L; Hall, Michael J; Mechanic, Karen Y; Bilusic, Marijo; Plimack, Elizabeth R; Martin, Lainie P; von Mehren, Margaret; Lewis, Bianca; Wong, Yu-Ning

2016-07-01

Recent studies have demonstrated increasing rates of financial toxicities and emotional distress related to cancer treatment. This study assessed and characterized the relationships among financial distress, emotional symptoms, and overall distress in patients with cancer. A cross-sectional sample of patients with cancer who visited our outpatient medical oncology and psychiatry clinics completed a pen-and-paper survey. The survey assessed demographics; cost concerns; and financial, emotional, and overall distress. One hundred twenty insured patients completed the survey. Sixty-five percent reported clinically significant overall distress scores, with the same percentage reporting at least one emotional problem (worry, anxiety, depression, etc). Twenty-nine percent scored in the range of high to overwhelming financial distress. By using structural equation modeling, we found that financial distress was associated with overall distress. This association was both direct (accounting for 76% of the effect) and indirect (accounting for 24% of the effect) via mediation by emotional distress. This cohort of patients with cancer reported significant levels of emotional distress, financial distress, and overall distress. These factors were interrelated, with both financial and emotional distress contributing to overall distress. Interventions targeted at alleviating financial distress may help to decrease levels of overall distress. Copyright © 2016 by American Society of Clinical Oncology.

Relationships Among Financial Distress, Emotional Distress, and Overall Distress in Insured Patients With Cancer

PubMed Central

Meeker, Caitlin R.; Geynisman, Daniel M.; Egleston, Brian L.; Hall, Michael J.; Mechanic, Karen Y.; Bilusic, Marijo; Plimack, Elizabeth R.; Martin, Lainie P.; von Mehren, Margaret; Lewis, Bianca

2016-01-01

Purpose: Recent studies have demonstrated increasing rates of financial toxicities and emotional distress related to cancer treatment. This study assessed and characterized the relationships among financial distress, emotional symptoms, and overall distress in patients with cancer. Methods: A cross-sectional sample of patients with cancer who visited our outpatient medical oncology and psychiatry clinics completed a pen-and-paper survey. The survey assessed demographics; cost concerns; and financial, emotional, and overall distress. Results: One hundred twenty insured patients completed the survey. Sixty-five percent reported clinically significant overall distress scores, with the same percentage reporting at least one emotional problem (worry, anxiety, depression, etc). Twenty-nine percent scored in the range of high to overwhelming financial distress. By using structural equation modeling, we found that financial distress was associated with overall distress. This association was both direct (accounting for 76% of the effect) and indirect (accounting for 24% of the effect) via mediation by emotional distress. Conclusion: This cohort of patients with cancer reported significant levels of emotional distress, financial distress, and overall distress. These factors were interrelated, with both financial and emotional distress contributing to overall distress. Interventions targeted at alleviating financial distress may help to decrease levels of overall distress. PMID:27328795

History of Romanian Medical Informatics: Learning from the Past to Reshape the Future.

PubMed

Mihalas, George I; Stoicu-Tivadar, Lacramioara

2018-04-22

 The paper presents a review of the history of medical informatics in Romania, starting from the pioneering works, relating the present, and foreseeing the future.  Major milestones of the development of this field have not been simply enumerated, but described within the specific socio-political frame, grasping the entire context over the last four decades in Romania. Two main perspectives have been traced: education and training in medical informatics and implementations in healthcare.  Four distinctive historical periods are identified and the major events of each period are described in a critical manner. The history of the Romanian Society of Medical Informatics is presented in a separate chapter. The last section is dedicated to the present state of the field in Romania.  The history of Romanian Medical Informatics spans many years and is rich in content. The Romanian Society of Medical Informatics is mainly the result of the efforts undertaken by an enthusiastic and sound professional community, trying to continue the tradition, to achieve new goals, and to work as an active member of the international biomedical/health informatics community. Georg Thieme Verlag KG Stuttgart.

Storing Astronomical Information on the Romanian Territory

NASA Astrophysics Data System (ADS)

Stavinschi, Magda; Mioc, Vasile

The Romanian astronomy has a more than 2000-year old tradition which is however too little known abroad. The first known archive of astronomical information is the Dacian sanctuary at Sarmizegetusa Regia very similar to that of Stonehenge. After a gap of more than 1000 years sources of astronomical information became to be recovered. They consist mainly of records of astronomical events seen on the Romanian territory. The most safe places to store these genuine archives were the monasteries. We present a classification of the manners of storing astronomical information along with characteristic examples.

Examples of Practice: An Intercultural Approach to Translate Romanian Children's Folklore into Spanish

ERIC Educational Resources Information Center

Oprica, Dana

2016-01-01

Due to the great number of Romanian pupils in Spanish public school, the local administration organises extra-curricular Romanian courses in order to preserve the Romanian language and culture. This is a way to contribute to build and consolidate a bicultural and bilingual profile of the young people. Besides, it is also an opportunity to align…

Framing the issues: moral distress in health care.

PubMed

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

2012-03-01

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

Moral distress: levels, coping and preferred interventions in critical care and transitional care nurses.

PubMed

Wilson, Melissa A; Goettemoeller, Diana M; Bevan, Nancy A; McCord, Jennifer M

2013-05-01

To examine the level and frequency of moral distress in staff nurses working in two types of units in an acute care hospital and to gather information for future interventions addressing moral distress. In 2008, the American Association of Critical Care Nurses published a Position Statement on Moral Distress. Nurses working in units where critically ill patients are admitted may encounter distressing situations. Moral distress is the painful feelings and/or psychological disequilibrium that may occur when taking care of patients. An exploratory, descriptive design study was used to identify the type and frequency of moral distress experienced by nurses. The setting was an acute care hospital in which the subjects were sampled from two groups of nurses based on their unit assignment. A descriptive, questionnaire study was used. Nurses completed the 38-item moral distress scale, a coping questionnaire, and indicated their preferred methods for institutional support in managing distressing situations. A convenience sample of staff nurses was approached to complete the moral distress questionnaire. Overall, the nurses reported low levels of moral distress. Situations creating the highest levels of moral distress were those related to futile care. A significance between group differences was found in the physician practice dimension. Specific resources were identified to help guide future interventions to recognise and manage moral distress. Nurses reported lower levels and frequency of moral distress in these units but their open-ended responses appeared to indicate moral distress. Nurses identified specific resources that they would find helpful to alleviate moral distress. There are numerous studies that identify the situations and the impact of moral distress, but not many studies explore treatments and interventions for moral distress. This study attempted to identify nurse preferences for lessening the impact of moral distress. © 2013 Blackwell Publishing Ltd.

Navigating moral distress using the moral distress map.

PubMed

Dudzinski, Denise Marie

2016-05-01

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

Romanian adoption. The Manitoba experience.

PubMed

Benoit, T C; Jocelyn, L J; Moddemann, D M; Embree, J E

1996-12-01

To study the developmental, behavioral, and medical features in a cohort of Romanian children adopted by Manitoba families. A prospective longitudinal study. The Child Development Clinic, Children's Hospital, Winnipeg, Manitoba, from September 1990 to June 1992. Developmental, behavioral, and medical features were assessed in 22 Romanian children adopted by 18 Manitoba families. Mean (+/- SD) age at adoption was 15.5 +/- 13 months. Mean (+/- SD) age at initial assessment was 19 +/- 12 months and at follow-up, 35 +/- 13 months. Medical complications included 6 children (27%) who were positive for the hepatitis B surface antigen, 5 with intestinal parasites (23%), 1 positive for the human immunodeficiency virus, 1 with rickets (5%), and 1 with monoplegia and cleft palate (5%). Initial growth parameters were less than the fifth percentile for age for head circumference in 10 children (45%), for weight in 8 (36%), and for height in 7 (32%). At follow-up, statistically significant improvement was seen in height and weight. Initial mean (+/- SD) developmental quotients were 82 +/- 20 for gross motor, 83 +/- 23 for fine motor, 83 +/- 19 for cognitive, and 79 +/- 18 for language domains. Follow-up mean developmental quotients improved in all domains (P < .05). Twelve children (55%) displayed abnormal behavior at the initial assessment; behavioral findings persisted in 8 (36%). Initial appropriate activity level and play behavior predicted normal cognitive outcome (P < .05). This longitudinal study of Romanian adoptees delineates improvements in growth and development once the children are placed in a nurturing environment. The persistence of abnormal behavior in some children underscores the importance of further follow-up.

CIM explorer--intelligent tool for exploring the ICD Romanian version.

PubMed

Filip, F; Haras, C

2000-01-01

The CIM Explorer software provides us with an intelligent interface for exploring the Romanian version of the International Classification of Diseases (in Romanian Clasificarea Internationala a Maladiilor-CIM). The ICD was transposed from its initial appearance as a printed document into a database. The classification can be accessed in two modes: "Navigation" and "Code" and queried in the "Key words" mode. In the last mode CIM Explorer program searches for the right content of the ICD records starting from naturally written expressions which it "understands". As a results it returns all the records containing the key words regardless their grammatical form. This program implements the specificity of the Romanian language where the words are made up from a root and a flexional termination.

A philosophical taxonomy of ethically significant moral distress.

PubMed

Thomas, Tessy A; McCullough, Laurence B

2015-02-01

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

The Holocaust as Reflected in Communist and Post-Communist Romanian Textbooks

ERIC Educational Resources Information Center

Barbulescu, Ana; Degeratu, Laura; Gusu, Cosmina

2013-01-01

Romanian history textbooks were mostly silent about the Holocaust during the Communist era. The authors reconstructed the different models of remembering the Holocaust that are present in post-Communist Romanian textbooks. The analysis revealed the existence of six different models of recollecting this history. The six models of representing the…

Creative Children in Romanian Society.

ERIC Educational Resources Information Center

Dinca, Margareta

1999-01-01

Romanian teachers and creative adolescents were interviewed to profile the creative adolescent, focusing on self-image and a description of social conditions contributing to creativity. Responses suggested that schools lack the means to stimulate creativity. Teachers recognize creativity but lack curricula to meet students' needs. Creative…

Individualism and collectivism: what differences between Portuguese and Romanian adolescents?

PubMed

Ciochină, Laura; Faria, Luísa

2009-11-01

This article presents the results of a series of preliminary comparisons, between the Portuguese and Romanian cultural contexts, on the individualism-collectivism (IND/COL) cultural dimension. The IND/COL was evaluated with the Individualism-Collectivism Questionnaire - ICQ -, constructed in New Zealand by Shulruf, Hattie and Dixon (2003, Anonymous Questionnaire of Self-Attitudes - AQSA), and adapted to the Portuguese and Romanian contexts by Ciochină and Faria (2007), using studies of confirmatory factor analysis. The ICQ composed by 26 items, 15 evaluating the IND scale--with three subscales (Uniqueness, Competition and Responsibility)--, and 11 evaluating the COL scale--with two subscales (Harmony and Advice)--, was administered to 395 subjects, 200 Portuguese and 195 Romanian, 10th and 12th graders. On the whole, in the Portuguese and Romanian samples, the multivariate and univariate statistical analyses evidenced the existence of two independent variables--gender and cultural context--, with significant effects, main and of interaction, on the scales and subscales of the ICQ. The results were discussed taking into consideration the specificities of the educational systems in the two cultural contexts, which are inevitably shaped by socio-cultural factors characteristic of the two countries considered in the present study--Portugal and Romania.

Psychological distress in the active duty military spine patient.

PubMed

Brooks, D Ethan; Agochukwu, Uzondu F; Arrington, Edward D; Mok, James M

2013-10-01

Disorders of the spine are a substantial burden to the military health care system that degrades readiness in the overall force. Because treatment outcomes are affected by psychosocial factors, assessment of psychological distress is important for patients with spine complaints. The incidence of psychological distress in the unique military population is not well described. The purpose of this retrospective case-control study was to determine the rate of psychological distress and identify associated patient characteristics among many variables collected in the military health system. A consecutive cohort of active duty service members presenting to a spine specialty clinic was assessed as Normal, At Risk, or Distressed using the Distress and Risk Assessment Method. Of 74 active duty patients (63 male, 11 female), 43 (58%) had some level of psychological distress: 29 (39%) At Risk, 12 (16%) Distressed-Depressive, and 2 (3%) Distressed-Somatic. Multivariate regression analysis identified female gender (odds ratio [OR] 7.90), higher disability as measured by Oswestry Disability Index/Neck Disability Index (OR 8.0 per 13.8 point increase), and assignment to a Warrior Transition Unit or Medical Evaluation Board (OR 7.35) as statistically significant variables. The results indicate that active duty patients are subject to similarly high levels of psychological distress as their civilian counterparts. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

Moral distress and moral conflict in clinical ethics.

PubMed

Fourie, Carina

2015-02-01

Much research is currently being conducted on health care practitioners' experiences of moral distress, especially the experience of nurses. What moral distress is, however, is not always clearly delineated and there is some debate as to how it should be defined. This article aims to help to clarify moral distress. My methodology consists primarily of a conceptual analysis, with especial focus on Andrew Jameton's influential description of moral distress. I will identify and aim to resolve two sources of confusion about moral distress: (1) the compound nature of a narrow definition of distress which stipulates a particular cause, i.e. moral constraint, and (2) the distinction drawn between moral dilemma (or, more accurately, moral conflict) and moral distress, which implies that the two are mutually exclusive. In light of these concerns, I argue that the definition of moral distress should be revised so that moral constraint should not be a necessary condition of moral distress, and that moral conflict should be included as a potential cause of distress. Ultimately, I claim that moral distress should be understood as a specific psychological response to morally challenging situations such as those of moral constraint or moral conflict, or both. © 2013 John Wiley & Sons Ltd.

Profile and predictors of global distress: can the DT guide nursing practice in prostate cancer?

PubMed

Lotfi-Jam, Kerryann; Gough, Karla; Schofield, Penelope; Aranda, Sanchia

2014-02-01

This study examines the ability of the distress thermometer to accurately identify patients with higher symptoms, unmet needs and psychological morbidity. Baseline data collected as part of a randomized controlled trial evaluating a nurse-led supportive care intervention for men with prostate cancer commencing radiotherapy at a specialist cancer hospital in Melbourne, Australia. Measures assessed global distress (DT), anxious and depressive symptomatology (HADS), prostate-cancer specific quality of life (EPIC-26), unmet supportive care needs (SCNS-SF34R) and cancer treatment-related concerns (CATS). Following descriptive and correlational analysis, hierarchical multiple regression was employed to examine the contribution of variable sets to explaining variance in DT scores. Less than 20% of men reported DT scores of 4 or higher, indicating overall low distress. The DT accurately identified almost all men reporting HADS score indicative of anxious or depressive symptomatology, suggesting it accurately identifies psychological morbidity. Importantly, the DT identified a further group of distressed men, not identified by HADS, whose distress related to unmet needs and prostate cancer-specific issues, indicating the DT is superior in identifying other forms of distress. While the hierarchical multiple regression confirmed anxious and depressive symptomatology as the best predictor of distress score, many other scales are also good predictors of DT scores, supporting the argument that distress is multi-determined. Nurses can be confident that the DT accurately identifies patients with psychological morbidity and importantly identifies other patients with distress who may require intervention. A distress score of 4 or higher identified participants with higher physical symptomatology, higher unmet needs, more concerns about treatment and poorer quality of life. The low prevalence of distress reaching cut off scores suggests nurses would not be overwhelmed by the outcomes

Romanian experience on packaging testing

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

Vieru, G.

2007-07-01

With more than twenty years ago, the Institute for Nuclear Research Pitesti (INR), through its Reliability and Testing Laboratory, was licensed by the Romanian Nuclear Regulatory Body- CNCAN and to carry out qualification tests [1] for packages intended to be used for the transport and storage of radioactive materials. Radioactive materials, generated by Romanian nuclear facilities [2] are packaged in accordance with national [3] and the IAEA's Regulations [1,6] for a safe transport to the disposal center. Subjecting these packages to the normal and simulating test conditions accomplish the evaluation and certification in order to prove the package technical performances.more » The paper describes the qualification tests for type A and B packages used for transport and storage of radioactive materials, during a period of 20 years of experience. Testing is used to substantiate assumption in analytical models and to demonstrate package structural response. The Romanian test facilities [1,3,6] are used to simulate the required qualification tests and have been developed at INR Pitesti, the main supplier of type A packages used for transport and storage of low radioactive wastes in Romania. The testing programme will continue to be a strong option to support future package development, to perform a broad range of verification and certification tests on radioactive material packages or component sections, such as packages used for transport of radioactive sources to be used for industrial or medical purposes [2,8]. The paper describes and contain illustrations showing some of the various tests packages which have been performed during certain periods and how they relate to normal conditions and minor mishaps during transport. Quality assurance and quality controls measures taken in order to meet technical specification provided by the design there are also presented and commented. (authors)« less

Anglicisms in the Romanian business and technology vocabulary

NASA Astrophysics Data System (ADS)

Todea, L.; Demarcsek, R.

2016-08-01

Multinational companies in Romania have imposed the use of the predominant language, in most cases - English, in professional communication. In contexts related to workplace communication, the main motivation for foreign borrowings is the need to denote concepts and activities. The article focuses on the English language as a wide source for a great number of innovations both at the lexical and the morphological level in the Romanian vocabulary related to business and technology. The aim of the paper is to demonstrate that Romanian language displays a natural disposition towards adopting and adapting foreign words, especially borrowed English terms, in the field of computer science and business without endangering its identity.

The cultural expression of spiritual distress in Israel.

PubMed

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

2018-03-30

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

Distress or no distress, that's the question: A cutoff point for distress in a working population

PubMed Central

van Rhenen, Willem; van Dijk, Frank JH; Schaufeli, Wilmar B; Blonk, Roland WB

2008-01-01

Background The objective of the present study is to establish an optimal cutoff point for distress measured with the corresponding scale of the 4DSQ, using the prediction of sickness absence as a criterion. The cutoff point should result in a measure that can be used as a credible selection instrument for sickness absence in occupational health practice and in future studies on distress and mental disorders. Methods Distress is measured using the Four Dimensional Symptom Questionnaire (4DSQ), a 50-item self-report questionnaire, in a working population with and without sickness absence due to distress. Sensitivity and specificity were compared for various potential cutoff points, and a receiver operating characteristics analysis was conducted. Results and conclusion A distress cutoff point of ≥11 was defined. The choice was based on a challenging specificity and negative predictive value and indicates a distress level at which an employee is presumably at risk for subsequent sick leave on psychological grounds. The defined distress cutoff point is appropriate for use in occupational health practice and in studies of distress in working populations. PMID:18205912

Distress or no distress, that's the question: A cutoff point for distress in a working population.

PubMed

van Rhenen, Willem; van Dijk, Frank Jh; Schaufeli, Wilmar B; Blonk, Roland Wb

2008-01-18

The objective of the present study is to establish an optimal cutoff point for distress measured with the corresponding scale of the 4DSQ, using the prediction of sickness absence as a criterion. The cutoff point should result in a measure that can be used as a credible selection instrument for sickness absence in occupational health practice and in future studies on distress and mental disorders. Distress is measured using the Four Dimensional Symptom Questionnaire (4DSQ), a 50-item self-report questionnaire, in a working population with and without sickness absence due to distress. Sensitivity and specificity were compared for various potential cutoff points, and a receiver operating characteristics analysis was conducted. A distress cutoff point of >/=11 was defined. The choice was based on a challenging specificity and negative predictive value and indicates a distress level at which an employee is presumably at risk for subsequent sick leave on psychological grounds. The defined distress cutoff point is appropriate for use in occupational health practice and in studies of distress in working populations.

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

PubMed

O'Connor, Mairead; Waller, Jo; Gallagher, Pamela; Martin, Cara M; O'Leary, John J; D'Arcy, Tom; Prendiville, Walter; Flannelly, Grainne; Sharp, Linda

2015-01-01

Women who have an abnormal cervical cytology test may be referred for a colposcopy. Accumulating evidence suggests some women may experience distress after colposcopy. This exploratory study examined women's differing experiences of post-colposcopy distress with the aim of identifying factors that are predictive of, or protective against, distress. We carried out semistructured, qualitative interviews with 23 women who had undergone colposcopies. Interviews were transcribed verbatim, coded, and analyzed thematically. The Framework Approach was used to summarize and organize the data and identify emerging higher order themes. Two forms of post-colposcopy distress emerged: 1) short term and 2) long term. Short-term distress was experienced immediately after the colposcopy and in the days afterward, and was usually related to the physical experience of the colposcopy. Long-term distress typically persisted over time and was related to concerns about fertility, cervical cancer, and sexual intercourse. The drivers of short-term and long-term distress differed. Factors related to short-term distress were feeling unprepared for the procedure, having a negative experience of the procedure, and attending the clinic alone. Factors related to long-term distress were future intentions to have (more) children, having physical after-effects of the procedure that impacted on the woman's life, and being under on-going clinic surveillance. Absence of these factors (e.g., being accompanied to the clinic) was protective against short- and long-term distress. Colposcopy can lead to short- and long-term post-procedural distress for some women. We identified a range of factors, some potentially modifiable, that seem to influence the chances of experiencing distress. These results may inform the development of strategies or interventions aimed at preventing or minimizing distress after colposcopy and related procedures. Copyright © 2015 Jacobs Institute of Women's Health. Published by

Identifying Psychosocial Distress and Stressors Using Distress-screening Instruments in Patients With Localized and Advanced Penile Cancer.

PubMed

Dräger, Désirée Louise; Protzel, Chris; Hakenberg, Oliver W

2017-10-01

We examined the effects of treatment on the psychological well-being of patients with localized or advanced penile cancer using screening questionnaires to determine the consecutive need for psychosocial care. Penile cancer is a rare, but highly aggressive, malignancy. The psychological stress of patients with penile cancer arises from the cancer diagnosis per se and the corresponding consequences of treatment. In addition, cancer-specific distress results (eg, fear of metastasis, progression, relapse, death). Studies of the psychosocial stress of penile cancer patients are rare. We undertook a prospective analysis of the data from patients with penile cancer who had undergone surgery or chemotherapy from August 2014 to October 2016 at our department. Patients were evaluated using standardized questionnaires for stress screening and the identification for the need for psychosocial care (National Comprehensive Cancer Network Distress Thermometer and Hornheider screening instrument) and by assessing the actual use of psychosocial support. The average stress level was 4.5. Of all the patients, 42.5% showed increased care needs at the time of the survey. Younger patients, patients undergoing chemotherapy, and patients with recurrence were significantly more integrated with the psychosocial care systems. Finally, 67% of all patients received inpatient psychosocial care. Owing to the potentially mutilating surgery, patients with penile cancer experience increased psychological stress and, consequently, have an increased need for psychosocial care. Therefore, the emotional stress of these patients should be recognized and support based on interdisciplinary collaboration offered. Copyright © 2017 Elsevier Inc. All rights reserved.

Distress in patients with cancer: definition, assessment, and suggested interventions.

PubMed

Vitek, Leesa; Rosenzweig, Margaret Quinn; Stollings, Susan

2007-06-01

Distress in patients with cancer impacts their quality of life. The National Comprehensive Cancer Network (NCCN) created a distress thermometer and a problem checklist to aid in recognizing distress. The thermometer measures distress on a 0-10 scale, and the problem checklist identifies more specific etiologies of distress, such as practical, spiritual, physical, emotional, and family problems. Oncology nurses play a key role in the success of the distress-screening tool because they have the most patient contact. The NCCN guidelines suggest that patients complete the screening tools at each visit and clinicians review the outcome. NCCN has provided clinical pathways for treating the etiologies of distress using a multidisciplinary approach, including members from social work, pastoral services, mental health, and oncology.

Distress and Burnout among Genetic Service Providers

PubMed Central

Bernhardt, Barbara A.; Rushton, Cynda H.; Carrese, Joseph; Pyeritz, Reed E.; Kolodner, Ken; Geller, Gail

2009-01-01

Purpose To determine the nature, sources, prevalence and consequences of distress and burnout among genetics professionals. Methods Mailed survey of randomly selected clinical geneticists (MDs), genetic counselors (GCs) and genetic nurses. Results 214 providers completed the survey (55% response rate). Eight discrete sources of distress were identified forming a valid 28-item scale (alpha=.89). The greatest sources of distress were compassion stress, the burden of professional responsibility, negative patient regard and concerns about informational bias. GCs were significantly more likely to experience personal values conflicts, burden of professional responsibility, and concerns about informational bias than MDs or nurses. Burnout scores were lower among those practicing more than 20 years and nurses. Distress scores were positively correlated with burnout and professional dissatisfaction (p<.0001). 18% of respondents think about leaving patient care, and burnout was the most significant predictor. Predictors of burnout included greater distress, fewer years in practice, working in university-based settings, being a GC or an MD, and deriving less meaning from patient care. Conclusions Genetic service providers experience various types of distress that may be risk factors for burnout and professional dissatisfaction. Interventions to reduce distress and burnout are needed for both trainees and practitioners. PMID:19444128

Identifying cancer patients who alter care or lifestyle due to treatment-related financial distress.

PubMed

Nipp, Ryan D; Zullig, Leah L; Samsa, Gregory; Peppercorn, Jeffrey M; Schrag, Deborah; Taylor, Donald H; Abernethy, Amy P; Zafar, S Yousuf

2016-06-01

Cancer patients may experience financial distress as a side effect of their care. Little is known about which patients are at greatest risk for altering their care or lifestyle due to treatment-related financial distress. We conducted a cross-sectional survey study to determine which patients are at greatest risk for altering their care or lifestyle due to treatment-related financial distress. Eligible patients were adults receiving cancer treatment enrolled between June 2010 and May 2011. We grouped coping strategies as lifestyle altering or care altering. We assessed coping strategies and relationships between covariates using descriptive statistics and analysis of variance. Among 174 participants, 89% used at least one lifestyle-altering coping strategy, while 39% used a care-altering strategy. Care-altering coping strategies adopted by patients included the following: not filling a prescription (28%) and taking less medication than prescribed (23%). Lifestyle-altering strategies included the following: spending less on leisure activities (77%), spending less on basics like food and clothing (57%), borrowing money (54%), and spending savings (50%). Younger patients were more likely than older patients to use coping strategies (p < 0.001). Lower-income patients adopted care-altering strategies more than higher-income patients (p = 0.03). Participants with more education and shorter duration of chemotherapy used lifestyle-altering strategies more than their counterparts (both p < 0.05). As a means of coping with treatment-related financial distress, patients were more likely to use lifestyle-altering approaches, but more than one-third adopted potentially harmful care-altering strategies. Younger age, lower income, higher education, and shorter duration of chemotherapy were characteristics associated with greater use of coping strategies. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

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

PubMed

Brown, Stephen L; Whiting, Demian

2014-04-01

Distressing health promotion advertising involves the elicitation of negative emotion to increase the likelihood that health messages will stimulate audience members to adopt healthier behaviors. Irrespective of its effectiveness, distressing advertising risks harming audience members who do not consent to the intervention and are unable to withdraw from it. Further, the use of these approaches may increase the potential for unfairness or stigmatization toward those targeted, or be considered unacceptable by some sections of the public. We acknowledge and discuss these concerns, but, using the public health ethics literature as a guide, argue that distressing advertising can be ethically defensible if conditions of effectiveness, proportionality necessity, least infringement, and public accountability are satisfied. We do not take a broad view as to whether distressing advertising is ethical or unethical, because we see the evidence for both the effectiveness of distressing approaches and their potential to generate iatrogenic effects to be inconclusive. However, we believe it possible to use the current evidence base to make informed estimates of the likely consequences of specific message presentations. Messages can be pre-tested and monitored to identify and deal with potential problems. We discuss how advertisers can approach the problems of deciding on the appropriate intensity of ethical review, and evaluating prospective distressing advertising campaigns against the conditions outlined. © 2013 International Union of Psychological Science.

Romanian, Spanish and US Secondary Science Teacher Perceptions of Threats to the Biosphere

ERIC Educational Resources Information Center

Robinson, Michael; Naumescu, Adrienne Kozan; Ives, Bob

2009-01-01

This paper presents the data from a current study involving 41 Romanian secondary science teachers and a previously published study that compared 89 Spanish and 42 US secondary science teachers. All three groups were convenience samples who answered a two part questionnaire that was given in English, Spanish or Romanian, depending on the sample.…

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

PubMed

Vannier, Sarah A; Rosen, Natalie O

2017-03-01

Sexual problems are common during pregnancy, but the proportion of pregnant women who experience sexual distress is unknown. In non-pregnant samples, sexual distress is associated with lower sexual and relationship satisfaction. To identify the proportion of women experiencing sexual distress during pregnancy and to compare the sexual and relationship satisfaction of women who report sexual distress during pregnancy with that of women without distress. Two-hundred sixty-one pregnant women completed a cross-sectional online survey. Women completed validated measurements of sexual functioning (Female Sexual Function Index; score < 26.55 indicates a sexual problem), sexual distress (Female Sexual Distress Scale; score ≥ 15 indicates clinically significant distress), sexual satisfaction (Global Measure of Sexual Satisfaction), and relationship satisfaction (Couples Satisfaction Index). Overall, 42% of women met the clinical cutoff for sexual distress. Of sexually active women (n = 230), 26% reported concurrent sexual problems and distress and 14% reported sexual distress in the absence of sexual problems. Sexual distress and/or problems in sexual functioning were linked to lower sexual and relationship satisfaction compared with pregnant women with lower sexual distress and fewer sexual problems. Sexual distress is common during pregnancy and associated with lower sexual and relationship satisfaction. Health care providers should ask pregnant women about feelings of sexual distress. Identifying pregnant women who experience sexual distress and referring them to appropriate resources could help minimize sexual and relationship problems during pregnancy. Vannier SA, Rosen NO. Sexual Distress and Sexual Problems During Pregnancy: Associations With Sexual and Relationship Satisfaction. J Sex Med 2017;14:387-395. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Screening for psychological distress in cancer: renewing the research agenda.

PubMed

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

2015-03-01

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

Acrylamide in Romanian food using HPLC-UV and a health risk assessment.

PubMed

Oroian, Mircea; Amariei, Sonia; Gutt, Gheorghe

2015-01-01

The aim of this study was to investigate the level of acrylamide from coffee, potato chips and French fries in Romanian food. According to the European Food Safety Authority, coffee beans, potato chips and French fries have the highest levels of acrylamide. For this survey, 50 samples of coffee beans, 50 samples of potato chips and 25 samples of French fries were purchased from different producers from the Romanian market. Acrylamide levels have been quantified using high-performance liquid chromatography with a diode array detector (HPLC-DAD) method, using water as mobile phase. Health risk assessment was achieved by computing the average daily intake, hazard quotient, cumulative risk, carcinogenic risk and cancer risk. For coffee, potato chips and French fries, acrylamide was not shown to pose a health risk in Romanian food.

Idioms of Distress.

PubMed

Desai, Geetha; Chaturvedi, Santosh K

2017-08-01

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

Demographic and Psychosocial Factors Associated With Psychological Distress and Resilience Among Transgender Individuals

PubMed Central

Lyons, Anthony; Leonard, William; Pitts, Marian; Badcock, Paul; Couch, Murray

2015-01-01

Objectives. We examined the independent demographic and psychosocial factors associated with psychological distress and resilience among transgender men and women. Methods. Our data came from an online survey involving a national Australian sample of 169 transgender men and women in 2011. Survey questions assessed demographics; sources of support; contact with lesbian, gay, bisexual, and transgender peers; and experiences of victimization. We assessed the outcomes with the Kessler Psychological Distress Scale and the Brief Resilience Scale. Results. In all, 46.0% of the sample reported high or very high levels of psychological distress. Multivariable regression analyses identified considerably different independent factors for psychological distress and resilience. Younger age, feeling unable to turn to family for support, and victimization experiences were associated with greater psychological distress, whereas higher income, identifying as heterosexual, and having frequent contact with lesbian, gay, bisexual, and transgender peers were associated with greater resilience. Conclusions. With different factors identified for psychological distress and resilience, these findings may help inform the development of tailored mental health interventions and resilience-building programs for this vulnerable population. PMID:26270284

Self-Identifying Emergency Radio Beacons

NASA Technical Reports Server (NTRS)

Friedman, Morton L.

1987-01-01

Rescue teams aided by knowledge of vehicle in distress. Similar to conventional emergency transmitters except contains additional timing and modulating circuits. Additions to standard emergency transmitter enable transmitter to send rescuers identifying signal in addition to conventional distress signal created by sweep generator. Data generator contains identifying code.

Examining Victimization and Psychological Distress in Transgender College Students

ERIC Educational Resources Information Center

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

2011-01-01

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

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

PubMed

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

2015-02-01

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

Symptom distress in older adults following cancer surgery.

PubMed

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

2013-01-01

Symptom distress remains a significant health problem among older adults with cancer following surgery. Understanding factors influencing older adults' symptom distress may lead to early identification and interventions, decreasing morbidity and improving outcomes. We conducted this study to identify factors associated with symptom distress following surgery among 326 community-residing patients 65 years or older with a diagnosis of thoracic, digestive, gynecologic, and genitourinary cancers. This secondary analysis used combined subsets of data from 5 nurse-directed intervention clinical trials targeting patients after surgery at academic cancer centers in northwest and northeastern United States. Symptom distress was assessed by the Symptom Distress Scale at baseline and at 3 and 6 months. A multivariable analysis, using generalized estimating equations, showed that symptom distress was significantly less at 3 and 6 months (3 months: P < .001, 6 months: P = .002) than at baseline while controlling for demographic, biologic, psychological, treatment, and function covariates. Thoracic cancer, comorbidities, worse mental health, and decreased function were, on average, associated with increased symptom distress (all P < .05). Participants 75 years or older reported increased symptom distress over time compared with those aged 65 to 69 years (P < .05). Age, type of cancer, comorbidities, mental health, and function may influence older adults' symptom distress following cancer surgery. Older adults generally experience decreasing symptom distress after thoracic, abdominal, or pelvic cancer surgery. Symptom management over time for those with thoracic cancer, comorbidities, those with worse mental health, those with decreased function, and those 75 years or older may prevent morbidity and improve outcomes of older adults following surgery.

Idioms of Distress

PubMed Central

Desai, Geetha; Chaturvedi, Santosh K.

2017-01-01

The presentations of psychosocial distress and cultural conflicts are often bodily symptoms, especially in traditional societies and village backgrounds. These might not meet the criteria of the current psychiatric diagnostic systems. Sociocultural milieu contributes to the unique presentations of the stress in the form of idioms of distress. The latter are alternative modes of expressing distress and indicate manifestations of distress in relation to personal and cultural meaning. Health professionals often consider these as hysterical, functional or having functional overlays, and abnormal illness behaviors. Management of idioms of distress would need cultural competence and sensitivity. This article highlights the common idioms of distress in India with specific focus on bodily symptoms. PMID:28936079

Marasti Village, 1918-1924 … A Neo-Romanian Experiment

NASA Astrophysics Data System (ADS)

Idiceanu-Mathe, Dan; Carjan, Roxana

2017-10-01

Mărăști Village, 1918, a village on the front line of the First World War, the place where General Mackensen and General Averescu met face to face for 12 days. After the 12 days of heavy fighting at an altitude of 536 meters, the Romanians won the battle, but they lost 4800 people and the village was destroyed. The village was rehabilitated due to Mărăști Society; whose objective was to rebuild it as a “historical village in the Romanian style”. The place was in a building site for 6 years. A number of 73 houses were rehabilitated and 20 new houses, a church and a school were erected. The village was provided with a water supply system and an electricity grid with diesel-generators. All this was designed in the Neo-Romanian style by 6 architects. In a short period and on a large territory, the terrible consequences of the war were changed into a reconstruction and modernization theme, from the infrastructure in general to the dwellings in particular. It was a tremendous effort because of the isolated position of the village, which required an impressive logistic support for those times. The new architectural products were designed in the style that was already considered the Neo-Romania style in the 1910-1920 decade. The village is important because it was modernized from the urban point of view. It was a completely new manner characteristic of the urban development in an area where the last Middle Ages peasant upheaval took place in 1907. In the Romanian context, the execution is unique in dimension, scale and theme. At the International level, it is considered a very precise and rare architectural intervention.

Parental Attachments and Psychological Distress among African American College Students

ERIC Educational Resources Information Center

Love, Keisha McGhee

2008-01-01

African American college students attending predominately White institutions often encounter stressors that their Caucasian peers do not experience. Because of these unique stressors, African American students are more prone to experience psychological distress. Identifying factors that counteract psychological distress among these students is…

Post-Institutional Autistic Syndrome in Romanian Adoptees

ERIC Educational Resources Information Center

Hoksbergen, Rene; ter Laak, Jan; Rijk, Kathinka; van Dijkum, Cor; Stoutjesdijk, Felicia

2005-01-01

Romanian adoptees have a background of severe neglect. International research has shown that this can give rise to symptoms of autistic behavior. Rutter "et al." (1999, "Journal of Child Psychology Psychiatry," 40 (4), 537-549.) refers to "quasi-autistic patterns", and Federici (1998, "Help for the hopeless…

Psychological distress in women who have experienced intrauterine insemination.

PubMed

Lin, Jia-Ling; Lin, Ya-Hui; Chueh, Ke-Hsin

2012-12-01

Despite evidence that psychological distress manifests itself in underreported and atypical ways, few studies have assessed these symptoms in women who have experienced intrauterine insemination (IUI). The aim of this study was to examine the prevalence of psychological distress and explore the relationships among psychological distress, various demographic characteristics, and somatic symptoms in women who had received IUI treatment in Taiwan. A cross-sectional study design was used in this study. The 117 participants were recruited from a teaching hospital in northern Taiwan. The brief symptom rating scale (BSRS-5) was used as the measurement instrument, and scores of more than 5 on the BSRS-5 were used to mark the boundary between milder and more severe psychological distress. Demographic characteristics and somatic symptoms of IUI that contributed most significantly to psychological distress were identified from the data. Thirty-eight (32.5%) participants experienced psychological distress. Psychological distress was most common in participants (a) with husbands who were an only son, (b) who had taken medication during the previous week, (c) with an education level below college or university, and (d) who reported feeling faint. The factors studied are important to understand psychological distress in women who have undergone IUI treatment.

Oncologists' identification of mental health distress in cancer patients: Strategies and barriers.

PubMed

Granek, L; Nakash, O; Ariad, S; Shapira, S; Ben-David, M

2018-03-06

The purpose of this research was to examine oncologists' perspectives on indicators of mental health distress in patients: what strategies they use to identify these indicators, and what barriers they face in this task. Twenty-three oncologists were interviewed, and the grounded theory method of data collection and analysis was used. Oncologists perceived distress to be a normative part of having cancer and looked for affective, physical, verbal and behavioural indicators using a number of strategies. Barriers to identification of mental health distress included difficulty in differentiating between mental health distress and symptoms of the disease, and lack of training. A systematic, time-efficient assessment of symptoms of emotional distress is critical for identification of psychiatric disorders among patients and differentiating normative emotional responses from psychopathology. Clinical bias and misdiagnosis can be a consequence of an ad hoc, intuitive approach to assessment, which can have consequences for patients and their families. Once elevated risk is identified for mental health distress, the patient can be referred to specialised care that can offer evidence-based treatments. © 2018 John Wiley & Sons Ltd.

Palatalization in Romanian: Experimental and Theoretical Approaches

ERIC Educational Resources Information Center

Spinu, Laura

2010-01-01

Within the larger context of the Romance languages, Romanian stands alone in exhibiting a surface contrast between plain and palatalized consonants (that is, consonants with a secondary palatal articulation). While the properties of secondary palatalization are well known for language families in which the set of palatalized consonants is…

Integration Processes of a Romanian Group in a Huelva Village through Family Life Stories

ERIC Educational Resources Information Center

Díaz-Reales, Antonia-María; Aguaded-Gómez, Ignacio

2015-01-01

This paper examines the integration of Romanian immigrants in Lucena del Puerto (Huelva, Spain) through the life stories of two families of Romanian origin. The experiences of the groups presented in this study were analyzed. Both families were in the town for work, to grow and harvest strawberries. We observed a contrast between idealistic views…

Defining and addressing moral distress: tools for critical care nursing leaders.

PubMed

Rushton, Cynda Hylton

2006-01-01

Nurse clinicians may experience moral distress when they are unable to translate their moral choices into moral action. The costs of unrelieved moral distress are high; ultimately, as with all unresolved professional conflicts, the quality of patient care suffers. As a systematic process for change, this article offers the AACN's Model to Rise Above Moral Distress, describing four A's: ask, affirm, assess, and act. To help critical care nurses working to address moral distress, the article identifies 11 action steps they can take to develop an ethical practice environment.

Psychological Distress and Coping amongst Higher Education Students: A Mixed Method Enquiry

PubMed Central

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

2014-01-01

Background Psychological distress among higher education students is of global concern. Students on programmes with practicum components such as nursing and teacher education are exposed to additional stressors which may further increase their risk for psychological distress. The ways in which these students cope with distress has potential consequences for their health and academic performance. An in-depth understanding of how nursing/midwifery and teacher education students experience psychological distress and coping is necessary to enable higher education providers to adequately support these students. Methods This mixed method study was employed to establish self-reported psychological distress (General Health Questionnaire), coping processes (Ways of Coping Questionnaire) and lifestyle behaviour (Lifestyle Behaviour Questionnaire) of a total sample (n = 1557) of undergraduate nursing/midwifery and teacher education students in one university in Ireland. Individual interviews (n = 59) provided an in-depth understanding of students experiences of psychological distress and coping. Results A significant percentage (41.9%) of respondents was psychologically distressed. The factors which contributed to their distress, included study, financial, living and social pressures. Students used varied coping strategies including seeking social support, problem solving and escape avoidance. The positive relationship between elevated psychological distress and escape avoidance behaviours including substance use (alcohol, tobacco and cannabis) and unhealthy diet is of particular concern. Statistically significant relationships were identified between “escape-avoidance” and gender, age, marital status, place of residence, programme/year of study and lifestyle behaviours such as diet, substance use and physical inactivity. Conclusion The paper adds to existing research by illuminating the psychological distress experienced by undergraduate nursing/midwifery and

Comparative Study on Romanian School Science Curricula and the Curriculum of TIMSS 2007 Testing

ERIC Educational Resources Information Center

Ciascai, Liliana

2009-01-01

The results of Romanian school students in Science PISA and TIMSS testings have been and continue to be systematically slack. In the present paper we intend to do a comparative analysis of Science curriculum TIMSS 2007 and Romanian Science school curricula of 4th and 8th grades. This analysis, based on Bloom's taxonomy of cognitive domain,…

Understanding women's experiences of distress during pregnancy in Dar es Salaam, Tanzania.

PubMed

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

2010-01-01

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

The study of the rs9939609 FTO gene polymorphism in association with obesity and the management of obesity in a Romanian cohort.

PubMed

Ursu, R I; Badiu, C; Cucu, N; Ursu, G F; Craciunescu, I; Severin, E

2015-01-01

The incidence of obesity especially in Romanian population is presently escalating as a major nutrition and health problem. Clinicians aided by scientists are engaged in research approaches that include heredity aspects linked with behavior, education, applied nutrition studies and clinical therapies in order to prevent, control and reverse obesity. The common goal is to identify areas of basic and clinical research to understand aspects of human biology that may be considered as obesogenic. Regarding these approaches, recent discoveries in genetics, epigenetics and functional genomics, based on advancing technologies, are tools employed to prevent and treat obesity. The purpose of this article is to present the current knowledge of key components of the FTO gene role in the obesogenic system that links genetic, epigenetic and environmental, lifestyle/ diet nutritional and behavioral components and to describe the results obtained by genotyping and interviewing relevant selected groups of Romanian population. FTO rs9939609 genotyping was performed on a Romanian study group of 53 subjects (30 obese, 23 normal). Results have been analyzed in association with obesity parameters and comorbidities in order to identify this polymorphism's effect on body mass in our Caucasian cohort. At the same time, personal history of the subjects in correlation with the FTO genotypes provided important information on the FTO gene's influence on the feeding behavior and food selection of these individuals. In conclusion, the FTO rs9939609 polymorphism has been identified as a common gene variant in our Romanian Caucasian cohort, proving a high association with all the parameters of obesity and obesity comorbidities. The adherence to a Mediterranean diet is benefic for subjects with genetic predisposition for this disorder as long as it is kept for a long period of time along with sustained physical exercise. Association studies are an extremely important tool in understanding the

Microsatellite and Mitochondrial DNA Study of Native Eastern European Cattle Populations: The Case of the Romanian Grey.

PubMed

Ilie, Daniela Elena; Cean, Ada; Cziszter, Ludovic Toma; Gavojdian, Dinu; Ivan, Alexandra; Kusza, Szilvia

2015-01-01

The Eastern European Grey cattle are regarded as the direct descendants of the aurochs (Bos taurus primigenius). Nowadays in Romania, less than 100 Grey animals are being reared and included in the national gene reserve. We examined the genetic diversity among Romanian Grey, Brown, Spotted and Black and White cattle breeds, with a particular focus on Romanian Grey through the use of (i) 11 bovine specific microsatellite markers on 83 animals and (ii) 638 bp length of mitochondrial DNA (mtDNA) D-loop region sequence data from a total of 81 animals. Both microsatellite and mtDNA analysis revealed a high level of genetic variation in the studied breeds. In Romanian Grey a total of 100 alleles were found, the mean number of observed alleles per locus was 9.091; the average observed heterozygosity was 0.940; the Wright's fixation index (FIS) was negative (-0.189) and indicates that there is no inbreeding and no selection pressure. MtDNA analysis revealed 52 haplotypes with 67 variable sites among the Romanian cattle breeds without any insertion or deletion. Haplotype diversity was 0.980 ± 0.007 and ranged from 0.883 ± 0.056 (Brown) to 0.990 ± 0.028 (Spotted and Black and White). The highest genetic variability of the mtDNA was recorded in the Grey breed, where 18 haplotypes were identified. The most frequent mtDNA D-loop region belonged to T3 haplogroup (80.247%), which was found across all studied breeds, while T2 haplotypes (16.049%) was only found in Grey, Spotted and Black and White genotypes. The T1 haplotypes (3.704%) were found in the Grey and Spotted. The current results contribute to the general knowledge on genetic diversity found in Eastern European cattle breeds and could prove a valuable tool for the conservation efforts of animal genetic resources (FAnGR).

Women with breast cancer: self-reported distress in early survivorship.

PubMed

Lester, Joanne; Crosthwaite, Kara; Stout, Robin; Jones, Rachel N; Holloman, Christopher; Shapiro, Charles; Andersen, Barbara L

2015-01-01

To identify and compare levels of distress and sources of problems among patients with breast cancer in early survivorship. Descriptive, cross-sectional. A National Cancer Institute-designated comprehensive cancer center. 100 breast cancer survivors were selected to represent four time points in the cancer trajectory. Distress was self-reported using the Distress Thermometer and its 38-item problem list. Analysis of variance and chi-square analyses were performed as appropriate. Distress scores, problem reports, and time groups. Participants scored in range of the cutoff of more than 4 (range = 4.1-5.1) from treatment through three months post-treatment. At six months post-treatment, distress levels were significantly lower. Significant differences were found between groups on the total problem list score (p = 0.007) and emotional (p = 0.01) and physical subscale scores (p = 0.003). Comparison of groups at different points in the cancer trajectory found similar elevated levels from diagnosis through three months. Distress remained elevated in early survivorship but significantly decreased at six months post-treatment. Interventions to reduce or prevent distress may improve outcomes in early survivorship.

Seeking help for perinatal psychological distress: a meta-synthesis of women's experiences.

PubMed

Button, Susan; Thornton, Alexandra; Lee, Suzanne; Shakespeare, Judy; Ayers, Susan

2017-10-01

Women may not seek help for perinatal psychological distress, despite regular contact with primary care services. Barriers include ignorance of symptoms, inability to disclose distress, others' attitudes, and cultural expectations. Much of the evidence has been obtained from North American populations and may not, therefore, extrapolate to the UK. To understand the factors affecting women's decision to seek help for perinatal distress. Meta-synthesis of the available published qualitative evidence on UK women's experiences of seeking help for perinatal distress. Systematic searches were conducted in accordance with PRISMA guidelines. Databases searched were PubMed, Scopus, PsycINFO, PsycARTICLES, CINAHL, and Academic Search Complete. Searches of grey literature and references were also conducted. Studies were eligible for inclusion if they reported qualitative data on UK women's experiences of perinatal distress and contact with healthcare professionals. The synthesis was conducted using meta-ethnography. In all, 24 studies were eligible for inclusion. Metasynthesis identified three main themes: identifying a problem, the influence of healthcare professionals, and stigma. These themes build on current understanding of help seeking by identifying the need for women to be able to frame their experience, for healthcare professionals to educate women about their roles, the need for continuity of care, and the way that being seen as a 'bad mother' causes women to self-silence. Perinatal care provision needs to allow for continuity of care and for staff training that facilitates awareness of factors that influence women's help seeking. Further research is required, particularly in relation to effective means of identifying perinatal psychological distress. © British Journal of General Practice 2017.

Diabetes Distress Among Persons With Type 1 Diabetes.

PubMed

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

2017-02-01

Purpose The purpose of this study is to evaluate associations between diabetes distress and a range of psychological health behaviors and concerns among persons with type 1 diabetes for the benefit of enhancing early identification and intervention of at-risk individuals. Methods Persons with type 1 diabetes (n = 268; 57.1% female, 91.0% white, 76.8% <18 years of age, average A1C 8.4%) completed the 2-item Diabetes Distress Screening Scale (DDS2) and a battery of psychometrically sound instruments measuring satisfaction with life, self-esteem, self-efficacy, depression, perfectionism, body image satisfaction, dietary restraint and eating, and shape and weight concerns. Each subscale score was compared within age groups (<18 years vs ≥18 years) between groups (diabetes distress level [low, moderate, high]) using analysis of variance (with Bonferroni correction or the Kruskal-Wallis test if the variables were not normally distributed). Results For both age groups, high diabetes distress was independently associated with greater A1C values, higher depression scores and eating, and shape and weight concerns than those with low or moderate distress. For patients <18 years of age, those with high diabetes distress scored lower on measures of satisfaction with life, self-esteem, and self-efficacy and higher on dietary restraint and several areas of perfectionism than those with low or moderate distress. Conclusions Individuals with type 1 diabetes who have high diabetes distress also report higher A1C values and poorer psychological health concerns. A brief diabetes distress questionnaire can help to identify those who need additional screening, education and support, and treatment for overall health and well-being.

Intercultural Development in the Romanian School System

ERIC Educational Resources Information Center

Chircu, Elena Sorina; Negreanu, Mirela

2010-01-01

The present paper aims to briefly describe the manner in which intercultural education is perceived in the Romanian school system, as well as the solutions that are being proposed (mainly in the form of activities) for reconsidering and strengthening interculturality as a dimension of education. We report on the results of semi-structured…

The recognition of Gheorghe Bilaşcu’s contributions in the Romanian history of dentistry

PubMed Central

BÂRSU, CRISTIAN

2013-01-01

Prof. Dr. Gheorghe Bilaşcu (1863–1926) was one of the founders of the Romanian Faculty of Medicine in Cluj. At this Faculty, in 1919/1920 he created the department and the clinic of dentistry. These two achievements were accomplished for the first time in Romania. Normally, his contribution should have been appreciated both during his life and after his death. Also, his name would be expected to be present in the large majority of Romanian medico-historians dictionaries, treatises, papers etc. Unfortunately, his posthumous appreciation was not as Bilaşcu would have deserved. In our paper we present the recognition of Gh. Bilaşcu’s contributions in the Romanian history of dentistry between 1926–2013. We divided this period into three intervals: from 1926 to 1948, the communist era, and after the anticommunist revolution (1990-present). In the first interval the achievements of Bilaşcu in the field of dentistry were very much appreciated and they were mentioned in a correct way in different medico-historical sources of information. During the communist era the name of Bilaşcu was omitted in some dictionaries, courses etc. After 1990, the important role of Bilaşcu in Romanian dentistry was put into its important place in the majority of Romanian history of medicine sources of information. PMID:26527965

Psychological distress in an incarcerated juvenile population.

PubMed

Lyu, Shu-Yu; Chi, Ying-Chen; Farabee, David; Tsai, Liang-Ting; Lee, Ming-Been; Lo, Feng-En; Morisky, Donald E

2015-11-01

This study sought to examine the prevalence and correlates of psychological distress among incarcerated youth in Taiwan using the 5-item Brief Symptom Rating Scale (BSRS-5). This cross-sectional census survey study was conducted in 2007 among all the juveniles incarcerated in 23 correctional institutions (n = 1505) in Taiwan using a self-administered anonymous questionnaire. Of the total 1505 participants, 1363 completed the questionnaire (91% response rate). We excluded 494 participants as they were aged either over 17 years or under 12 years. Psychological distress was measured among the final 869 participants using the BSRS-5. Psychological distress was defined as a total score of at least 6 out of 20. Those identified as having psychological distress were then pooled into a case group and compared with control participants without psychological distress. The prevalence of psychological distress was 44.1%. Among the case group, sleep disturbance (36.8%) had the highest prevalence of severe or very severe symptoms, followed by depression (34.7%), and hostility (27.9%). Multivariate logistic regression analysis revealed that correlates of psychological distress included the following: being female; having a poor self-rated health status; having joined a gang; having experienced life disturbances prior to the current imprisonment; and having ever had a smoking habit. Significant sex differences were found for both the overall BSRS-5, as well as for each individual item of the BSRS-5. Treatment programs and interventions should be carefully tailored to address the mental health needs of juvenile inmates in a sex-specific manner using a multifaceted approach. Copyright © 2014. Published by Elsevier B.V.

A Three Year Follow-up of Attachment and Indiscriminate Friendliness in Children Adopted from Romanian Orphanages.

ERIC Educational Resources Information Center

Chisholm, Kim

1998-01-01

Assessed attachment/indiscriminate friendliness in children who spent at least eight months in Romanian orphanages (RO); a nonadopted, never-institutionalized Canadian group; and an early-adopted Romanian group. Found that RO children showed more insecure attachment and indiscriminate friendliness than others. Insecure RO children had more…

Distress among young adult cancer survivors: a cohort study.

PubMed

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

2013-09-01

Being diagnosed with cancer as a young adult can lead to significant psychological distress and impaired quality of life. Compared to children and older adults diagnosed with cancer, fewer studies have addressed psychological distress among young adult cancer survivors. This study sought to identify the prevalence of, and factors associated with, distress among young adult cancer survivors (ages 18-39). Young adult cancer survivors (N = 335, mean age = 31.8, women = 68.4%) were recruited from an online research panel and stratified by cohort (time postactive treatment: 0-12, 13-24, and 25-60 months). Participants completed measures assessing demographic and clinical characteristics, global impact of cancer, cancer-related education and work interruption, and cancer-specific distress using the impact of event scale (IES). The mean score on the IES (M = 31.0, range = 0-75) was above the cut point of 20, suggesting clinically elevated distress. Analysis of covariance revealed significant main effects for cohort, global impact and cancer-related education/work interruption, and an interaction between cohort and cancer-related education/work interruption on distress. Although there was no significant effect of education/work interruption on distress for those in the 0-12 month cohort (p = .88), survivors in the 13-24 and 25-60 month cohorts reporting education/work interruption were significantly more distressed than those not reporting education/work interruption in the respective cohorts (p < .05). Young adult cancer survivors face unique challenges. These data underscore the importance of attending to cancer-related distress beyond the completion of treatment and may help inform targeted interventions to prevent or reduce significant distress and related sequelae in this population.

Distress tolerance is linked to unhealthy eating through pain catastrophizing.

PubMed

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

2016-12-01

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

Romanian Approach to Media Portrayals of Disability

ERIC Educational Resources Information Center

Ciot, Melania-Gabriela; Van Hove, Geert

2010-01-01

There is a wide range of media representations of disability, but not just because of the societal stigma. They are a function of norms of journalism as well as biases among people with disabilities themselves. This article is a contribution to the issue of social representation of persons with disabilities from a Romanian perspective, which will…

Moral distress and professional freedom of speech among doctors.

PubMed

Førde, Reidun; Aasland, Olaf Gjerløw

2013-06-25

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

Use of the Romanian product Silimarina in the treatment of chronic liver diseases.

PubMed

Tănăsescu, C; Petrea, S; Băldescu, R; Macarie, E; Chiriloiu, C; Purice, S

1988-01-01

The Romanian product Silimarina (synonym Legalon) was administered in a randomized double-blind trial, to a group of 180 patients with chronic persistent hepatitis (CPH), chronic active hepatitis (CAH) and hepatic cirrhosis (HC). The trial lasted for 40 days. The results showed favourable effects similar with those obtained with other preparations produced by foreign drug industries. The Romanian product proved to have no toxic effect. The authors discuss the present possibilities of estimating the evolution of chronic liver disease.

Maternal distress and intended breastfeeding duration.

PubMed

Rondó, Patricia H C; Souza, Márcia R

2007-03-01

To evaluate the associations between maternal psychological status and intended breastfeeding duration. A total of 852 pregnant women who attended antenatal care between September 1997 and August 2000 in 12 health units and five hospitals in Jundiaí city, Brazil, were included in the study. Psychological measures (stress and distress) were obtained at a gestational age from 30 to 36 weeks, using standardized scales, questionnaires and inventories. Psychological factors specifically related to breastfeeding assessed their worries, concerns, and support when breastfeeding. Multiple linear regression analysis identified the associations between the outcome "intended duration of breastfeeding" and psychological status of the mothers, controlling for toxic exposure, socioeconomic, demographic, obstetric and nutritional factors. There were negative associations between the outcome and distress, "concerned about body's changes", and work outside home, and a positive association between the outcome and marital status (p < or = 0.03). Early identification of distress in pregnant women and a more attentive encouragement to breastfeed is probably one of the steps to improve intended breastfeeding duration.

UNDERSTANDING THE SOURCES OF DIABETES DISTRESS IN ADULTS WITH TYPE 1 DIABETES

PubMed Central

Fisher, Lawrence; Polonsky, William H.; Hessler, Danielle M.; Masharani, Umesh; Blumer, Ian; Peters, Anne L.; Strycker, Lisa A.; Bowyer, Vicky

2015-01-01

Aims To identify the unique sources of diabetes distress (DD) for adults with type 1 diabetes (T1D). Methods Sources of DD were developed from qualitative interviews with 25 T1D adults and 10 diabetes health care providers. Survey items were then developed and analyzed using both exploratory (EFA) and confirmatory CFA) analyses on two patient samples. Construct validity was assessed by correlations with depressive symptoms (PHQ8), complications, HbA1C, BMI, and hypoglycemia worry scale (HWS). Scale cut-points were created using multiple regression. Results An EFA with 305 U.S. participants yielded 7 coherent, reliable sources of distress that were replicated by a CFA with 109 Canadian participants: Powerlessness, Negative Social Perceptions, Physician Distress, Friend/Family Distress, Hypoglycemia Distress, Management Distress, Eating Distress. Prevalence of DD was high with 41.6% reporting at least moderate DD. Higher DD was reported for women, those with complications, poor glycemic control, younger age, without a partner, and non-White patients. Conclusions We identified a profile of seven major sources of DD among T1D using a newly developed assessment instrument. The prevalence of DD is high and is related to glycemic control and several patient demographic and disease-related patient characteristics, arguing for a need to address DD in clinical care. PMID:25765489

Women With Breast Cancer: Self-Reported Distress in Early Survivorship

PubMed Central

Lester, Joanne; Crosthwaite, Kara; Stout, Robin; Jones, Rachel N.; Holloman, Christopher; Shapiro, Charles; Andersen, Barbara L.

2015-01-01

Purpose/Objectives To identify and compare levels of distress and sources of problems among patients with breast cancer in early survivorship. Design Descriptive, cross-sectional. Setting A National Cancer Institute–designated comprehensive cancer center. Sample 100 breast cancer survivors were selected to represent four time points in the cancer trajectory. Methods Distress was self-reported using the Distress Thermometer and its 38-item problem list. Analysis of variance and chi-square analyses were performed as appropriate. Main Research Variables Distress scores, problem reports, and time groups. Findings Participants scored in range of the cutoff of more than 4 (range = 4.1–5.1) from treatment through three months post-treatment. At six months post-treatment, distress levels were significantly lower. Significant differences were found between groups on the total problem list score (p = 0.007) and emotional (p = 0.01) and physical subscale scores (p = 0.003). Conclusions Comparison of groups at different points in the cancer trajectory found similar elevated levels from diagnosis through three months. Distress remained elevated in early survivorship but significantly decreased at six months post-treatment. Implications for Nursing Interventions to reduce or prevent distress may improve outcomes in early survivorship. PMID:25542330

Development of Professional Identity in Romanian Business Students

ERIC Educational Resources Information Center

Glaser-Segura, Daniel A.; Mudge, Suzanne; Bratianu, Constantin; Dumitru, Ionela

2010-01-01

Purpose: This study aims to focus on the role of learning activities on the development of Romanian students making the change from academia to the workplace, specifically focusing on the role of three learning activities: classroom teaching pedagogies ("in-vitro"); field experiences ("in-situ"); and self-development…

Distinguishing fear versus distress symptomatology in pediatric OCD

PubMed Central

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

2018-01-01

Prior research has identified OCD subtypes or “clusters” of symptoms that differentially relate to clinical features of the disorder. Given the high comorbidity between OCD and anxiety, OCD symptom clusters may more broadly associate with fear and/or distress internalizing constructs. This study examines fear and distress dimensions, including physical concerns (fear), separation anxiety (fear), perfectionism (distress), and anxious coping (distress), as predictors of previously empirically-derived OCD symptom clusters in a sample of 215 youth diagnosed with primary OCD (ages 7 to 17, mean age = 12.25). Self-reported separation fears predicted membership in Cluster 1 (aggressive, sexual, religious, somatic obsessions, and checking compulsions) while somatic/autonomic fears predicted membership in Cluster 2 (symmetry obsessions and ordering, counting, repeating compulsions). Results highlight the diversity of pediatric OCD symptoms and their differential association with fear, suggesting the need to carefully assess both OCD and global fear constructs that might be directly targeted in treatment. PMID:27225633

Distinguishing Fear Versus Distress Symptomatology in Pediatric OCD.

PubMed

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

2017-02-01

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

Trajectories of distress, anxiety, and depression among women with breast cancer: Looking beyond the mean.

PubMed

Bidstrup, Pernille Envold; Christensen, Jane; Mertz, Birgitte Goldschmidt; Rottmann, Nina; Dalton, Susanne Oksbjerg; Johansen, Christoffer

2015-05-01

Little is known about the development of psychological wellbeing over time among women who have been treated for breast cancer. The aim of this study was to identify distinct patterns of distress, anxiety, and depression in such women. We invited 426 consecutive women with newly diagnosed primary breast cancer to participate in this study, and 323 (76%) provided information on distress ('distress thermometer') and on symptoms of anxiety and depression ('hospital anxiety and depression scale'). Semiparametric group-based mixture modeling was used to identify distinct trajectories of distress, anxiety, and depressive symptoms assessed the week before surgery and four and eight months later. Logistic regression analysis was used to evaluate the characteristics of women in the distinct groups. Although no sub-group of women with chronic severe anxiety or depressive symptoms was found, we did identify a sub-group of 8% of the women who experienced continuously severe distress. Young age, having a partner, shorter education, and receiving chemotherapy but not radiotherapy might characterize women whose psychological symptoms remain strong eight months after diagnosis. By looking beyond the mean, we found that 8% of the women experienced chronic severe distress; no sub-groups with chronic severe anxiety or depression were identified. Several socio-demographic and treatment factors characterized the women whose distress level remained severe eight months after diagnosis. The results suggest that support could be focused on relatively small groups of patients most in need.

Psychological Distress among Victimized Women on Probation and Parole: A Latent Class Analysis

PubMed Central

Golder, Seana; Engstrom, Malitta; Hall, Martin T.; Higgins, George; Logan, TK

2015-01-01

Latent class analysis was used to identify subgroups of victimized women (N=406) on probation and parole differentiated by levels of general psychological distress. The nine primary symptom dimensions from the Brief Symptom Inventory (BSI) were used individually as latent class indicators (Derogatis, 1993). Results identified three classes of women characterized by increasing levels of psychological distress; classes were further differentiated by posttraumatic stress disorder symptoms, cumulative victimization, substance use and other domains of psychosocial functioning (i.e., sociodemographic characteristics; informal social support and formal service utilization; perceived life stress; and resource loss). The present research was effective in uncovering important heterogeneity in psychological distress using a highly reliable and easily accessible measure of general psychological distress. Differentiating levels of psychological distress and associated patterns of psychosocial risk can be used to develop intervention strategies targeting the needs of different subgroups of women. Implications for treatment and future research are presented. PMID:25915692

Contemporary healthcare practice and the risk of moral distress.

PubMed

Austin, Wendy

2016-05-01

Healthcare professionals are moral agents whose fiduciary relationship with the public is animated by responsibility and the promise to use knowledge and skills to aid those in their care. When their ability to keep this promise is constrained or compromised, moral distress can result. Moral distress in healthcare is defined and outlined. Constraints and factors that lead to moral distress are identified as are the means that individual professionals and organizations use to address it. A call is made for transformative change to overcome a culture of silence and to sustain a healthcare system that is morally habitable. © 2016 The Canadian College of Health Leaders.

Neonatal respiratory distress syndrome

MedlinePlus

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

Romanians Abroad: A Snapshot of Highly Skilled Migration

ERIC Educational Resources Information Center

Ferro, Anna

2004-01-01

This paper is about the experience of labour migration among skilled Romanians, mainly Information Technology workers and highly qualified researchers. It is based on a questionnaire survey where, among other elements, the researcher investigated the push-pull aspects of qualified migration and the strategies of labour migration. This paper…

Partner relationship, social support and perinatal distress among pregnant Icelandic women.

PubMed

Jonsdottir, Sigridur Sia; Thome, Marga; Steingrimsdottir, Thora; Lydsdottir, Linda Bara; Sigurdsson, Jon Fridrik; Olafsdottir, Halldora; Swahnberg, Katarina

2017-02-01

It is inferred that perinatal distress has adverse effects on the prospective mother and the health of the foetus/infant. More knowledge is needed to identify which symptoms of perinatal distress should be assessed during pregnancy and to shed light on the impact of women's satisfaction with their partner relationship on perinatal distress. The current study aimed to generate knowledge about the association of the partner relationship and social support when women are dealing with perinatal distress expressed by symptoms of depression, anxiety and stress. A structured interview was conducted with 562 Icelandic women who were screened three times during pregnancy with the Edinburgh Depression Scale and the Depression, Anxiety, Stress Scale. Of these, 360 had symptoms of distress and 202 belonged to a non-distress group. The women answered the Multidimensional Scale of Perceived Social Support and the Dyadic Adjustment Scale. The study had a multicentre prospective design allowing for exploration of association with perinatal distress. Women who were dissatisfied in their partner relationship were four times more likely to experience perinatal distress. Women with perinatal distress scored highest on the DASS Stress Subscale and the second highest scores were found on the Anxiety Subscale. Satisfaction in partner relationship is related to perinatal distress and needs to be assessed when health care professionals take care of distressed pregnant women, her partner and her family. Assessment of stress and anxiety should be included in the evaluation of perinatal distress, along with symptoms of depression. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Moral distress and burnout syndrome: are there relationships between these phenomena in nursing workers?

PubMed

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

2014-01-01

to identify relationships between moral distress and Burnout in the professional performance from the perceptions of the experiences of nursing workers. this is a survey type study with 375 nursing workers working in three different hospitals of southern Rio Grande do Sul, with the application of adaptations of the Moral Distress Scale and the Maslach Burnout Inventory, validated and standardized for use in Brazil. Data validation occurred through factor analysis and Cronbach's alpha. For the data analysis bivariate analysis using Pearson's correlation and multivariate analysis using multiple regression were performed. the existence of a weak correlation between moral distress and Burnout was verified. A possible positive correlation between Burnout and therapeutic obstinacy, and a negative correlation between professional fulfillment and moral distress were identified. the need was identified for further studies that include mediating and moderating variables that may explain more clearly the models studied.

Sensitivity and specificity of the Distress Thermometer in screening for distress in long-term nasopharyngeal cancer survivors.

PubMed

Hong, J S; Tian, J

2013-12-01

The Distress Thermometer (dt) is a screening tool recommended to quickly identify cancer patients with distress. Our study aimed to examine the sensitivity and specificity of the dt in detecting psychological distress in long-term Chinese nasopharyngeal cancer (npc) survivors. Data for the 442 participating npc survivors were collected through a self-administered questionnaire based on the dt and the Hospital Anxiety and Depression Scale (hads). The hads was used to define cases of psychological distress. Positive and negative groups were defined based on 4 hads criteria (Anxiety, Depression, Anxiety or Depression, and overall score). Receiver operating characteristic (roc) curves were used to examine the ability of all possible cut-off values of the dt to detect positive and negative cases. For each roc curve, the area under the curve (auc) was used as an indicator of the overall accuracy of the dt to identify positive cases of distress. The positive auc values [with 95% confidence intervals (ci)] for the 4 hads criteria were 0.715 (95% ci: 0.667 to 0.764), 0.714 (95% ci: 0.661 to 0.768), 0.724 (95% ci: 0.677 to 0.771), and 0.724 (95% ci: 0.664 to 0.775) respectively. At a cut-off score of 4, the sensitivity of the dt to the four hads criteria was, respectively, 0.366 (95% ci: 0.296 to 0.436), 0.448 (95% ci: 0.364 to 0.532), 0.362 (95% ci: 0.299 to 0.425), and 0.421 (95% ci: 0.339 to 0.502), and the specificity of the dt to the 4 hads criteria was, respectively, 0.860 (95% ci: 0.818 to 0.902), 0.860 (95% ci: 0.821 to 0.899), 0.854 (95% ci: 0.814 to 0.894), and 0.854 (95% ci: 0.814 to 0.894). At a cut-off score of 5, the corresponding sensitivities were lower than those at the cut-off score of 4. All potential cut-off scores showed poor sensitivity (<0.90). The roc analysis showed poor discrimination. No potential dt cut-off score had an acceptable sensitivity. The dt showed poor sensitivity in npc survivors. Thus, the dt might not be a valid scale for

Sensitivity and specificity of the Distress Thermometer in screening for distress in long-term nasopharyngeal cancer survivors

PubMed Central

Hong, J.S.; Tian, J.

2013-01-01

Background The Distress Thermometer (dt) is a screening tool recommended to quickly identify cancer patients with distress. Our study aimed to examine the sensitivity and specificity of the dt in detecting psychological distress in long-term Chinese nasopharyngeal cancer (npc) survivors. Methods Data for the 442 participating npc survivors were collected through a self-administered questionnaire based on the dt and the Hospital Anxiety and Depression Scale (hads). The hads was used to define cases of psychological distress. Positive and negative groups were defined based on 4 hads criteria (Anxiety, Depression, Anxiety or Depression, and overall score). Receiver operating characteristic (roc) curves were used to examine the ability of all possible cut-off values of the dt to detect positive and negative cases. For each roc curve, the area under the curve (auc) was used as an indicator of the overall accuracy of the dt to identify positive cases of distress. Results The positive auc values [with 95% confidence intervals (ci)] for the 4 hads criteria were 0.715 (95% ci: 0.667 to 0.764), 0.714 (95% ci: 0.661 to 0.768), 0.724 (95% ci: 0.677 to 0.771), and 0.724 (95% ci: 0.664 to 0.775) respectively. At a cut-off score of 4, the sensitivity of the dt to the four hads criteria was, respectively, 0.366 (95% ci: 0.296 to 0.436), 0.448 (95% ci: 0.364 to 0.532), 0.362 (95% ci: 0.299 to 0.425), and 0.421 (95% ci: 0.339 to 0.502), and the specificity of the dt to the 4 hads criteria was, respectively, 0.860 (95% ci: 0.818 to 0.902), 0.860 (95% ci: 0.821 to 0.899), 0.854 (95% ci: 0.814 to 0.894), and 0.854 (95% ci: 0.814 to 0.894). At a cut-off score of 5, the corresponding sensitivities were lower than those at the cut-off score of 4. All potential cut-off scores showed poor sensitivity (<0.90). Conclusions The roc analysis showed poor discrimination. No potential dt cut-off score had an acceptable sensitivity. The dt showed poor sensitivity in npc survivors. Thus, the dt

Psychological Distress in Afghan Refugees: A Mixed-Method Systematic Review

PubMed Central

Alemi, Qais; James, Sigrid; Cruz, Romalene; Zepeda, Veronica; Racadio, Michael

2013-01-01

Mental health problems disproportionately affect Afghan refugees and asylum seekers who continue to seek international protection with prolonged exposure to war. We performed a systematic review aimed at synthesizing peer-reviewed literature pertaining to mental health problems among Afghans resettled in industrialized nations. We used five databases to identify studies published between 1979 and 2013 that provided data on distress levels, and subjective experiences with distress. Seventeen studies met our inclusion criteria consisting of 1 mixed-method, 7 qualitative, and 9 quantitative studies. Themes from our qualitative synthesis described antecedents for distress being rooted in cultural conflicts and loss, and also described unique coping mechanisms. Quantitative findings indicated moderate to high prevalence of depressive and posttraumatic symptomatology. These findings support the need for continued mental health research with Afghans that accounts for: distress among newly resettled groups, professional help-seeking utilization patterns, and also culturally relevant strategies for mitigating distress and engaging Afghans in research. PMID:23784146

Patterns of gender equality at workplaces and psychological distress.

PubMed

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

2013-01-01

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

Patterns of Gender Equality at Workplaces and Psychological Distress

PubMed Central

Bolin, Malin; Hammarström, Anne

2013-01-01

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

Artiodactyl and Perissodactyl acoustics: Identifying distress calls by farm animals

NASA Astrophysics Data System (ADS)

Browning, David G.; Scheifele, Peter M.

2004-05-01

There is growing concern for the welfare of farm animals. Vocal signals are discernable in a herd, generally carry over relatively long ranges, and, as Jahns has shown, can be easily automatically detected. Analysis of vocalizations from the two principal farm animal families show, however, that only a few, a pig's squeal, for example, meet Morton's classic criteria for distress. In general, Artiodactyls (cows, sheep, goats, etc.) have tonal bellows or bleats where apparently one vocalization fits many emotional situations. Duration and repetition, as Grandin has suggested, may be the important criteria in indicating stress. In contrast, Perissodactyls vary frequency during some vocalizations, such as a horse whinny, but no direct connection between frequency change and stress has yet been determined. The apparent reliance of Perissodactyles (with keen eyesight) on visual detection of body language appears to limit to some degree the amount of vocalization.

Investigating the perception of Romanian adults on ophthalmology services from an experiential marketing perspective

PubMed Central

Gheorghe, Consuela-Mădălina; Gheorghe, Iuliana-Raluca; Purcărea, Victor Lorin

2017-01-01

Nowadays, we live in a world in which we are daily bombed by hundreds of advertisements. Specialists have to discover other channels or embed attractive elements in the advertisements’ messages to cut through the clutter and catch the consumers’ attention. The evolution of the concept of service has changed from the commercial status to determining a lifestyle. Buying a service has led to a change in the consumer behavior. Consumers want to buy services that dazzle their senses, touch their hearts, and stimulate their minds, not as before, excellent or satisfying. Ophthalmology is the medical specialty that is the most oriented toward outpatient care, as hospitalization is required only in a small percentage of cases. The objective of this case study was to investigate the perception of Romanian adult consumers on ophthalmology services from an experiential marketing perspective, by using the Focus Group method. Ophthalmology requires a wide range of skills due to the diversity of consumers who demand specialized consultations. Experiential marketing is a valuable strategy that ophthalmologic organizations may use to target specific consumers. The purpose of this case study was to identify the perceptions of Romanian adults on experiential marketing campaigns and determine the degree to which these campaigns influenced their decisions of buying an ophthalmologic service. Using a snowball sampling technique we have sent a filter questionnaire to 40 people on the internet. The filter questionnaire consisted of questions about wearing eyeglasses, the period of wearing them, the last ophthalmologic consultation, the type of ophthalmologic clinic they were going to, age and education. The respondents revealed there is almost no visibility on promoting services even if there is an upsurge of organizations offering this type of health service in the Romanian ophthalmology sector. PMID:29450395

Investigating the perception of Romanian adults on ophthalmology services from an experiential marketing perspective.

PubMed

Gheorghe, Consuela-Mădălina; Gheorghe, Iuliana-Raluca; Purcărea, Victor Lorin

2017-01-01

Nowadays, we live in a world in which we are daily bombed by hundreds of advertisements. Specialists have to discover other channels or embed attractive elements in the advertisements' messages to cut through the clutter and catch the consumers' attention. The evolution of the concept of service has changed from the commercial status to determining a lifestyle. Buying a service has led to a change in the consumer behavior. Consumers want to buy services that dazzle their senses, touch their hearts, and stimulate their minds, not as before, excellent or satisfying. Ophthalmology is the medical specialty that is the most oriented toward outpatient care, as hospitalization is required only in a small percentage of cases. The objective of this case study was to investigate the perception of Romanian adult consumers on ophthalmology services from an experiential marketing perspective, by using the Focus Group method. Ophthalmology requires a wide range of skills due to the diversity of consumers who demand specialized consultations. Experiential marketing is a valuable strategy that ophthalmologic organizations may use to target specific consumers. The purpose of this case study was to identify the perceptions of Romanian adults on experiential marketing campaigns and determine the degree to which these campaigns influenced their decisions of buying an ophthalmologic service. Using a snowball sampling technique we have sent a filter questionnaire to 40 people on the internet. The filter questionnaire consisted of questions about wearing eyeglasses, the period of wearing them, the last ophthalmologic consultation, the type of ophthalmologic clinic they were going to, age and education. The respondents revealed there is almost no visibility on promoting services even if there is an upsurge of organizations offering this type of health service in the Romanian ophthalmology sector.

Post-Institutional Autistic Syndrome in Romanian adoptees.

PubMed

Hoksbergen, René; ter Laak, Jan; Rijk, Kathinka; van Dijkum, Cor; Stoutjesdijk, Felicia

2005-10-01

Romanian adoptees have a background of severe neglect. International research has shown that this can give rise to symptoms of autistic behavior. Rutter et al. (1999, Journal of Child Psychology Psychiatry, 40(4), 537-549.) refers to "quasi-autistic patterns", and Federici (1998, Help for the hopelss child: A guide for families. Alexandria: Federici & Assocoates.) to Post-Institutional Autistic Syndrome (PIAS). Eighty Romanian adoptees, averaging 8 years of age, who had resided in the Netherlands for 5 years were studied. Parent interviews and the Auti-R scale showed the extent to which the children exhibited PIAS. In one third of these children we observed (in addition to other behavioral problems) stereotypic behaviors and communication and language disorders. Our findings resembled the Rutter et al. (1999, Journal of Child Psychology Psychiatry, 40(4), 537-549). data. Six of the children were classified within the autistic spectrum pursuant to the Auti-R, and seven within the so-called intermediate group. No difference was found between the girls and the boys. Children who had been in their adoptive families for 5 years or more showed fewer behavior problems than children who had been in their adoptive families for four or less years.

Romanian wild boars and Mangalitza pigs have a European ancestry and harbour genetic signatures compatible with past population bottlenecks

PubMed Central

Manunza, A.; Amills, M.; Noce, A.; Cabrera, B.; Zidi, A.; Eghbalsaied, S.; de Albornoz, E. Carrillo; Portell, M.; Mercadé, A.; Sànchez, A.; Balteanu, V.

2016-01-01

We aimed to analyse the genetic diversity of Romanian wild boars and to compare it with that from other wild boar and pig populations from Europe and Asia. Partial sequencing of the mitochondrial encoded cytochrome b (MT-CYB) gene from 36 Romanian wild boars and 36 domestic pigs (Mangalitza, Bazna and Vietnamese breeds) showed that the diversity of Romanian wild boars and Mangalitza pigs is fairly reduced, and that most of the members of these two populations share a common MT-CYB haplotype. Besides, in strong contrast with the Bazna animals, Romanian wild boars and Mangalitza swine did not carry Asian variants at the MT-CYB locus. The autosomal genotyping of 18 Romanian wild boars with the Illumina Porcine SNP60 BeadChip revealed that their genetic background is fundamentally European, even though signs of a potential Near Eastern ancestry (~25%) were detectable at K = 4 (the most significant number of clusters), but not at higher K-values. Admixture analysis also showed that two wild boars are of a hybrid origin, which could be explained by the mating of feral animals with domestic pigs. Finally, a number of Romanian wild boars displayed long runs of homozygosity, an observation that is consistent with the occurrence of past population bottlenecks and the raise of inbreeding possibly due to overhunting or to the outbreak of infectious diseases. PMID:27418428

Romanian wild boars and Mangalitza pigs have a European ancestry and harbour genetic signatures compatible with past population bottlenecks.

PubMed

Manunza, A; Amills, M; Noce, A; Cabrera, B; Zidi, A; Eghbalsaied, S; de Albornoz, E Carrillo; Portell, M; Mercadé, A; Sànchez, A; Balteanu, V

2016-07-15

We aimed to analyse the genetic diversity of Romanian wild boars and to compare it with that from other wild boar and pig populations from Europe and Asia. Partial sequencing of the mitochondrial encoded cytochrome b (MT-CYB) gene from 36 Romanian wild boars and 36 domestic pigs (Mangalitza, Bazna and Vietnamese breeds) showed that the diversity of Romanian wild boars and Mangalitza pigs is fairly reduced, and that most of the members of these two populations share a common MT-CYB haplotype. Besides, in strong contrast with the Bazna animals, Romanian wild boars and Mangalitza swine did not carry Asian variants at the MT-CYB locus. The autosomal genotyping of 18 Romanian wild boars with the Illumina Porcine SNP60 BeadChip revealed that their genetic background is fundamentally European, even though signs of a potential Near Eastern ancestry (~25%) were detectable at K = 4 (the most significant number of clusters), but not at higher K-values. Admixture analysis also showed that two wild boars are of a hybrid origin, which could be explained by the mating of feral animals with domestic pigs. Finally, a number of Romanian wild boars displayed long runs of homozygosity, an observation that is consistent with the occurrence of past population bottlenecks and the raise of inbreeding possibly due to overhunting or to the outbreak of infectious diseases.

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

PubMed

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

2015-10-01

Fathers' parenting behavior is a likely key mechanism underlying the consistent associations between paternal mental health difficulties and poor emotional-behavioral outcomes for children. This study investigates the association between fathers' mental health trajectories and key parenting behaviors (warmth, hostility, consistency) spanning the first 8-9 years postpartum. Secondary analyses of 5 waves of data from 2,662 fathers participating in the Longitudinal Study of Australian Children were conducted. Latent growth class analysis was used to identify distinct trajectories of fathers' distress (Kessler-6; Kessler et al., 2003), and latent growth models estimated parenting warmth, hostility, and consistency. Multiple group analyses were conducted to describe and compare the course of parenting behaviors for fathers assigned to the distress trajectories identified. Two distinct classes of fathers were identified based on the trajectories of distress: minimal distress (92%) and persistent and increasing distress (8%). The latter group reported significantly lower parenting warmth when their children were 8-9 years and lower consistency and higher hostility across all study intervals. The postnatal and early parenting period is a critical time for the development of parenting behaviors that are important for children's development. Engagement and support for fathers around well-being and parenting is vital for promoting optimal family and child developmental outcomes. (c) 2015 APA, all rights reserved).

Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students.

PubMed

Dyrbye, Liselotte N; Thomas, Matthew R; Shanafelt, Tait D

2006-04-01

To systematically review articles reporting on depression, anxiety, and burnout among U.S. and Canadian medical students. Medline and PubMed were searched to identify peer-reviewed English-language studies published between January 1980 and May 2005 reporting on depression, anxiety, and burnout among U.S. and Canadian medical students. Searches used combinations of the Medical Subject Heading terms medical student and depression, depressive disorder major, depressive disorder, professional burnout, mental health, depersonalization, distress, anxiety, or emotional exhaustion. Reference lists of retrieved articles were inspected to identify relevant additional articles. Demographic information, instruments used, prevalence data on student distress, and statistically significant associations were abstracted. The search identified 40 articles on medical student psychological distress (i.e., depression, anxiety, burnout, and related mental health problems) that met the authors' criteria. No studies of burnout among medical students were identified. The studies suggest a high prevalence of depression and anxiety among medical students, with levels of overall psychological distress consistently higher than in the general population and age-matched peers by the later years of training. Overall, the studies suggest psychological distress may be higher among female students. Limited data were available regarding the causes of student distress and its impact on academic performance, dropout rates, and professional development. Medical school is a time of significant psychological distress for physicians-in-training. Currently available information is insufficient to draw firm conclusions on the causes and consequences of student distress. Large, prospective, multicenter studies are needed to identify personal and training-related features that influence depression, anxiety, and burnout among students and explore relationships between distress and competency.

Loss of Infinitival Complementation in Romanian Diachronic Syntax

ERIC Educational Resources Information Center

Jordan, Maria

2009-01-01

For the most part, my study is a descriptive analysis of infinitival complement clauses and the corresponding subjunctive clauses in Romanian, that is, obligatory control (OC) structures. OC is a relation of obligatory coreferentiality between a matrix argument (controller) and the null subject of the subordinate (controlee) of the same sentence.…

Persistent Distress after Water Contamination.

PubMed

Schade, Charles P; Gupta, Rahul; Jha, Ayan; Wright, Nasandra

2016-01-01

A chemical spill contaminated the public water supply of Charleston, West Virginia in January 2014 for at least a week. Psychological distress is common after disasters. We surveyed the exposed population to assess psychological distress during and three months after the incident. We inquired about stressors that might predict distress, adequacy of communication from public officials, and use of the water supply and perceptions of its safety three months after the incident. Twenty six percent of interviewees had persistent symptoms of distress. Female sex, negative household experiences during the episode (especially having someone sick), and poor perception of communication increased odds of persistent distress. Households of respondents without persistent distress were significantly more likely to report drinking tap water (RR=1.95) than those with persistent distress. Distress in Charleston area residents persisted and may have resulted in continuing mistrust of the water supply.

Predicting general and cancer-related distress in women with newly diagnosed breast cancer.

PubMed

Gibbons, Andrea; Groarke, AnnMarie; Sweeney, Karl

2016-12-03

Psychological distress can impact medical outcomes such as recovery from surgery and experience of side effects during treatment. Identifying the factors that explain variability in distress would guide future interventions aimed at decreasing distress. Two factors that have been implicated in distress are illness perceptions and coping, and are part of the Self-Regulatory Model of Illness Behaviour (SRM). The model suggests that coping mediates the relationship between illness perceptions and distress. Despite this; very little research has assessed this relationship with cancer-related distress, and none have examined women with screen-detected breast cancer. This study is the first to examine the relative contribution of illness perceptions and coping on general and cancer-related distress in women with screen-detected breast cancer. Women recently diagnosed with breast cancer (N = 94) who had yet to receive treatment completed measures of illness perceptions (Revised Illness Perception Questionnaire), cancer-specific coping (Mental Adjustment to Cancer Scale), general anxiety and depression (Hospital Anxiety and Depression scale), and cancer-related distress. Hierarchical regression analyses revealed that medical variables, illness perceptions and coping predicted 50% of the variance in depression, 42% in general anxiety, and 40% in cancer-related distress. Believing in more emotional causes to breast cancer (β = .22, p = .021), more illness identity (β = .25, p = .004), greater anxious preoccupation (β = .23, p = .030), and less fighting spirit (β = -.31, p = .001) predicted greater depression. Greater illness coherence predicted less cancer-related distress (β = -.20, p = .043). Greater anxious preoccupation also led to greater general anxiety (β = .44, p < .001) and cancer-related distress (β = .37, p = .001). Mediation analyses revealed that holding greater beliefs in a chronic timeline

Microsatellite and Mitochondrial DNA Study of Native Eastern European Cattle Populations: The Case of the Romanian Grey

PubMed Central

Cean, Ada; Cziszter, Ludovic Toma; Gavojdian, Dinu; Ivan, Alexandra

2015-01-01

The Eastern European Grey cattle are regarded as the direct descendants of the aurochs (Bos taurus primigenius). Nowadays in Romania, less than 100 Grey animals are being reared and included in the national gene reserve. We examined the genetic diversity among Romanian Grey, Brown, Spotted and Black and White cattle breeds, with a particular focus on Romanian Grey through the use of (i) 11 bovine specific microsatellite markers on 83 animals and (ii) 638 bp length of mitochondrial DNA (mtDNA) D-loop region sequence data from a total of 81 animals. Both microsatellite and mtDNA analysis revealed a high level of genetic variation in the studied breeds. In Romanian Grey a total of 100 alleles were found, the mean number of observed alleles per locus was 9.091; the average observed heterozygosity was 0.940; the Wright’s fixation index (FIS) was negative (-0.189) and indicates that there is no inbreeding and no selection pressure. MtDNA analysis revealed 52 haplotypes with 67 variable sites among the Romanian cattle breeds without any insertion or deletion. Haplotype diversity was 0.980 ± 0.007 and ranged from 0.883 ± 0.056 (Brown) to 0.990 ± 0.028 (Spotted and Black and White). The highest genetic variability of the mtDNA was recorded in the Grey breed, where 18 haplotypes were identified. The most frequent mtDNA D-loop region belonged to T3 haplogroup (80.247%), which was found across all studied breeds, while T2 haplotypes (16.049%) was only found in Grey, Spotted and Black and White genotypes. The T1 haplotypes (3.704%) were found in the Grey and Spotted. The current results contribute to the general knowledge on genetic diversity found in Eastern European cattle breeds and could prove a valuable tool for the conservation efforts of animal genetic resources (FAnGR). PMID:26398563

Psychosocial distress and stroke risk in older adults.

PubMed

Henderson, Kimberly M; Clark, Cari J; Lewis, Tené T; Aggarwal, Neelum T; Beck, Todd; Guo, Hongfei; Lunos, Scott; Brearley, Ann; Mendes de Leon, Carlos F; Evans, Denis A; Everson-Rose, Susan A

2013-02-01

To investigate the association of psychosocial distress with risk of stroke mortality and incident stroke in older adults. Data were from the Chicago Health and Aging Project, a longitudinal population-based study conducted in 3 contiguous neighborhoods on the south side of Chicago, IL. Participants were community-dwelling black and non-Hispanic white adults, aged 65 years and older (n=4120 for stroke mortality; n=2649 for incident stroke). Psychosocial distress was an analytically derived composite measure of depressive symptoms, perceived stress, neuroticism, and life dissatisfaction. Cox proportional hazards models examined the association of distress with stroke mortality and incident stroke over 6 years of follow-up. Stroke deaths (151) and 452 incident strokes were identified. Adjusting for age, race, and sex, the hazard ratio (HR) for each 1-SD increase in distress was 1.47 (95% confidence interval [CI]=1.28-1.70) for stroke mortality and 1.18 (95% CI=1.07-1.30) for incident stroke. Associations were reduced after adjustment for stroke risk factors and remained significant for stroke mortality (HR=1.29; 95% CI=1.10-1.52) but not for incident stroke (HR=1.09; 95% CI=0.98-1.21). Secondary analyses of stroke subtypes showed that distress was strongly related to incident hemorrhagic strokes (HR=1.70; 95% CI=1.28-2.25) but not ischemic strokes (HR=1.02; 95% CI=0.91-1.15) in fully adjusted models. Increasing levels of psychosocial distress are related to excess risk of both fatal and nonfatal stroke in older black and white adults. Additional research is needed to examine pathways linking psychosocial distress to cerebrovascular disease risk.

47 CFR 80.1115 - Transmission of a distress alert by a station not itself in distress.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Safety System (GMDSS) Operating Procedures for Distress and Safety Communications § 80.1115 Transmission of a distress alert by a station not itself in distress. (a) A station in the mobile or mobile-satellite service which learns that a mobile unit is in distress must initiate and transmit a distress alert...

47 CFR 80.1115 - Transmission of a distress alert by a station not itself in distress.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Safety System (GMDSS) Operating Procedures for Distress and Safety Communications § 80.1115 Transmission of a distress alert by a station not itself in distress. (a) A station in the mobile or mobile-satellite service which learns that a mobile unit is in distress must initiate and transmit a distress alert...

Exploring Sources of Variation in Romanian Science Achievement

ERIC Educational Resources Information Center

Istrate, Olimpius; Noveanu, Gabriela; Smith, Thomas M.

2006-01-01

The shift from a centrally-controlled to a market-oriented economy in the early 1990s put pressure on the Romanian education system to reform both the curriculum and methods of instruction employed in primary and secondary education. At least part of the pressure to implement educational reforms came from the relatively poor performance of…

Diabetes Distress and Depression in South Asian Canadians with Type 2 Diabetes.

PubMed

Sidhu, Rawel; Tang, Tricia S

2017-02-01

South Asians are disproportionately affected by diabetes compared to some other ethnic groups in Canada. Although depression and diabetes distress are psychological issues well studied in the general population of those with diabetes, they have not been investigated in South Asian Canadians with type 2 diabetes. We sought to identify the rates of depression and diabetes distress in South Asian adults with type 2 diabetes and to explore the relationship among glycemic control, depression and diabetes distress. We recruited 41 South Asian adults with type 2 diabetes for this study. Glycated hemoglobin (A1C) levels were collected via venous puncture. We utilized the Diabetes Distress Scale to assess total diabetes distress and its subscales (emotional distress, interpersonal distress, regimen-related distress and physician distress) and the Personal Health Questionnaire-9 to assess depressive symptoms. The rate of depression was 15%, and the rate of total diabetes distress was 52.5%. Although neither measure was found to be correlated with A1C levels, depression had a moderate positive correlation with total diabetes distress (r=0.696; p<0.001); subscales of regimen distress and emotional burden emerged as the strongest correlates. This is the first study to report that diabetes distress is a serious concern for South Asian Canadians with type 2 diabetes. Given that depression and diabetes distress are linked, studies recruiting a larger and more diverse sample of South Asian Canadians should be conducted to better understand the psychological issues that may impact diabetes self-management in this community. Copyright © 2016 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Gender, age and surgery as a treatment modality leads to higher distress in patients with cancer.

PubMed

Thomas, Bejoy C; NandaMohan, V; Nair, Madhvan K; Pandey, Manoj

2010-02-01

Distress has been defined as a multidimensional construct that extends along a continuum, ranging from common normal feelings of vulnerability, sadness and fears to problems that can become disabling, such as depression, anxiety, panic, social isolation and existential and spiritual crisis. Several studies have pointed out the need to screen for distress in the cancer. Emotional distress has been found as a core indicator of a patient's health and well-being and has installed it as the sixth vital sign. The aim of the present study was to identify the predictors of distress in cancer patients. For the present study, a total of 760 patients with cancer in a tertiary cancer centre were assessed using the Distress Inventory for Cancer Version 2 (DIC V2). A multivariate logistic regression was carried out to identify the predictors of distress and six subscales. Female patients under the age of 44 years scheduled to undergo surgery or those who had undergone surgery predicted significantly higher levels of overall distress. Composite disease stage other than stage IV metastatic disease and being a daily wage employee predicted significantly lower levels of overall distress. Higher distress among women undergoing surgery could imply distress associated with significant cosmetic disfigurement and feeling of loss of womanhood especially in those with breast or cervix cancer. The study once again demonstrate gender and age differences in distress and also highlights the importance of knowing that cancer is confined to one organ and has not spread.

Validation of an instrument to measure moral distress within the Australian residential and community care environments.

PubMed

Burston, Adam; Eley, Robert; Parker, Deborah; Tuckett, Anthony

2017-06-01

The aim of this study was to gain insight into the experience of moral distress within the aged care workforce. The objective of this study was to use and validate an existing instrument to measure moral distress within the aged care setting. Moral distress, a phenomenon associated with worker satisfaction and retention, is common within nursing. Instruments to measure moral distress exist; however, there are no validated instruments to measure moral distress within an aged care setting. An existing instrument, the Moral Distress Scale (Revised) was identified and amended. Amendments were subject to expert review for face and content validity. Data were collected from aged care nurses working in residential and community aged care, in Australia. Reliability was assessed using Cronbach's alpha with exploratory factor analysis undertaken for construct validity. 106 participants completed the survey, 93 (87.7%) identified as female and 13 (12.3%) male. Participants ranged in age from 21 to 73 years, with a mean time working in nursing of 20.6 years. The frequency component of the instrument demonstrated an alpha of 0.89, the intensity component 0.95 and the instrument as a whole 0.94. Three factors were identified and labelled as: Quality of Care, Capacity of Team and Professional Practice. Mean scores indicate a low occurrence of moral distress, but this distress, when experienced, was felt with a moderate level of intensity. Primary causes of moral distress were insufficient staff competency levels, poor quality care because of poor communication and delays in implementing palliation. The instrument demonstrates validity and reliability within the Australian aged care setting. Further analysis with larger populations is required to support these findings. Australian aged care workers do experience moral distress. They suffer adverse consequences of this distress and quality of care is negatively impacted. This newly validated instrument can be used to quantify the

Moral distress and Burnout syndrome: are there relationships between these phenomena in nursing workers?1

PubMed Central

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

2014-01-01

Objective to identify relationships between moral distress and Burnout in the professional performance from the perceptions of the experiences of nursing workers. Methods this is a survey type study with 375 nursing workers working in three different hospitals of southern Rio Grande do Sul, with the application of adaptations of the Moral Distress Scale and the Maslach Burnout Inventory, validated and standardized for use in Brazil. Data validation occurred through factor analysis and Cronbach's alpha. For the data analysis bivariate analysis using Pearson's correlation and multivariate analysis using multiple regression were performed. Results the existence of a weak correlation between moral distress and Burnout was verified. A possible positive correlation between Burnout and therapeutic obstinacy, and a negative correlation between professional fulfillment and moral distress were identified. Conclusion the need was identified for further studies that include mediating and moderating variables that may explain more clearly the models studied. PMID:24553701

Sensitivity and specificity of the Distress Thermometer and a two-item depression screen (Patient Health Questionnaire-2) with a 'help' question for psychological distress and psychiatric morbidity in patients with advanced cancer.

PubMed

Ryan, Dermot Anthony; Gallagher, Pamela; Wright, Shelagh; Cassidy, Eugene M

2012-12-01

Brief screening tools may help clinicians in busy settings detect patients who are experiencing severe psychological distress. This study examined the performance of the Distress Thermometer (DT) and a two-item depression screen [the Patient Health Questionnaire-2 (PHQ-2)] with a 'help' question in screening for distress and psychiatric morbidity among patients with advanced cancer. Two hundred and five patients with advanced cancer completed the DT, the PHQ-2 and 'help' question and the Hospital Anxiety and Depression Scale and were interviewed using the Structured Clinical Interview for DSM-IV (SCID). The performance of the screening tools was examined against the Hospital Anxiety and Depression Scale and the SCID. Overall, discrimination levels were comparable for the DT [area under the curve (AUC) 0.80-0.81] and the PHQ-2 (AUC 0.73-0.85). The DT performed best in detecting cases of distress and mood, anxiety or adjustment disorders (sensitivity 100%), but it had poor specificity (49-60%). The best performance in terms of combined sensitivity and specificity was the PHQ depression item versus the SCID (sensitivity 88%, specificity 73%). The inclusion of the 'help' question with the PHQ-2 resulted in high levels of specificity (≥89%), but there was a significant drop in sensitivity (≤54%). Ultra-brief screening tools offer an efficient means of identifying patients with advanced cancer with severe distress or psychiatric morbidity but are less effective at identifying non-distressed individuals. Used in conjunction with a 'help' question, these tools can help clinicians identify patients who are both distressed and likely to accept professional support. Copyright © 2011 John Wiley & Sons, Ltd.

Medical students' experiences of moral distress: development of a web-based survey.

PubMed

Wiggleton, Catherine; Petrusa, Emil; Loomis, Kim; Tarpley, John; Tarpley, Margaret; O'Gorman, Mary Lou; Miller, Bonnie

2010-01-01

To develop an instrument for measuring moral distress in medical students, measuring the prevalence of moral distress in a cohort of students, and identifying the situations most likely to cause it. Moral distress, defined as the negative feelings that arise when one knows the morally correct thing to do but cannot act because of constraints or hierarchies, has been documented in nurses but has not been measured in medical students. The authors constructed a survey consisting of 55 items describing potentially distressing situations. Responders rated the frequency of these situations and the intensity of distress that they caused. The survey was administered to 106 fourth-year medical students during a three-week period in 2007; the response rate was 60%. Each of the situations was experienced by at least some of the 64 respondents, and each created some degree of moral distress. On average, students witnessed almost one-half of the situations at least once, and more than one-third of the situations caused mild-to-moderate distress. The survey measured individual distress (Cronbach alpha = 0.95), which varied among the students. Whereas women witnessed potentially distressing situations significantly more frequently than did men (P = .04), men tended to become more distressed by each event witnessed (P = .057). Medical students frequently experience moral distress. Our survey can be used to measure aspects of the learning environment as well as individual responses to the environment. The variation found among student responses warrants further investigation to determine whether students at either extreme of moral distress are at risk of burnout or erosion of professionalism.

Progress and Challenges in Reducing Economic Distress in Appalachia: An Analysis of National and Regional Trends since 1960.

ERIC Educational Resources Information Center

Wood, Lawrence E.; Bischak, Gregory A.

This report analyzes changes in the number of distressed counties in Appalachia since 1960, identifies macroeconomic trends associated with distress in Appalachia, and examines socioeconomic factors associated with long-term distress as well as factors that predict whether a county moved out of distress. These data are also compared with similar…

Resources, stressors and psychological distress among older adults in Chennai, India.

PubMed

Chokkanathan, Srinivasan

2009-01-01

Scant information exists on the complex interaction between resources and stressors and their subsequent influence on the psychological distress of older adults in India. Within the framework of resource theory, the present study examined the various pathways through which resources and stressors influence psychological distress by testing four models - the independence model, the stress-suppression model, the counteractive model and the resource-deterioration model. The independence model posits that resources and stressors have a direct relationship with psychological distress. The stress-suppression model hypothesizes that stressors mediate the influence of resources on psychological distress. The counteractive model postulates that stressors mobilize resources, which in turn influence psychological distress. The resource-deterioration model states that stressors deplete resources and subsequently exacerbate distress. In the present study, resources include social support, religiosity and mastery; stressors include life events, abuse and health problems. Psychological distress was measured using the Center for Epidemiological Studies Depression scale and Geriatric Depression Scale. Interviews were conducted among 400 adults aged 65 years and above, randomly selected from the electoral list of urban Chennai, India. The battery of instruments was translated into Tamil (local language) by back-translation. Structural Equation Modeling was conducted to test the three models. The results supported the stress-suppressor model. Resources had an indirect, negative relationship with psychological distress, and stressors had a direct, positive effect on distress. As such there is a need to identify and strengthen the resources available to older adults in India.

Emotional Distress as a Predictor of Work-Related Musculoskeletal Disorders in Malaysian Nursing Professionals.

PubMed

Amin, Nur Azma; Quek, Kia Fatt; Oxley, Jennifer Anne; Noah, Rahim; Nordin, Rusli

2018-04-01

Emotional distress is becoming a great concern and is more common in both developed and developing countries. It is associated with several disease conditions. To determine the prevalence of self-perceived emotional distress and its relation to work-related musculoskeletal disorders (WRMSDs) in nurses. A self-administered questionnaire survey was carried out on 660 female nurses working in public hospitals in the Klang Valley, Malaysia. The validated Malay version of the standardized Nordic musculoskeletal questionnaire (M-SNMQ) was used to identify the annual prevalence of WRMSDs; perceived emotional distress was assessed using the validated Malay short version, depression, anxiety, and stress (M-DASS) instrument. In addition, socio-demographic and occupational profiles of the participants were considered. Factors associated with WRMSDs were identified using logistic regression analysis. A total of 376 nurses completed the survey (response rate 83.3%). 73.1% of the nursing staffs experienced WRMSDs in at least one anatomical site 12 months prior to the study. 75% of nurses expressed emotional distress. Of these, over half also reported anxiety and stress. Multiple logistic regression analysis showed that stress and anxiety significantly increased the risk of WRMSDs by approximately twofold. There were significant associations between emotional distress and WRMSDs. Future longitudinal studies are therefore needed to investigate and identify the sources of emotional distress (non-occupational and occupational) to be used to establish preventive strategies to reduce the risk of WRMSDs.

Trajectories of perceived emotional and physical distress in patients with an implantable cardioverter defibrillator.

PubMed

van den Broek, Krista C; Kupper, Nina; van der Voort, Pepijn H; Alings, Marco; Denollet, Johan; Nyklíček, Ivan

2014-02-01

Little is known about the course of emotional and physical distress in patients with an implantable cardioverter defibrillator (ICD). We examined (1) trajectories of emotional and physical distress in the first 18 months postimplantation and (2) predictors of these trajectories, including demographical, clinical, and personality factors. Dutch patients with an ICD (N = 645) completed measures on anxiety, depression, somatic symptoms, and perceived disability at the time of implantation, and 2, 12, and 18 months postimplantation. Measures on Type D personality (tendency to inhibit the expression of negative emotions) and anxiety sensitivity (tendency to fear anxiety-related sensations) were also completed at baseline. Latent class analysis (LatentGOLD) identified six to seven distinct trajectories, varying largely in overall levels of distress, and remaining relatively stable after a small initial decline. Multinomial regression showed that Type D personality and anxiety sensitivity were the most prominent predictors, particularly of trajectories that reflected higher distress levels. Cardiac resynchronization therapy and coronary artery disease also increased the risk for distress, whereas ICD indication and shocks did not. The course of emotional and physical distress may be relatively stable after ICD implantation. In clinical practice, identification of patients with high risk of higher levels of emotional and physical distress may be warranted; as such, patients with high levels of anxiety sensitivity or a Type D personality should be identified and offered behavioral support.

Moral distress in emergency nurses.

PubMed

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

2013-11-01

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

Predicting parental distress among children newly diagnosed with craniopharyngioma.

PubMed

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

2018-06-22

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

Effects of Screening for Psychological Distress on Patient Outcomes in Cancer: a Systematic Review

PubMed Central

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

2013-01-01

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

The unintended consequences of cervical screening: distress in women undergoing cytologic surveillance.

PubMed

Sharp, Linda; Cotton, Seonaidh; Cruickshank, Margaret; Gray, Nicola M; Harrild, Kirsten; Smart, Louise; Walker, Leslie G; Little, Julian

2014-04-01

It is well known that receipt of an initial abnormal cervical cytology test can trigger considerable anxiety among women. Less is known about the impact of follow-up by repeat cytology tests. We quantified prevalence, and identified predictors, of distress after repeat cytologic testing in women with a single low-grade test. Within the framework of the TOMBOLA randomized controlled trial of alternative managements, 844 women aged 20 to 59 years with a single routine cytology test showing borderline nuclear abnormalities (BNA; broadly equivalent to atypical squamous cells of undetermined significance) were assigned to follow-up by repeat cytology in primary care (the first test was due 6 months after the initial BNA result). Women completed sociodemographic and psychosocial questionnaires at recruitment and the Impact of Event Scale (IES) 6 weeks after their first follow-up cytology test. Factors associated with significant psychologic distress (IES ≥ 9) were identified using logistic regression. The response rate was 74% (n = 621/844). Of all the respondents, 39% scored in the range for significant distress. Distress varied by follow-up cytology result: negative, 36%; BNA or mild dyskaryosis, 42%; other (including high grade and inadequate), 55%. After adjusting for the cytology result, risk of distress was significantly raised in women who had significant anxiety at recruitment, reported experiencing pain after the follow-up cytology, had children, or were dissatisfied with support they had received after their initial BNA test. Substantial proportions of women experience surveillance-related psychologic distress after a follow-up cytology test, even when the result is negative. This is an important, albeit unintended, consequence of cervical screening. Strategies to alleviate this distress merit attention.

Using the patients concerns inventory for distress screening in post-treatment head and neck cancer survivors.

PubMed

Ghazali, Naseem; Roe, Brenda; Lowe, Derek; Tandon, Sank; Jones, Terry; Shaw, Richard; Risk, Janet; Rogers, Simon N

2017-10-01

Cancer patients can experience significant distress during their cancer trajectory, which impacts upon clinical outcomes and quality of life. Screening for distress using holistic assessments can help identify and address unmet concerns/needs. The purpose of this study was to evaluate the relationship between concerns and distress, and the impact of distress on clinic outcomes in post-treatment head and neck cancer patients. 170 patients attending routine follow-up clinics were prospectively recruited. All patients completed the Patient Concerns Inventory (PCI) and the Distress thermometer (DT) at preconsultation. The rate of significant distress (i.e. DT cut-off score ≥4) was 36% (62/170). Significantly distressed patients selected more items overall than patients without distress (mean, median (QR) of 5.40, 5 (2-8) vs 2.61, 2 (0-4), p < 0.001). Significant distress was most strongly associated with Physical and Functional well-being (p < 0.001) and Psychological and Emotional well-being domains (p = 0.001). On balance, very little difference was noted between cut-off points of either ≥4 or ≥5 PCI items of concern selected. Both cut-off points demonstrated an acceptable level of sensitivity, specificity and predictive values for significant distress. Consultations were longer with increasing numbers of concerns. Just over one-third of patients are significantly distressed. They were more likely to express a higher number of concerns. A cutoff score ≥4 or ≥5 PCI items selected can identify those at risk of significant distress. Concerns causing significant distress were related to emotional/psychological issues and physical function. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Iowa Gambling Task performance and emotional distress interact to predict risky sexual behavior in individuals with dual substance and HIV diagnoses

PubMed Central

Wardle, Margaret C.; Gonzalez, Raul; Bechara, Antoine; Martin-Thormeyer, Eileen M.

2013-01-01

HIV+ substance-dependent individuals (SDIs) show emotional distress and executive impairment, but in isolation these poorly predict sexual risk. We hypothesized that an executive measure sensitive to emotional aspects of judgment (Iowa Gambling Task; IGT) would identify HIV+ SDIs whose sexual risks were influenced by emotional distress. We assessed emotional distress and performance on several executive tasks in 190 HIV+ SDIs. IGT performance interacted significantly with emotional distress, such that only in better performers were distress and risk related. Our results are interpreted using the somatic marker hypothesis and indicate that the IGT identifies HIV+ SDIs for whom psychological distress influences HIV risk. PMID:20480423

Adolescent emotional distress: the role of family obligations and school connectedness.

PubMed

Wilkinson-Lee, Ada M; Zhang, Qionghui; Nuno, Velia Leybas; Wilhelm, Mari S

2011-02-01

The current study draws upon ecodevelopmental theory to identify protective and risk factors that may influence emotional distress during adolescence. Hierarchical regression analyses were used to examine the relationship among family obligations, school connectedness and emotional distress of 4,198 (51% female) middle and high school students who were primarily (59%) European American. The overall model explained 21.1% of the variance in student emotional distress. A significant interaction effect was found indicating that school connectedness moderated the relationship between family obligations and emotional distress. Specifically, for students with low to moderate levels of family obligations, a stronger sense of school connectedness was associated with lower emotional distress. The buffering effect of school connectedness was weakened as the level of family obligations increased and completely disappeared for students who experienced high levels of family obligations. The creation of a program that takes a holistic approach, in order to curtail the levels of highly emotionally distressed adolescents, must continue to address the ever changing demands that adolescents encounter and prepare youth to deal with functioning within multiple contexts and do so while maintaining emotional well-being.

Partner relationship satisfaction and maternal emotional distress in early pregnancy

PubMed Central

2011-01-01

Background Recognition of maternal emotional distress during pregnancy and the identification of risk factors for this distress are of considerable clinical- and public health importance. The mental health of the mother is important both for herself, and for the physical and psychological health of her children and the welfare of the family. The first aim of the present study was to identify risk factors for maternal emotional distress during pregnancy with special focus on partner relationship satisfaction. The second aim was to assess interaction effects between relationship satisfaction and the main predictors. Methods Pregnant women enrolled in the Norwegian Mother and Child Cohort Study (n = 51,558) completed a questionnaire with questions about maternal emotional distress, relationship satisfaction, and other risk factors. Associations between 37 predictor variables and emotional distress were estimated by multiple linear regression analysis. Results Relationship dissatisfaction was the strongest predictor of maternal emotional distress (β = 0.25). Other predictors were dissatisfaction at work (β = 0.11), somatic disease (β = 0.11), work related stress (β = 0.10) and maternal alcohol problems in the preceding year (β = 0.09). Relationship satisfaction appeared to buffer the effects of frequent moving, somatic disease, maternal smoking, family income, irregular working hours, dissatisfaction at work, work stress, and mother's sick leave (P < 0.05). Conclusions Dissatisfaction with the partner relationship is a significant predictor of maternal emotional distress in pregnancy. A good partner relationship can have a protective effect against some stressors. PMID:21401914

From punishment to education--juvenile delinquency in Romanian criminal law.

PubMed

Ioan, Beatrice; Damian, Simona; Scripcaru, C; Neagu, M; Chirilă, B

2015-01-01

For centuries children were considered "mini-adults". Together with expressing the need to educate children and putting a stop to their integration in the work field from the earliest years the 19th century also displayed a new image of the child, which clearly separates him from the adults. In this paper the authors analyze the Romanian legislation addressing juvenile delinquency in criminal temporal evolution. On the one hand the minority age limits are sought and modulation of legislative provisions according to these, and on the other hand, types of penalties for minors are discussed. The authors conclude that the approach to juvenile delinquency in the current Romanian Criminal Code is the result of a long process of reflection of the legislators on adopting a different system of sanctions for juvenile offenders and on creating special regulations concerning the prosecution, trial and enforcement of the decisions regarding them.

Acute respiratory distress syndrome without identifiable risk factors: A secondary analysis of the ARDS network trials.

PubMed

Harrington, John S; Schenck, Edward J; Oromendia, Clara; Choi, Augustine M K; Siempos, Ilias I

2018-06-02

We examined whether patients with acute respiratory distress syndrome (ARDS) lacking risk factors are enrolled in therapeutic trials and assessed their clinical characteristics and outcomes. We performed a secondary analysis of patient-level data pooled from the ARMA, ALVEOLI, FACTT, ALTA and EDEN ARDSNet randomized controlled trials obtained from the Biologic Specimen and Data Repository Information Coordinating Center of the National Heart, Lung and Blood Institute. We compared baseline characteristics and clinical outcomes (before and after adjustment using Poisson regression model) of ARDS patients with versus without risk factors. Of 3733 patients with ARDS, 81 (2.2%) did not have an identifiable risk factor. Patients without risk factors were younger, had lower baseline severity of illness, were more likely to have the ARDS resolve rapidly (i.e., within 24 h) (p < 0.001) and they had more ventilator-free days (median 21; p = 0.003), more intensive care unit-free days (18; p = 0.010), and more non-pulmonary organ failure-free days (24; p < 0.001) than comparators (17, 14 and 18, respectively). Differences persisted after adjustment for potential confounders. Patients with ARDS without identifiable risk factors are enrolled in therapeutic trials and may have better outcomes, including a higher proportion of rapidly resolving ARDS, than those with risk factors. Copyright © 2018. Published by Elsevier Inc.

A Bowen Family Systems Model of Generalized Anxiety Disorder and Romantic Relationship Distress.

PubMed

Priest, Jacob B

2015-07-01

Many individuals with generalized anxiety disorder (GAD) do not respond well to currently available treatments. Moreover, treatments are less effective when GAD is accompanied by romantic relationship distress. In order to develop effective treatments for GAD and relationship distress, it is necessary to conduct theory-based research to identify links common to both GAD and romantic relationship distress. Drawing on Bowen's family systems theory, the roles of family abuse/violence and differentiation in GAD and romantic relationship distress were examined using existing data from the National Comorbidity Survey Replication (n = 2,312; 2005). As predicted, family abuse/violence was directly linked to both GAD and romantic relationship distress. Differentiation mediated the relationship between family abuse/violence and GAD, and partially mediated the relationship between family abuse/violence and romantic relationship distress. Findings suggest that current and past relationship processes may help maintain chronic anxiety and that Bowen's theory may be a useful framework for developing couple therapy treatment of GAD and romantic relationship distress. © 2013 American Association for Marriage and Family Therapy.

Understanding Distress in People with Severe Communication Difficulties: Developing and Assessing the Disability Distress Assessment Tool (DisDAT)

ERIC Educational Resources Information Center

Regnard, C.; Reynolds, Joanna; Watson, Bill; Matthews, Dorothy; Gibson, Lynn; Clarke, Charlotte

2007-01-01

Background: Meaningful communication with people with profound communication difficulties depends on the ability of carers to recognize and translate many different verbal cues. Carers appear to be intuitively skilled at identifying distress cues, but have little confidence in their observations. To help in this process, a number of pain tools…

Development and validation of a questionnaire to measure moral distress in community pharmacists.

PubMed

Astbury, Jayne L; Gallagher, Cathal T

2017-02-01

Background Pharmacists work within a highly-regulated occupational sphere, and are bound by strict legal frameworks and codes of professional conduct. This regulatory environment creates the potential for moral distress to occur due to the limitations it places on acting in congruence with moral judgements. Very little research regarding this phenomenon has been undertaken in pharmacy: thus, prominent research gaps have arisen for the development of a robust tool to measure and quantify moral distress experienced in the profession. Objective The aim of this study was to develop an instrument to measure moral distress in community pharmacists. Setting Community pharmacies in the United Kingdom. Method This study adopted a three-phase exploratory sequential mixed-method design. Three semi-structured focus groups were then conducted to allow pharmacists to identify and explore scenarios that cause moral distress. Each of the identified scenarios were developed into a statement, which was paired with twin seven-point Likert scales to measure the frequency and intensity of the distress, respectively. Content validity, reliability, and construct validity were all tested, and the questionnaire was refined. Main outcome measure The successful development of the valid instrument for use in the United Kingdom. Results This research has led to the development of a valid and reliable instrument to measure moral distress in community pharmacists in the UK. The questionnaire has already been distributed to a large sample of community pharmacists. Conclusion Results from this distribution will be used to inform the formulation of coping strategies for dealing with moral distress.

Romanian Youths' Civic Identities: 20 Years after the Revolution

ERIC Educational Resources Information Center

Obenchain, Kathryn; Bellows, Elizabeth; Bernat, Simona-Elena; Smith, Billy

2013-01-01

The study explores the civic identities of Romanian youth. Children born after 1989 have no memory of the communism; yet, they are the children and students of those who were educated under communism. Data sources were small group interviews with 21 youth and results indicate that participants believe "civic engagement is possible and…

Value and Benefits of European Student Mobility for Romanian Students: Experiences and Perspectives of Participants in the ERASMUS Programme

ERIC Educational Resources Information Center

Salajan, Florin D.; Chiper, Sorina

2012-01-01

This article reports on the experiences and perspectives of Romanian students participating in the ERASMUS Programme, regarding the benefits and value of academic mobility. It situates their accounts in the framework of internationalization and Europeanization processes occurring in Romanian higher education. The study draws on primary data…

Discrimination and externalizing problems among Moroccan- and Romanian-origin early adolescents in Italy: Moderating role of cultural orientations and impulse control.

PubMed

Miconi, Diana; Altoè, Gianmarco; Salcuni, Silvia; Di Riso, Daniela; Schiff, Sami; Moscardino, Ughetta

2018-05-24

Although discrimination is a common stressor in the everyday life of immigrant youth, individuals are not equally susceptible to its adverse effects. This cross-sectional study aimed to examine whether cultural orientation preferences and impulse control (IC) moderate the association between perceived discrimination and externalizing problems among Moroccan- and Romanian-origin early adolescents in Italy. The sample included 126 Moroccan and 126 Romanian youths (46% girls, 42% first-generation) aged 11-13 years and their parents. Perceived discrimination and cultural orientations were assessed using self-report questionnaires, while IC was evaluated via a computerized version of the Iowa Gambling Task. Externalizing behaviors were assessed via parental report. Cluster analysis identified separated, assimilated, and integrated early adolescents. Regression analyses revealed that when facing discrimination, youths who endorsed separation and exhibited low levels of IC were more vulnerable to externalizing problems. In contrast, among assimilated adolescents the discrimination-externalizing difficulties link was significant at high levels of IC. Furthermore, low levels of IC were associated with more externalizing problems for Romanian, but not for Moroccan early adolescents. Findings underscore the need to consider both cultural orientation processes and early adolescents' ability to control their impulses when developing interventions aimed to reduce discrimination-related problem behaviors in immigrant youth. Implications for theory and practice are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Diabetes-related emotional distress instruments: a systematic review of measurement properties.

PubMed

Lee, Jiyeon; Lee, Eun-Hyun; Kim, Chun-Ja; Moon, Seung Hei

2015-12-01

The objectives of this study were to identify all available diabetes-related emotional distress instruments and evaluate the evidence regarding their measurement properties to help in the selection of the most appropriate instrument for use in practice and research. A systematic literature search was performed. PubMed, Embase, CINAHL, and PsycINFO were searched systematically for articles on diabetes-related emotional distress instruments. The Consensus-based Standards for the Selection of Health Measurement Instruments checklist was used to evaluate the methodological quality of the identified studies. The quality of results with respect to the measurement properties of each study was evaluated using Terwee's quality criteria. An ancillary meta-analysis was performed. Of the 2345 articles yielded by the search, 19 full-text articles evaluating 6 diabetes-related emotional distress instruments were included in this study. No instrument demonstrated evidence for all measurement properties. The Problem Areas in Diabetes scale (PAID) was the most frequently studied and the best validated of the instruments. Pooled summary estimates of the correlation coefficient between the PAID and serum glycated hemoglobin revealed a positive but weak correlation. No diabetes-related emotional distress instrument demonstrated evidence for all measurement properties. No instrument was better than another, although the PAID was the best validated and is thus recommended for use. Further psychometric studies of the diabetes-related emotional distress instruments with rigorous methodologies are required. Copyright © 2015 Elsevier Ltd. All rights reserved.

The patient dignity inventory: a novel way of measuring dignity-related distress in palliative care.

PubMed

Chochinov, Harvey Max; Hassard, Thomas; McClement, Susan; Hack, Thomas; Kristjanson, Linda J; Harlos, Mike; Sinclair, Shane; Murray, Alison

2008-12-01

Quality palliative care depends on a deep understanding of distress facing patients nearing death. Yet, many aspects of psychosocial, existential and spiritual distress are often overlooked. The aim of this study was to test a novel psychometric--the Patient Dignity Inventory (PDI)--designed to measure various sources of dignity-related distress among patients nearing the end of life. Using standard instrument development techniques, this study examined the face validity, internal consistency, test-retest reliability, factor structure and concurrent validity of the PDI. The 25-items of the PDI derive from a model of dignity in the terminally ill. To establish its basic psychometric properties, the PDI was administered to 253 patients receiving palliative care, along with other measures addressing issues identified within the Dignity Model in the Terminally Ill. Cronbach's coefficient alpha for the PDI was 0.93; the test-retest reliability was r = 0.85. Factor analysis resulted in a five-factor solution; factor labels include Symptom Distress, Existential Distress, Dependency, Peace of Mind, and Social Support, accounting for 58% of the overall variance. Evidence for concurrent validity was reported by way of significant associations between PDI factors and concurrent measures of distress. The PDI is a valid and reliable new instrument, which could assist clinicians to routinely detect end-of-life dignity-related distress. Identifying these sources of distress is a critical step toward understanding human suffering and should help clinicians deliver quality, dignity-conserving end-of-life care.

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

PubMed

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

2015-02-01

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

Impact of Multiple Factors on the Degree of Tinnitus Distress.

PubMed

Brüggemann, Petra; Szczepek, Agnieszka J; Rose, Matthias; McKenna, Laurence; Olze, Heidi; Mazurek, Birgit

2016-01-01

The primary cause of subjective tinnitus is a dysfunction of the auditory system; however, the degree of distress tinnitus causes depends largely on the psychological status of the patient. Our goal was to attempt to associate the grade of tinnitus-related distress with the psychological distress, physical, or psychological discomfort patients experienced, as well as potentially relevant social parameters, through a simultaneous analysis of these factors. We determined the level of tinnitus-related distress in 531 tinnitus patients using the German version of the tinnitus questionnaire (TQ). In addition, we used the Perceived Stress Questionnaire (PSQ); General Depression Scale Allgemeine Depression Skala (ADS), Berlin Mood Questionnaire (BSF); somatic symptoms inventory (BI), and SF-8 health survey as well as general information collected through a medical history. The TQ score significantly correlated with a score obtained using PSQ, ADS, BSF, BI, and SF-8 alongside psychosocial factors such as age, gender, and marital status. The level of hearing loss and the auditory properties of the specific tinnitus combined with perceived stress and the degree of depressive mood and somatic discomfort of a patient were identified as medium-strong predictors of chronic tinnitus. Social factors such as gender, age, or marital status also had an impact on the degree of tinnitus distress. The results that were obtained were implemented in a specific cortical distress network model. Using a large representative sample of patients with chronic tinnitus permitted a simultaneous statistical measurement of psychometric and audiological parameters in predicting tinnitus distress. We demonstrate that single factors can be distinguished in a manner that explains their causative association and influence on the induction of tinnitus-related distress.

Impact of Multiple Factors on the Degree of Tinnitus Distress

PubMed Central

Brüggemann, Petra; Szczepek, Agnieszka J.; Rose, Matthias; McKenna, Laurence; Olze, Heidi; Mazurek, Birgit

2016-01-01

Objective: The primary cause of subjective tinnitus is a dysfunction of the auditory system; however, the degree of distress tinnitus causes depends largely on the psychological status of the patient. Our goal was to attempt to associate the grade of tinnitus-related distress with the psychological distress, physical, or psychological discomfort patients experienced, as well as potentially relevant social parameters, through a simultaneous analysis of these factors. Methods: We determined the level of tinnitus-related distress in 531 tinnitus patients using the German version of the tinnitus questionnaire (TQ). In addition, we used the Perceived Stress Questionnaire (PSQ); General Depression Scale Allgemeine Depression Skala (ADS), Berlin Mood Questionnaire (BSF); somatic symptoms inventory (BI), and SF-8 health survey as well as general information collected through a medical history. Results: The TQ score significantly correlated with a score obtained using PSQ, ADS, BSF, BI, and SF-8 alongside psychosocial factors such as age, gender, and marital status. The level of hearing loss and the auditory properties of the specific tinnitus combined with perceived stress and the degree of depressive mood and somatic discomfort of a patient were identified as medium-strong predictors of chronic tinnitus. Social factors such as gender, age, or marital status also had an impact on the degree of tinnitus distress. The results that were obtained were implemented in a specific cortical distress network model. Conclusions: Using a large representative sample of patients with chronic tinnitus permitted a simultaneous statistical measurement of psychometric and audiological parameters in predicting tinnitus distress. We demonstrate that single factors can be distinguished in a manner that explains their causative association and influence on the induction of tinnitus-related distress. PMID:27445776

The Romanian need of postgraduate specialization in dentistry considering the integration to the European Union

PubMed Central

Dragos, Stanciu; Alexandru, Bucur; Anca, Temelcea; Radu, Stanciu

2008-01-01

Once that Romania became part of the European Union, conditions regarding the activity in dentistry changed, and open borders are now a fact that we have to accept. The Romanian activity in dentistry developed a lot after the 1990, being a result of private dental practice – which covers over 98% and also of material resources of patients that were asking for more performing dental treatments. In order to be able to face all this, the dentists followed many of postgraduate specializations. We have to consider as well that the situation of the Romanian dentists is not the best, because they had to face the dentists that got their certificates in Eastern countries, where they only had to pay a fee and not pass an exam. Also, the Romanians that wanted to specialize abroad were not able to do that because the National Dentists’ Association was protecting their own colleagues. PMID:20108483

Psychological distress screener for risk of future mental sickness absence in non-sicklisted employees.

PubMed

van Hoffen, Marieke F A; Twisk, Jos W R; Heymans, Martijn W; de Bruin, Johan; Joling, Catelijne I; Roelen, Corné A M

2016-06-01

Recently, a three-item screener, derived from the 16-item distress scale of the Four-Dimensional Symptom Checklist (4DSQ), was used to measure psychological distress in sicklisted employees. The aim of the present study was to investigate the ability of the 16-item distress scale and three-item distress screener to identify non-sicklisted employees at risk of sickness absence (SA) due to mental disorders. Prospective cohort study including 4877 employees working in distribution and transport. The 4DSQ distress scale was distributed at baseline in November 2010. SA diagnosed within the International Classification of Diseases -10 chapter F was defined as mental SA and retrieved from an occupational health register during 2-year follow-up. The area under the receiver operating characteristic curve (AUC) was used to discriminate between workers with ('cases') and without ('non-cases') mental SA during follow-up. A total of 2782 employees (57%) were included in complete cases analysis; 73 employees had mental SA during 2-year follow-up. Discrimination between cases and non-cases was similar for the 16-item distress scale (AUC = 0.721; 95% CI, 0.622-0.823) and the three-item screener (AUC = 0.715; 95% CI, 0.615-0.815). Healthcare providers could use the three-item distress screener to identify non-sicklisted employees at risk of future mental SA. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

47 CFR 80.1111 - Distress alerting.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE... Safety Communications § 80.1111 Distress alerting. (a) The transmission of a distress alert indicates... distress message format, which is relayed through space stations. (b) The distress alert must be sent...

47 CFR 80.1111 - Distress alerting.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE... Safety Communications § 80.1111 Distress alerting. (a) The transmission of a distress alert indicates... distress message format, which is relayed through space stations. (b) The distress alert must be sent...

47 CFR 80.1111 - Distress alerting.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE... Safety Communications § 80.1111 Distress alerting. (a) The transmission of a distress alert indicates... distress message format, which is relayed through space stations. (b) The distress alert must be sent...

47 CFR 80.1111 - Distress alerting.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE... Safety Communications § 80.1111 Distress alerting. (a) The transmission of a distress alert indicates... distress message format, which is relayed through space stations. (b) The distress alert must be sent...

47 CFR 80.1111 - Distress alerting.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE... Safety Communications § 80.1111 Distress alerting. (a) The transmission of a distress alert indicates... distress message format, which is relayed through space stations. (b) The distress alert must be sent...

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

PubMed

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

2015-01-01

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

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

PubMed Central

BAMBERGER, Simon Grandjean; LARSEN, Anelia; VINDING, Anker Lund; NIELSEN, Peter; FONAGER, Kirsten; NIELSEN, René Nesgaard; RYOM, Pia; OMLAND, Øyvind

2015-01-01

Work intensification is a popular management strategy to increase productivity, but at the possible expense of employee mental stress. This study examines associations between ratings of work intensification and psychological distress, and the level of agreement between compared employee-rated and manager-rated work intensification. Multi-source survey data were collected from 3,064 employees and 573 company managers from the private sector in 2010. Multilevel regression models were used to compare different work intensification ratings across psychological distress strata. Distressed employees rated higher degree of total work intensification compared to non-distressed employees, and on three out of five sub ratings there were an increased prevalence of work intensification in the case group. In general, there was poor agreement between employee and company work intensification rating. Neither manager-rated work intensification nor employee/manager discrepancy in work intensification ratings was associated with psychological distress. Distressed employees had a higher total score of employee/manager agreed work intensification, and a higher prevalence of increased demands of labour productivity. This study demonstrates higher ratings of employee/manager agreed work intensification in distressed employees compared to non-distressed employees, challenging previous findings of reporting bias in distressed employees’ assessment of work environment. PMID:25752252

Psychological distress among homeless adults.

PubMed

Gelberg, L; Linn, L S

1989-05-01

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

Automated georeference of the 1: 20,000 Romanian maps under Lambert-Cholesky (1916-1959) projection system

NASA Astrophysics Data System (ADS)

Rus, I.; Balint, C.; Craciunescu, V.; Constantinescu, S.; Ovejanu, I.; Bartos-Elekes, Zs.

2009-04-01

Before the 1918 Union, the Romanian territories were subject of several dominations, for which reason the cartographic data base for each Romanian province was different from an area to another. Starting from the second half of the 19th century, Valachia, Moldavia and Dobrogea (Dacia Pontica or Scitia Minor) field mapping was made, implicitly cartographic representations, different as structure. The projection systems used, the chosen geoid, the nomenclature and the distribution of the map pages were not uniform. For an example, the Bessel ellipsoid and the Cassini cross cylindrical projection were used especially to the eastern side of the Zimnicea central meridian (23 degree east from Paris), while to its western side the Bonne conic equivalent projection was used, as defined on the Clarke ellipsoid (Năstase, 1975, pages 86-87). In the other Romanian provinces, such as Transylvania, Romanian Banat, Bessarabia (Moldavia Republic) and Southern Bucovina, the major part of the cartographic products (surface contour maps) were made as polyhedral projections. During the World War I, when artillery was a redoubtable weapon a necessary idea was born to articulate an unitary cartographic projection concerning the entire Romanian territory, which should respond to the principle of conformity. Between 1916-1917, pursuant to the above argumented measure, a new datum/location surface, a new projection system and a new nomenclature were introduced. The Lambert projection system was used as modified by the French land surveyor, the mathematician and officer Andre Louis Cholensky. He was born in 1875 in Mont Guyon and passed away on the battle field in Northern France in the month of August 1918. During September 1916 up to February 1918, following the Franco-Romanian military convention, he was a Commander of the Geographic Department of the Romanian Army (Brezinsky-Gross-Cholensky, 1996). The calculations for passing from the various projections (as previously mentioned

Psychosocial distress in acute cancer patients assessed with an expert rating scale.

PubMed

Senf, Bianca; Brandt, Holger; Dignass, Axel; Kleinschmidt, Rolf; Kaiser, Jochen

2010-08-01

The identification of psychosocial stress in cancer patients has remained a challenging task especially in an acute care environment. The aims of the present study were to apply a short expert rating scale for the assessment of distress during the acute treatment phase and to identify potential sociodemographic and disease-related predictors. Four hundred seventy-eight ward cancer patients were assessed with the short form of the psycho-oncological basis documentation and its breast-cancer-specific version. In addition, they completed a self-rating questionnaire on stress in cancer patients. We recorded sociodemographic and disease-related variables and assessed their predictive value for psychosocial distress. According to the expert rating scale, 56.3% of patients were rated distressed. While only 31.3% of patients were classified as distressed according to a patient self-rating, both approaches showed a good degree of concurrence with a consistent classification of 69% of patients. Younger age, current psychotropic medication, and past psychological treatment were associated with higher distress levels. Patients with metastases and those with a poorer functional status were more distressed. Interestingly, having an operation was associated with a better psychological well-being. This study demonstrated that a substantial proportion of cancer patients in acute care are psychosocially distressed. A short expert rating scale proved to be a feasible tool for the assessment of distress in an acute care setting.

Barriers to the provision of smoking cessation assistance: a qualitative study among Romanian family physicians

PubMed Central

Panaitescu, Catalina; Moffat, Mandy A; Williams, Siân; Pinnock, Hilary; Boros, Melinda; Oana, Cristian Sever; Alexiu, Sandra; Tsiligianni, Ioanna

2014-01-01

Background: Smoking cessation is the most effective intervention to prevent and slow down the progression of several respiratory and other diseases and improve patient outcomes. Romania has legislation and a national tobacco control programme in line with the World Health Organization Framework for Tobacco Control. However, few smokers are advised to quit by their family physicians (FPs). Aim: To identify and explore the perceived barriers that prevent Romanian FPs from engaging in smoking cessation with patients. Methods: A qualitative study was undertaken. A total of 41 FPs were recruited purposively from Bucharest and rural areas within 600 km of the city. Ten FPs took part in a focus group and 31 participated in semistructured interviews. Analysis was descriptive, inductive and themed, according to the barriers experienced. Results: Five main barriers were identified: limited perceived role for FPs; lack of time during consultations; past experience and presence of disincentives; patients’ inability to afford medication; and lack of training in smoking cessation skills. Overarching these specific barriers were key themes of a medical and societal hierarchy, which undermined the FP role, stretched resources and constrained care. Conclusions: Many of the barriers described by the Romanian FPs reflected universally recognised challenges to the provision of smoking cessation advice. The context of a relatively hierarchical health-care system and limitations of time and resources exacerbated many of the problems and created new barriers that will need to be addressed if Romania is to achieve the aims of its National Programme Against Tobacco Consumption. PMID:25010432

Where are Romanian biomedical journals now and what does the future hold for them? A scientometric analysis.

PubMed

Dumitrascu, Dan L

2018-01-01

There is a competition between scientific journals in order to achieve leadership in their scientific field. There are several Romanian biomedical journals which are published in English and a smaller number in Romanian. We need a periodical analysis of their visibility and ranking according to scientometric measures. We searched all biomedical journals indexed on international data bases: Web of Science, PubMed, Scopus, Embase, Google Scholar. We analyzed their evaluation factors. Several journals from Romania in the biomedical field are indexed in international databases. Their scientometric indexes are not high. The best journal was acquired by an international publisher and is no longer listed for Romania. There are several Romanian biomedical journals indexed in international databases that deserve periodical analysis. There is a need to improve their ranking.

African American Men, Gender Role Conflict, and Psychological Distress: The Role of Racial Identity

ERIC Educational Resources Information Center

Wester, Stephen R.; Vogel, David L.; Wei, Meifen; McLain, Rodney

2006-01-01

Little research exists exploring the intersection of male gender role conflict (GRC), racial identity, and psychological distress. Accordingly, using a sample of 130 self-identified African American male participants, this study explored which aspects of racial identity mediated the relationship between GRC and psychological distress. Results…

Idioms of distress: alternatives in the expression of psychosocial distress: a case study from South India.

PubMed

Nichter, M

1981-12-01

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

Prevalence of psychological distress, as measured by the Kessler 6 (K6), and related factors in Japanese employees.

PubMed

Fushimi, Masahito; Saito, Seiji; Shimizu, Tetsuo; Kudo, Yasutsugu; Seki, Masayuki; Murata, Katsuyuki

2012-06-01

The aim of this study was to examine the prevalence of and related factors for psychological distress among employees. The employees in Akita prefecture, Japan, were invited to complete the Kessler 6 (K6). A value of 13 or higher on the K6 scale indicated high psychological distress. Furthermore, we identified the relationships among the prevalence of high psychological distress, socio-demographic status, and employment-related variables. The data of 1,709 employees indicated that 10.8% of the employees had high psychological distress; the proportion of psychological distress found in the present study was high compared to that found in previous studies. The identified socio-demographic and occupation-related factors included young age groups associated with a high risk and clerical or administrative tasks associated with a low risk of psychological distress. The data of this study can be used as K6 benchmark values, which enhance the significance of future corporate health risk appraisal surveys.

Distress Intolerance and Prescription Opioid Misuse among Patients with Chronic Pain

PubMed Central

McHugh, R. Kathryn; Weiss, Roger D.; Cornelius, Marise; Martel, Marc O.; Jamison, Robert N.; Edwards, Robert R.

2016-01-01

The risk for misuse of opioid medications is a significant challenge in the management of chronic pain. The identification of those who may be at greater risk for misusing opioids is needed to facilitate closer monitoring of high-risk subgroups, and may help to identify therapeutic targets for mitigating this risk. The aim of this study was to examine whether distress intolerance--the perceived or actual inability to manage negative emotional and somatic states--was associated with opioid misuse in those with chronic pain. A sample of 51 participants prescribed opioid analgesics for chronic back or neck pain were recruited for a one-time laboratory study. Participants completed measures of distress intolerance and opioid misuse, and a quantitative sensory testing battery. Results suggested that distress intolerance was associated with opioid misuse, even controlling for pain severity and negative affect. Distress intolerance was not associated with pain severity, threshold or tolerance, but was associated with self-reported anxiety and stress following noxious stimuli. This study found robust differences in distress intolerance between adults with chronic pain with and without opioid medication misuse. Distress intolerance may be a relevant marker of risk for opioid misuse among those with chronic pain. PMID:27058161

KRAS, NRAS and BRAF mutations in Greek and Romanian patients with colorectal cancer: a cohort study

PubMed Central

Negru, Serban; Papadopoulou, Eirini; Apessos, Angela; Stanculeanu, Dana Lucia; Ciuleanu, Eliade; Volovat, Constantin; Croitoru, Adina; Kakolyris, Stylianos; Aravantinos, Gerasimos; Ziras, Nikolaos; Athanasiadis, Elias; Touroutoglou, Nikolaos; Pavlidis, Nikolaos; Kalofonos, Haralabos P; Nasioulas, George

2014-01-01

Objectives Treatment decision-making in colorectal cancer is often guided by tumour tissue molecular analysis. The aim of this study was the development and validation of a high-resolution melting (HRM) method for the detection of KRAS, NRAS and BRAF mutations in Greek and Romanian patients with colorectal cancer and determination of the frequency of these mutations in the respective populations. Setting Diagnostic molecular laboratory located in Athens, Greece. Participants 2425 patients with colorectal cancer participated in the study. Primary and secondary outcome measures 2071 patients with colorectal cancer (1699 of Greek and 372 of Romanian origin) were analysed for KRAS exon 2 mutations. In addition, 354 tumours from consecutive patients (196 Greek and 161 Romanian) were subjected to full KRAS (exons 2, 3 and 4), NRAS (exons 2, 3 and 4) and BRAF (exon 15) analysis. KRAS, NRAS and BRAF mutation detection was performed by a newly designed HRM analysis protocol, followed by Sanger sequencing. Results KRAS exon 2 mutations (codons 12/13) were detected in 702 of the 1699 Greek patients with colorectal carcinoma analysed (41.3%) and in 39.2% (146/372) of the Romanian patients. Among the 354 patients who were subjected to full KRAS, NRAS and BRAF analysis, 40.96% had KRAS exon 2 mutations (codons 12/13). Among the KRAS exon 2 wild-type patients 15.31% harboured additional RAS mutations and 12.44% BRAF mutations. The newly designed HRM method used showed a higher sensitivity compared with the sequencing method. Conclusions The HRM method developed was shown to be a reliable method for KRAS, NRAS and BRAF mutation detection. Furthermore, no difference in the mutation frequency of KRAS, NRAS and BRAF was observed between Greek and Romanian patients with colorectal cancer. PMID:24859998

Distress Intolerance and Prescription Opioid Misuse Among Patients With Chronic Pain.

PubMed

McHugh, R Kathryn; Weiss, Roger D; Cornelius, Marise; Martel, Marc O; Jamison, Robert N; Edwards, Robert R

2016-07-01

The risk for misuse of opioid medications is a significant challenge in the management of chronic pain. The identification of those who may be at greater risk for misusing opioids is needed to facilitate closer monitoring of high-risk subgroups, and may help to identify therapeutic targets for mitigating this risk. The aim of this study was to examine whether distress intolerance-the perceived or actual inability to manage negative emotional and somatic states-was associated with opioid misuse in those with chronic pain. A sample of 51 participants prescribed opioid analgesics for chronic back or neck pain were recruited for a 1-time laboratory study. Participants completed measures of distress intolerance and opioid misuse, and a quantitative sensory testing battery. Results suggested that distress intolerance was associated with opioid misuse, even controlling for pain severity and negative affect. Distress intolerance was not associated with pain severity, threshold, or tolerance, but was associated with self-reported anxiety and stress after noxious stimuli. This study found robust differences in distress intolerance between adults with chronic pain with and without opioid medication misuse. Distress intolerance may be a relevant marker of risk for opioid misuse among those with chronic pain. This study demonstrated that distress intolerance was associated with opioid misuse in adults with chronic pain who were prescribed opioids. Distress intolerance can be modified with treatment, and thus may be relevant not only for identification of risk for opioid misuse, but also for mitigation of this risk. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

Understanding psychological distress among pediatric cancer caregivers.

PubMed

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

2016-07-01

Few studies have examined distress in caregivers of pediatric cancer patients. We evaluated the association of socioeconomic, demographic, and patient clinical factors on caregivers' self-reported psychological distress associated with having a child with cancer. N = 366 pediatric cancer caregivers completed a self-administered questionnaire from July 2010 to July 2012. The Impact of Event Scale (IES), along with two subscales "intrusion" and "avoidance" measured caregiver cancer-specific distress, with higher scores indicating greater distress. Multivariable linear regression models were used to calculate coefficients (β) and 95 % confidence intervals (95 % CI) of IES by socioeconomic, demographic, and clinical factors. Average caregiver IES score was 31.2 (standard deviation (SD) = 16.9, range 0-75). Mean intrusion score was 18.1 (SD 9.8, range 0-35) and avoidance score was 12.8 (SD 9.0, range 0-40). Caregivers with household incomes <$40,000 reported higher mean distress scores than those with incomes ranging from $40,000 to $79,999 (β = 4.45, 95 % CI 0.04-8.87, p = 0.05). Infrequently or never attending religious services, younger child age, and a diagnosis of AML were associated with higher intrusion (all p < 0.05). Caregivers with a child currently receiving therapy reported higher overall IES (β = 5.9, 95 % CI 2.15-9.7, p < 0.01) and intrusion (β = 4.1, 95 % CI 1.9-6.3, p < 0.001) scores compared to those off therapy (β = 3.13, 95 % CI 0.93-5.33, p < 0.01). Our findings identify socioeconomic and clinical factors that influence psychological distress for caregivers of pediatric oncology patients. These findings underscore the importance of developing and testing interventions aimed at evaluating and addressing the psychosocial needs for high-risk caregivers in addition to those of patients.

Moral distress: a review of the argument-based nursing ethics literature.

PubMed

McCarthy, Joan; Gastmans, Chris

2015-02-01

The aim of this review is to examine the ways in which the concept of moral distress has been delineated and deployed in the argument-based nursing ethics literature. It adds to what we already know about moral distress from reviews of the qualitative and quantitative research. CINAHL, PubMed, Web of Knowledge, EMBASE, Academic Search Complete, PsycInfo, Philosophers' Index and Socindex. A total of 20 argument-based articles published between January 1984 and December 2013 were analysed. We found that like the empirical literature, most authors in this review draw on Jameton's original definition and describe moral distress in psychological-emotional-physiological terms. They also agree that moral distress is linked to the presence of some kind of constraint on nurses' moral agency, and that it is best understood as a two-staged process that can intensify over time. There is also consensus that moral distress has an important normative meaning, although different views concerning the normative meaning of moral distress are expressed. Finally, the authors generally agree that moral distress arises from a number of different sources and that it (mostly) affects negatively on nurses' personal and professional lives and, ultimately, harms patients. However, despite this consensus, many authors take issue with the way in which moral distress is conceptualized and operationalized. Moreover, while some worry that identifying nurses as a group of health professionals whose voices are ignored or marginalized might disempower nurses and encourage them to avoid their moral responsibilities, others take situations involving moral distress as indicative of more fundamental, structural inequities at the heart of contemporary healthcare provision. We conclude that research on moral distress in nursing is timely and important because it highlights the specifically moral labour of nurses. However, we suggest that significant concerns about the conceptual fuzziness and

46 CFR 28.145 - Distress signals.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 1 2011-10-01 2011-10-01 false Distress signals. 28.145 Section 28.145 Shipping COAST... VESSELS Requirements for All Vessels § 28.145 Distress signals. Except as provided by 28.305, each vessel must be equipped with the distress signals specified in table 28.145. Table 28.145—Distress Signals...

46 CFR 28.145 - Distress signals.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 1 2012-10-01 2012-10-01 false Distress signals. 28.145 Section 28.145 Shipping COAST... VESSELS Requirements for All Vessels § 28.145 Distress signals. Except as provided by 28.305, each vessel must be equipped with the distress signals specified in table 28.145. Table 28.145—Distress Signals...

46 CFR 28.145 - Distress signals.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 1 2013-10-01 2013-10-01 false Distress signals. 28.145 Section 28.145 Shipping COAST... VESSELS Requirements for All Vessels § 28.145 Distress signals. Except as provided by 28.305, each vessel must be equipped with the distress signals specified in table 28.145. Table 28.145—Distress Signals...

46 CFR 28.145 - Distress signals.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 1 2014-10-01 2014-10-01 false Distress signals. 28.145 Section 28.145 Shipping COAST... VESSELS Requirements for All Vessels § 28.145 Distress signals. Except as provided by 28.305, each vessel must be equipped with the distress signals specified in table 28.145. Table 28.145—Distress Signals...

Stakeholders' Perception of Sustainability Orientation within a Major Romanian University

ERIC Educational Resources Information Center

Dabija, Dan-Cristian; Postelnicu, Catalin; Dinu, Vasile; Mihaila, Alin

2017-01-01

Purpose: The research attempts to aim to evaluate the perception that different stakeholder groups have of one of the largest and most important Romanian university with respect to its sustainability orientation. The exploratory empirical research reveals some important aspects which must be closely pursued and properly implemented by the…

Exploring Psychological Distress in Burundi During and After the Armed Conflict.

PubMed

Familiar, Itziar; Hall, Brian; Bundervoet, Tom; Verwimp, Philip; Bass, Judith

2016-01-01

We assessed symptoms of psychological distress among a population-based sample of 9000-plus adults in Burundi during (1998) and after (2007) armed conflict. After exploratory and confirmatory factor analysis to an 8-item, self-report measure, we identified two domains of psychological distress "Depression/Anxiety" and "Functioning" with good fit to data. The questionnaire was invariant in males and females. Depression and Anxiety symptoms during conflict were more frequently reported than Functioning symptoms; all symptoms were more frequently reported by women. Psychological distress was found in 44 % of individuals during conflict and in 29 % 2 years after the conflict. Results call for further research in Burundi that can inform the development of mental health interventions.

Acute respiratory distress syndrome

MedlinePlus

... page: //medlineplus.gov/ency/article/000103.htm Acute respiratory distress syndrome To use the sharing features on this page, please enable JavaScript. Acute respiratory distress syndrome (ARDS) is a life-threatening lung ...

Exploring health promotion practitioners' experiences of moral distress in Canada and Australia.

PubMed

Sunderland, Naomi; Harris, Paul; Johnstone, Kylie; Del Fabbro, Letitia; Kendall, Elizabeth

2015-03-01

This article introduces moral distress - the experience of painful feelings due to institutional constraints on personal moral action - as a significant issue for the international health promotion workforce. Our exploratory study of practitioners' experiences of health promotion in Australia and Canada during 2009-2010 indicated that practitioners who work in upstream policy- and systems-level health promotion are affected by experiences of moral distress. Health promotion practitioners at all levels of the health promotion continuum also described themselves as being engaged in a minority practice within a larger dominant system that does not always value health promotion. We argue that health promotion practitioners are vulnerable to moral distress due to the values-driven and political nature of the practice, the emphasis on systems change and the inherent complexity and diversity of the practice. This vulnerability to moral distress poses significant challenges to both workers and organisations and the communities they seek to benefit. We propose that further research should be undertaken to fully identify the causes and symptoms of moral distress in health promotion. Extensive existing research on moral distress in nursing provides ample resources to conduct such research. © The Author(s) 2014.

Improving Distress in Dialysis (iDiD): A tailored CBT self-management treatment for patients undergoing dialysis.

PubMed

Hudson, Joanna L; Moss-Morris, Rona; Game, David; Carroll, Amy; Chilcot, Joseph

2016-12-01

There is significant psychological distress in adults with end-stage kidney disease (ESKD). However, psychological treatments tailored to address the unique challenges of kidney failure are absent. We identified psychological correlates of distress in ESKD to develop a cognitive-behavioural therapy (CBT) treatment protocol that integrates the mental health needs of patients alongside their illness self-management demands. Studies which examined relationships between distress and psychological factors that apply in the context of ESKD including: health threats, cognitive illness representations and illness management behaviours were narratively reviewed. Review findings were translated into a CBT formulation model to inform the content of a renal-specific seven session CBT treatment protocol, which was commented on and refined by patient representatives. Health threats related to distress were grouped into four themes including: acute ESKD events, loss of role, uncertainty and illness self-management. Having pessimistic illness and treatment perceptions were associated with elevated distress. Non-adherence and avoidance behaviours were related to feelings of distress, whereas cognitive reappraisal, acceptance, social support and assertiveness were associated with less distress. The dialysis-specific CBT formulation identifies the importance of targeting ESKD-specific correlates of distress to allow the delivery of integrated mental and physical health care. The 'Improving Distress in Dialysis (iDiD)' treatment protocol now requires further evaluation in terms of content, feasibility and potential efficacy. © 2016 European Dialysis and Transplant Nurses Association/European Renal Care Association.

Understanding mental distress in film and media: a new agenda?

PubMed

Harper, Stephen

2008-07-01

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

Healthcare Engagement as a Potential Source of Psychological Distress among People without Religious Beliefs: A Systematic Review

PubMed Central

Weber, Samuel R.; Lomax, James W.; Pargament, Kenneth I.

2017-01-01

Research into religion and mental health is increasing, but nonbelievers in terms of religion are often overlooked. Research has shown that nonbelievers experience various forms of psychological distress and that the negative perception of nonbelievers by others is a potential source of distress. This review builds on that research by identifying another potential source of psychological distress for nonbelievers: engagement with the healthcare system. Poor understanding of nonbelievers by healthcare professionals may lead to impaired communication in the healthcare setting, resulting in distress. Attempts by nonbelievers to avoid distress may result in different patterns of healthcare utilization. Awareness of these concerns may help healthcare providers to minimize distress among their nonbelieving patients. PMID:28379161

Healthcare Engagement as a Potential Source of Psychological Distress among People without Religious Beliefs: A Systematic Review.

PubMed

Weber, Samuel R; Lomax, James W; Pargament, Kenneth I

2017-04-05

Research into religion and mental health is increasing, but nonbelievers in terms of religion are often overlooked. Research has shown that nonbelievers experience various forms of psychological distress and that the negative perception of nonbelievers by others is a potential source of distress. This review builds on that research by identifying another potential source of psychological distress for nonbelievers: engagement with the healthcare system. Poor understanding of nonbelievers by healthcare professionals may lead to impaired communication in the healthcare setting, resulting in distress. Attempts by nonbelievers to avoid distress may result in different patterns of healthcare utilization. Awareness of these concerns may help healthcare providers to minimize distress among their nonbelieving patients.

Factors influencing maternal distress among Dutch women with a healthy pregnancy.

PubMed

Fontein-Kuipers, Yvonne; Ausems, Marlein; Budé, Luc; Van Limbeek, Evelien; De Vries, Raymond; Nieuwenhuijze, Marianne

2015-09-01

Maternal distress is a public health concern. Assessment of emotional wellbeing is not integrated in Dutch antenatal care. Midwives need to understand the influencing factors in order to identify women who are more vulnerable to experience maternal distress. To examine levels of maternal distress during pregnancy and to determine the relationship between maternal distress and aetiological factors. A cross-sectional study including 458 Dutch-speaking women with uncomplicated pregnancies during all trimesters of pregnancy. Data were collected with questionnaires between 10 September and 6 November 2012. Demographic characteristics and personal details were obtained. Maternal distress was measured with the Edinburgh Depression Scale (EDS), State-Trait Anxiety Inventory (STAI), and Pregnancy-Related Anxiety Questionnaire (PRAQ). Behaviour was measured with Coping Operations Preference Enquiry-Easy (COPE-Easy). Descriptive statistics and multiple linear regression analysis were used. Just over 20 percent of the women in our sample (21.8%) had a heightened score on one or more of the EDS, STAI or PRAQ. History of psychological problems (B=1.071; p=.001), having young children (B=2.998; p=.001), daily stressors (B=1.304; p=<.001), avoidant coping (B=1.047, p=<.001), somatisation (B=.484; p=.004), and negative feelings towards the forthcoming birth (B=.636; p=<.001) showed a significant positive relationship with maternal distress. Self-disclosure (B=-.863; p=.004) and acceptance of the situation (B=-.542; p=.008) showed a significant negative relationship with maternal distress. Maternal distress occurs among women with a healthy pregnancy and is significantly influenced by a variety of factors. Midwives need to recognise the factors that make women more vulnerable to develop and experience maternal distress in order to give adequate advice about how to best cope with this condition. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights

Influence of DGAT1 K232A polymorphism on milk fat percentage and fatty acid profiles in Romanian holstein cattle.

PubMed

Tăbăran, A; Balteanu, V A; Gal, E; Pusta, D; Mihaiu, R; Dan, S D; Tăbăran, A F; Mihaiu, M

2015-01-01

Milk and dairy products are considered the main sources of saturated fatty acids, which are a valuable source of nutrients in the human diet. Fat composition can be adjusted through guided nutrition of dairy animals but also through selective breeding. Recently, a dinucleotide substitution located in the exon 8 of the gene coding for acyl CoA: diacylglycerol acyltransferase 1 (DGAT1), that alters the amino acid sequence from a lysine to an alanine (p.Lys232Ala) in the mature protein, was shown to have a strong effect on milk fat content in some cattle breeds. Therefore, the objectives of this work were to study the occurrence of the DGAT1 p.Lys232Ala polymorphism in Romanian Holstein cattle and Romanian Buffalo breeds and to further investigate its possible influence on fat percentage and fatty acid profiles. The results obtained in this study show that in Romanian Holstein cattle the K allele is associated with increased fat percentage and higher levels of C16:0 and C18:0 fatty acids. The ratio of saturated fatty acids versus unsaturated fatty acids (SFA/UFA) was also higher in KK homozygous individuals, whereas the fractions of C14:0, unsaturated C18 decreased. The DGAT1 p.Lys232Ala polymorphism revealed a high genetic variance for fat percentage, unsaturated C18, C16:0, and SFA/UFA. Although the effect of this polymorphism was not so evident for short chain fatty acids such as C4:0-C8:0, it was significant for C14:0 fatty acids. We concluded that selective breeding of carriers of the A allele in Romanian Holsteins can contribute to improvement in unsaturated fatty acids content of milk. However, in buffalo, the lack of the A allele makes selection inapplicable because only the K allele, associated with higher saturated fatty acids contents in milk, was identified.

Predictors of emotional distress a year or more after diagnosis of cancer: A systematic review of the literature.

PubMed

Cook, Sharon A; Salmon, Peter; Hayes, Gemma; Byrne, Angela; Fisher, Peter L

2018-03-01

Why some people recover emotionally after diagnosis and treatment of cancer and others do not is poorly understood. To identify factors around the time of diagnosis that predict longer-term distress is a necessary step in developing interventions to reduce patients' vulnerability. This review identified the demographic, clinical, social, and psychological factors available at or within 3 months of diagnosis that are reliable predictors of emotional distress at least 12 months later. A systematic search of literature for prospective studies addressing our research question and predicting a range of distress outcomes was conducted. Thirty-nine papers (reporting 36 studies) were subjected to narrative synthesis of the evidence. There was no consistent evidence that demographic, clinical, or social factors reliably predicted longer-term distress. Of the psychological factors examined, only baseline distress (significant in 26 of 30 relevant papers; 24 of 28 studies) and neuroticism (significant in all 5 papers/studies that examined it) consistently predicted longer-term distress. The heterogeneity of included studies, particularly in populations studied and methodology, precluded meta-analytic techniques. This review supports current clinical guidance advising early assessment of distress as a marker of vulnerability to persistent problems. Additionally, neuroticism is also indicated as a useful marker of vulnerability. However, the review also highlights that more sophisticated research designs, capable of identifying the psychological processes that underlie the association between these marker variables and persistent distress, are needed before more effective early interventions can be developed. © 2018 The Authors. Psycho-Oncology Published by John Wiley & Sons Ltd.

Emotion displays in media: a comparison between American, Romanian, and Turkish children's storybooks

PubMed Central

Wege, Briana Vander; Sánchez González, Mayra L.; Friedlmeier, Wolfgang; Mihalca, Linda M.; Goodrich, Erica; Corapci, Feyza

2014-01-01

Children's books may provide an important resource of culturally appropriate emotions. This study investigates emotion displays in children's storybooks for preschoolers from Romania, Turkey, and the US in order to analyze cultural norms of emotions. We derived some hypotheses by referring to cross-cultural studies about emotion and emotion socialization. For such media analyses, the frequency rate of certain emotion displays can be seen as an indicator for the salience of the specific emotion. We expected that all children's storybooks would highlight dominantly positive emotions and that US children's storybooks would display negative powerful emotions (e.g., anger) more often and negative powerless emotions (e.g., sadness) less often than Turkish and Romanian storybooks. We also predicted that the positive and negative powerful emotion expressions would be more intense in the US storybooks compared to the other storybooks. Finally, we expected that social context (ingroup/outgroup) may affect the intensity emotion displays more in Turkish and Romanian storybooks compared to US storybooks. Illustrations in 30 popular children's storybooks (10 for each cultural group) were coded. Results mostly confirmed the hypotheses but also pointed to differences between Romanian and Turkish storybooks. Overall, the study supports the conclusion that culture-specific emotion norms are reflected in media to which young children are exposed. PMID:24987384

Emotion displays in media: a comparison between American, Romanian, and Turkish children's storybooks.

PubMed

Wege, Briana Vander; Sánchez González, Mayra L; Friedlmeier, Wolfgang; Mihalca, Linda M; Goodrich, Erica; Corapci, Feyza

2014-01-01

Children's books may provide an important resource of culturally appropriate emotions. This study investigates emotion displays in children's storybooks for preschoolers from Romania, Turkey, and the US in order to analyze cultural norms of emotions. We derived some hypotheses by referring to cross-cultural studies about emotion and emotion socialization. For such media analyses, the frequency rate of certain emotion displays can be seen as an indicator for the salience of the specific emotion. We expected that all children's storybooks would highlight dominantly positive emotions and that US children's storybooks would display negative powerful emotions (e.g., anger) more often and negative powerless emotions (e.g., sadness) less often than Turkish and Romanian storybooks. We also predicted that the positive and negative powerful emotion expressions would be more intense in the US storybooks compared to the other storybooks. Finally, we expected that social context (ingroup/outgroup) may affect the intensity emotion displays more in Turkish and Romanian storybooks compared to US storybooks. Illustrations in 30 popular children's storybooks (10 for each cultural group) were coded. Results mostly confirmed the hypotheses but also pointed to differences between Romanian and Turkish storybooks. Overall, the study supports the conclusion that culture-specific emotion norms are reflected in media to which young children are exposed.

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

PubMed

de Veer, Anke J E; Francke, Anneke L; Struijs, Alies; Willems, Dick L

2013-01-01

Moral distress is associated with job dissatisfaction, turnover and early retirement. Because of these negative consequences moral distress should be reduced. Little research has been done on what job factors contribute to whether or not a situation causes moral distress. To identify individual and job characteristics associated with moral distress in nursing staff. This is a cross sectional correlational study. Nursing staff members completed two survey questionnaires with a time-interval of 3 months. In the first survey questions were asked about job characteristics and job satisfaction. Three months afterwards the respondents answered questions on moral distress. 365 nursing staff members employed in nursing homes, homes for the elderly, home care and acute care hospitals completed both questionnaires. High moral distress levels were related to lower job satisfaction. Moral distress is higher when nurses perceive less time available to give care to patients. If satisfaction with the consultation possibilities within the team is low and when an instrumental leadership style exists, nursing staff members are also more likely to experience moral distress. Nursing staff members working 30-40h per week experience less moral distress than colleagues working fewer hours per week. Multivariate analyses showed no relations with other individual characteristics measured. Job characteristics that contribute to moral distress should be an issue for managers because it is related to job satisfaction. Interventions to reduce moral distress should target at organisational issues. The way a team is supported can raise or decrease moral distress levels. Copyright © 2012 Elsevier Ltd. All rights reserved.

Patterns and Predictors of Academic Dishonesty in Romanian University Students

ERIC Educational Resources Information Center

Ives, Bob; Alama, Madalina; Mosora, Liviu Cosmin; Mosora, Mihaela; Grosu-Radulescu, Lucia; Clinciu, Aurel Ion; Cazan, Ana-Maria; Badescu, Gabriel; Tufis, Claudiu; Diaconu, Mihaela; Dutu, Amalia

2017-01-01

Academic dishonesty in higher education is an increasingly visible problem throughout the world and in Romania in particular. A total of 1127 university students from six public Romanian universities were surveyed for their experiences and beliefs with 22 behaviors that might be considered academically dishonest. A five-factor solution to the…

Girls in Distress in Israel.

ERIC Educational Resources Information Center

Steiner, Yosepha

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

Hypertension Awareness and Psychological Distress

PubMed Central

Hamer, Mark; Batty, G. David; Stamatakis, Emmanuel; Kivimaki, Mika

2011-01-01

There is conflicting evidence regarding the association of hypertension with psychological distress, such as anxiety and depressive symptoms. The association may be due to a direct effect of the raised blood pressure; side effects of treatment; or the consequences of labelling. In a representative study of 33,105 adults (aged 51.7 ±12.1 yrs, 45.8% men) we measured levels of psychological distress using the 12-item General Health Questionnaire and collected blood pressure, data on history of hypertension diagnosis, and medication usage. Awareness of hypertension was confirmed through a physician’s diagnosis or the use of anti-hypertensive medication and unaware hypertension was defined by elevated clinic blood pressure (systolic/diastolic ≥140/90 mm Hg) without prior treatment or diagnosis. In comparison with normotensive participants, an elevated risk of distress (General Health Questionnaire score ≥4) was observed in aware hypertensive participants (multivariable adjusted odds ratio [OR]=1.57, 95% CI, 1.41 – 1.74), although not in unaware hypertensives (OR = 0.91, 95% CI, 0.78 – 1.07). Anti-hypertensive medication and co-morbidity was also associated with psychological distress although this did not explain the greater risk of distress in aware hypertensives. We observed a weak curvilinear association between systolic blood pressure and distress which suggested that distressed participants were more likely to have low or highly elevated blood pressure. These findings suggest that labelling individuals as hypertensive, rather than elevated blood pressure per se, may partially explain the greater levels of distress in patients treated for hypertension. PMID:20625078

Factors Associated With Presenteeism and Psychological Distress Using a Theory-Driven Approach.

PubMed

Coutu, Marie-France; Corbière, Marc; Durand, Marie-José; Nastasia, Iuliana; Labrecque, Marie-Elise; Berbiche, Djamal; Albert, Valérie

2015-06-01

To test a model of presenteeism on the basis of established and emerging theories separated into organizational and individual factors that could be mediated by psychological distress. This was a Web survey of 2371 employees (response rate of 48%) of a provincial government agency. We assessed theories with validated measures for organizational and individual factors. Psychological distress was negatively associated to presenteeism, when controlling for sex, short-term work absence in the last year, and social desirability. Both individual and organizational factors were related to psychological distress. The most important factors included the presence of stress events in the preceding 6 months, extrinsic efforts (interruptions, work requirements), self-esteem as a worker, and internal amotivation. By identifying modifiable factors, our results suggest that the implementation of a work organization structure that promotes stimulation and accomplishment would reduce psychological distress and further presenteeism.

Cancer-Related Psychological Distress: A Concept Analysis.

PubMed

Gundelach, Amy; Henry, Barb

2016-12-01

Cancer-related psychological distress, as a concept, has limited research literature substantiation. Several studies report that patients with cancer suffer from significant psychological distress; however, the description of the concept of cancer-related psychological distress has not been clearly described. Theoretical work based on the concept is also unclear. This article is a report on the concept of cancer-related psychological distress to clarify the concept as separate from non-cancer-related psychological distress and promote the use of the term in nursing practice and research across the cancer trajectory. This article used a content analysis to examine the literature. The literature review for this article used CINAHL®, PsycINFO®, and PubMed to search publications from 1999-2016. Content analysis of the literature revealed that the term psychological distress was used often with regard to distress in patients with cancer, but the concept of cancer-related psychological distress was not clearly defined. Four attributes encompass the concept of cancer-related psychological distress.

Storing Astronomical Information on the Romanian Territory

NASA Astrophysics Data System (ADS)

Stavinschi, M.; Mioc, V.

2004-12-01

Romanian astronomy has a more than 2000-year old tradition, which is, however, little known abroad. The first known archive of astronomical information is the Dacian sanctuary at Sarmizegetusa Regia, erected in the first century AD, having similarities with that of Stonehenge. After a gap of more than 1000 years, more sources of astronomical information become available, mainly records of astronomical events. Monasteries were the safest storage places of these genuine archives. We present a classification of the ways of storing astronomical information, along with characteristic examples.

Healthcare utilization, Medicare spending, and sources of patient distress identified during implementation of a lay navigation program for older patients with breast cancer.

PubMed

Rocque, Gabrielle B; Williams, Courtney P; Jones, Meredith I; Kenzik, Kelly M; Williams, Grant R; Azuero, Andres; Jackson, Bradford E; Halilova, Karina I; Meneses, Karen; Taylor, Richard A; Partridge, Ed; Pisu, Maria; Kvale, Elizabeth A

2018-01-01

Despite benefits for patients, sustainability of breast cancer navigation programs is challenging due to the lack of reimbursement for navigators. This analysis describes distress reported by breast cancer patients to navigators and the impact of navigation on healthcare utilization for older adults with breast cancer. We conducted a retrospective cohort study of Medicare administrative claims data and patient-reported distress assessments. The primary outcome was Medicare spending per beneficiary per quarter. Secondary outcomes included (1) the number of hospitalizations or ER visits in each quarter; (2) distress levels; and (3) causes of distress reported by patients to their navigators. A subset analysis was conducted for stage I/II/III versus stage IV patients. 776 navigated and 776 control patients were included in the analysis. The average age at diagnosis was 74 years; 13% of the subjects were African American; 95% of patients had stage I-III. Medicare spending declined faster for the navigated group than the matched comparison group by $528 per quarter per patient (95% CL -$667, -$388). Stage I/II/III navigated patients showed a statistically significant decline in Medicare spending, ER visits, and hospitalizations over time compared to the matched comparison group. No differences were observed for stage IV patients. Eighteen percent of patients reported moderate distress. Informational and physical distress were more common in late stage than in early-stage breast cancer. Lay navigation reduced healthcare utilization in older adults with breast cancer, with the greatest impact observed in early-stage breast cancer patients.

Distress | Springboard Beyond Cancer

Cancer.gov

Distress may affect your ability to cope with a cancer diagnosis or treatment. It may cause you to miss check-ups or delay treatment. Even mild distress can affect the quality of life for you and your caregivers.

Prediction of surface distress using neural networks

NASA Astrophysics Data System (ADS)

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

2017-06-01

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

Pediatric Food Allergies and Psychosocial Functioning: Examining the Potential Moderating Roles of Maternal Distress and Overprotection

PubMed Central

Pincus, Donna B.; Comer, Jonathan S.

2015-01-01

Objectives Identify factors associated with maternal perceptions of health-related quality of life (QoL) among youth with food allergies (FA), and identify maternal factors that may moderate relationships between FA-related challenges and child QoL. Methods In all, 533 mothers of children with FA completed measures assessing characteristics of their child’s FA, maternal perceptions of child QoL, maternal psychological distress, and maternal overprotection. Results FA severity, maternal psychological distress, and overprotection were significantly associated with maternal reports of poorer child functioning and/or poorer QoL among youth with FA. Hierarchical linear regression analyses showed an FA severity by maternal distress interaction in the prediction of child FA-related anxiety; children of higher stress mothers showed a stronger link between auto-injector use and anxiety than children of lower stress mothers. Conclusions When identifying youth with FA who are at risk for low QoL, it is important to assess history of FA-related challenges, parental psychological distress, and overprotection. PMID:26089553

Providing care to relatives with mental illness: reactions and distress among primary informal caregivers.

PubMed

Chang, Sherilyn; Zhang, Yunjue; Jeyagurunathan, Anitha; Lau, Ying Wen; Sagayadevan, Vathsala; Chong, Siow Ann; Subramaniam, Mythily

2016-03-25

The responsibility of caring for relatives with mental illness often falls on the family members. It has been reported that the reactions to or consequences of providing care are what rendered the role of a caregiver challenging and hence a source of distress. This present study thus aimed to identify socio-demographic correlates of caregiving experiences using the Caregiver Reaction Assessment (CRA) and to examine the associations between reactions to caregiving and psychological distress. A total of 350 caregivers with relatives seeking outpatient care at a tertiary psychiatric hospital were recruited for this study. Distress among caregivers was assessed using the Patient Health Questionnaire (PHQ-9). The CRA was administered to measure reactions from caregiving in four domains including impact on schedule and health (ISH), impact on finance (IF), lack of family support (LFS) and caregiver esteem (CE). Participants also completed a questionnaire that asked for their socio-demographic information. Multivariable linear regression analysis was first used with domains of CRA as outcome variables and socio-demographic variables as predictors in the models. The next set of multivariable linear regression analysis tested for the association between CRA domains and distress with CRA domain scores as outcome variables and PHQ-9 score as predictor, controlling for socio-demographic variables. Socio-demographic correlates of CRA domains identified were age, education, employment, income and ethnicity. Domain scores of CRA were significantly associated with PHQ-9 score even after controlling for socio-demographic variables. A higher distress score was associated with greater impact felt in the domain of ISH (β = 0.080, P < 0.001), IF (β = 0.064, P < 0.001), and LFS (β = 0.057, P < 0.001), and was associated with lower CE domain scores (β = -0.021, P < 0.05). This study identified several socio-demographic correlates of caregiving reaction in the different domains. Each

Community perceptions of mental distress in a post-conflict setting: a qualitative study in Burundi.

PubMed

Familiar, Itziar; Sharma, Sonali; Ndayisaba, Herman; Munyentwari, Norbert; Sibomana, Seleus; Bass, Judith K

2013-01-01

There is scant documentation of the mental health characteristics of low-income communities recovering from armed conflict. To prepare for quantitative health surveys and health service planning in Burundi, we implemented a qualitative study to explore concepts related to mental distress and coping among adults. Mental distress was defined as problems related to feelings, thinking, behaviour and physical stress. Using free listing and key informant interviews with a range of community members, we triangulated data to identify salient issues. Thirty-eight free list respondents and 23 key informants were interviewed in 5 rural communities in Burundi using 2 interview guides from the WHO Toolkit for Mental Health Assessment in Humanitarian Settings. Based on these interviews, we identified four locally defined idioms/terms relating to mental distress: ihahamuka (anxiety spectrum illnesses), ukutiyemera (a mix of depression and anxiety-like syndrome), akabonge (depression/grief-like syndrome) and kwamana ubwoba burengeje (anxiety-like syndrome). Mental distress terms were perceived as important problems impacting community development. Affected individuals sought help from several sources within the community, including community leaders and traditional healers. We discuss how local expressions of distress can be used to tailor health research and service integration from the bottom up.

47 CFR 80.314 - Distress communications.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

Laying the Foundations of Contemporary Romanian Astronomy

NASA Astrophysics Data System (ADS)

Marin, Sorin

2017-11-01

This article describes the first stage in the history of Romanian astronomy represented by the events, processes and evolution which led to the formation of great scientific personalities, development drives and the creation of the material base for the contemporary Romanian astronomy, having a focus point on the activity of Bucharest Observatory. The article discusses the roots of an evolution pathway determined and inspired by the activity of several scientific personalities of Romania such as Stefan Hepites, Spiru Haret, Nicolae Coculescu and others. It also underlines that a great importance for the astronomical research in Romania was given by the outstanding technical value of the main instruments used at the Observatory in the first decades of activity and, consequentially, by their longevity in service: in the Equatorial Dome - the impressive 6 m. Prin-Mertz telescope and in the Meridian Hall - the GautierPrin telescope. This determined the formation of a powerful astrometry division and a research drive which led over time to important scientific works such as the ultraprecise stellar catalogues developed in Romania at Bucharest Observatory, which were appreciated and awarded nationally and internationally. Therefore, the article includes the moments and the people which determined the success of laying the foundations of the Observatory in 1908 and then having completed the initial scientific infrastructure in 1912 when the construction work was finished, and briefly presents the features, scientific utilisation and outputs of its telescopes, some of the best in the world in their golden years.

47 CFR 80.1115 - Transmission of a distress alert by a station not itself in distress.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 5 2012-10-01 2012-10-01 false Transmission of a distress alert by a station not itself in distress. 80.1115 Section 80.1115 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and...

47 CFR 80.1115 - Transmission of a distress alert by a station not itself in distress.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 5 2014-10-01 2014-10-01 false Transmission of a distress alert by a station not itself in distress. 80.1115 Section 80.1115 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and...

The relationship between coping styles and benefit finding of Chinese cancer patients: The mediating role of distress.

PubMed

Liu, Zhunzhun; Zhang, Lanfeng; Cao, Yuerong; Xia, Wenkai; Zhang, Liying

2018-06-01

To identify the relationship of medical coping styles and benefit finding in Chinese early-stage cancer patients by preliminary pilot study. Three hundred and fifty one cancer patients were recruited from the Affiliated Jiangyin Hospital of Southeast University medical college and the Nantong Tumor Hospital in this study. Measurements were Chinese Benefit Finding Scale, Medical Coping Modes Questionnaire- Chinese version and Distress Thermometer. Regression analysis and pathway analysis were employed to identify the correlation of medical coping styles and benefit finding, and the mediating role of distress. Hierarchical regression analyses showed that confrontation coping style explained 24% of the variance in benefit finding, controlling for demographics and medical variables. While confrontation and resignation coping styles explained 10% and 6% of variance in distress separately. Pathway analyses implied that distress was found to mediate the effect of confrontation coping style on benefit finding in our study. Our study suggested an indirect association between medical coping styles and benefit finding, and a negative correlation of distress to medical coping styles and benefit finding. These results indicated that medical coping styles could influence benefit finding through distress. Copyright © 2018. Published by Elsevier Ltd.

Psychosocial distress in patients with thyroid cancer.

PubMed

Buchmann, Luke; Ashby, Shaelene; Cannon, Richard B; Hunt, Jason P

2015-04-01

The purpose of this study is to evaluate levels of psychosocial distress in thyroid cancer patients. An analysis of factors contributing to levels of distress is included. Individual retrospective cohort study. Head and neck cancer clinic at the Huntsman Cancer Institute. A total of 118 newly diagnosed thyroid cancer patients were included in the study. Univariate and multivariate analyses evaluated levels of and factors contributing to distress. Almost half (43.3%) of patients had significant distress. Those with self-reported psychiatric history, use of antidepressant medication, and history of radiation treatment had higher levels of distress. On multivariate analysis, patient endorsement of emotional issues predicted a higher distress level. Thyroid cancer patients have high distress levels. Identification of thyroid cancer patients with high distress levels is important to offer additional support during cancer therapy. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

Understanding psychological distress among mothers in rural Nepal: a qualitative grounded theory exploration

PubMed Central

2014-01-01

Background There is a large burden of psychological distress in low and middle-income countries, and culturally relevant interventions must be developed to address it. This requires an understanding of how distress is experienced. We conducted a qualitative grounded theory study to understand how mothers experience and manage distress in Dhanusha, a low-resource setting in rural Nepal. We also explored how distressed mothers interact with their families and the wider community. Methods Participants were identified during a cluster-randomised controlled trial in which mothers were screened for psychological distress using the 12-item General Health Questionnaire (GHQ-12). We conducted 22 semi-structured interviews with distressed mothers (GHQ-12 score ≥5) and one with a traditional healer (dhami), as well as 12 focus group discussions with community members. Data were analysed using grounded theory methods and a model was developed to explain psychological distress in this setting. Results We found that distress was termed tension by participants and mainly described in terms of physical symptoms. Key perceived causes of distress were poor health, lack of sons, and fertility problems. Tension developed in a context of limited autonomy for women and perceived duty towards the family. Distressed mothers discussed several strategies to alleviate tension, including seeking treatment for perceived physical health problems and tension from doctors or dhamis, having repeated pregnancies until a son was delivered, manipulating social circumstances in the household, and deciding to accept their fate. Their ability to implement these strategies depended on whether they were able to negotiate with their in-laws or husbands for resources. Conclusions Vulnerability, as a consequence of gender and social disadvantage, manifests as psychological distress among mothers in Dhanusha. Screening tools incorporating physical symptoms of tension should be envisaged, along with

Systematic Review: Predisposing, Precipitating, Perpetuating, and Present Factors Predicting Anticipatory Distress to Painful Medical Procedures in Children

PubMed Central

Pillai Riddell, Rebecca R.; Khan, Maria; Calic, Masa; Taddio, Anna; Tablon, Paula

2016-01-01

Objective To conduct a systematic review of the factors predicting anticipatory distress to painful medical procedures in children. Methods A systematic search was conducted to identify studies with factors related to anticipatory distress to painful medical procedures in children aged 0–18 years. The search retrieved 7,088 articles to review against inclusion criteria. A total of 77 studies were included in the review. Results 31 factors were found to predict anticipatory distress to painful medical procedures in children. A narrative synthesis of the evidence was conducted, and a summary figure is presented. Conclusions Many factors were elucidated that contribute to the occurrence of anticipatory distress to painful medical procedures. The factors that appear to increase anticipatory distress are child psychopathology, difficult child temperament, parent distress promoting behaviors, parent situational distress, previous pain events, parent anticipation of distress, and parent anxious predisposition. Longitudinal and experimental research is needed to further elucidate these factors. PMID:26338981

Why do Romanian junior high school students start to smoke?

PubMed

Lotrean, L M; Mesters, I; de Vries, H

2013-11-01

Adolescence is a crucial period in the development of smoking behaviour. To develop efficient prevention programmes for teenagers, it is essential to understand why adolescents start to smoke. The objective of this study was to assess the predictors of smoking onset among Romanian junior high school students aged 13-14. The data were obtained from a two-wave, 9-month longitudinal study carried out among 504 junior high school non-smokers from Cluj-Napoca, Romania. Questionnaires assessed smoking behaviour, attitudes, social influence, self-efficacy and intention regarding smoking (motivational variables), as well as different sociodemographic features. The results from the logistic regression analysis revealed that baseline lower self-efficacy in refraining from smoking in several social situations, baseline pressures from peers to smoke and baseline intentions to smoke significantly increased the risk of non-smokers to become smokers at follow-up 9 months later. These findings underline that reinforcing social self-efficacy to refuse smoking, resisting peer pressures and maintaining negative intentions regarding smoking are essential ingredients for smoking prevention programmes among Romanian junior high school students. © 2012 John Wiley & Sons Ltd.

Moral distress in Iranian pediatric nurses.

PubMed

Ghasemi, Elham; Negarandeh, Reza; Janani, Leila

2017-01-01

Moral distress is a very common experience in the nursing profession, and it is one of the main reasons for job dissatisfaction, burnout, and quitting among nurses. For instance, morally difficult situations in taking care of child patients who are severely ill may lead to moral distress for nurses. However, most of the studies about moral distress have been conducted on nurses of special wards and adult medical centers with much focus on developed countries. Subsequently, little has been researched on this topic among nurses in other nations such as Iran, and most certainly, there has been hardly any such research involving Iranian pediatric nurses. Aim/objectives: This study was conducted to evaluate moral distress among nurses in selected pediatric hospitals in Tehran, Iran. This cross-sectional study was conducted on eligible nurses who were selected through proportional stratified sampling and who completed demographic characteristics and the pediatric version of Moral Distress Scale-Revised questionnaires. Data were analyzed using descriptive statistics, t test, one-way analysis of variance, and Pearson correlation coefficient. Participants and research context: In total, 195 pediatric nurses working at three selected children's specialized university hospitals in Tehran participated in this study. Ethical considerations: This study was evaluated and approved by the institutional review board of Tehran University of Medical Sciences. The mean and standard deviation of total score of moral distress was 106.41 ± 61.64 within a range of 10-257. Also, the difference between the mean score of moral distress of the group who had not quitted their position and those who have quit in the past was statistically significant (p = 0.043). The situation that was associated with the highest moral distress was "observing medical students performing painful procedures on patients just to gain some skill." Total score of moral distress was significantly higher among male

Pre-Hurricane Perceived Social Support Protects Against Psychological Distress: A Longitudinal Analysis of Low-Income Mothers

PubMed Central

Lowe, Sarah R.; Chan, Christian S.; Rhodes, Jean E.

2013-01-01

Objective In this study, we examined the influence of pre-disaster perceived social support on post-disaster psychological distress among survivors of Hurricane Katrina. Method Participants (N = 386) were low-income mothers between 18 and 34 years of age at baseline (M = 26.4, SD = 4.43). The majority (84.8%) was African American; 10.4% identified as Caucasian, 3.2% identified as Hispanic, and 1.8% identified as other. Participants were enrolled in an educational intervention study in 2004 and 2005. Those who had completed a 1-year follow-up assessment prior to Hurricane Katrina were reassessed approximately 1 year after the hurricane. Measures of perceived social support and psychological distress were included in pre-and post-disaster assessments. Using structural equation modeling and multiple mediator analysis, we tested a model wherein pre-disaster perceived social support predicted post-disaster psychological distress both directly and indirectly through its effects on pre-disaster psychological distress, exposure to hurricane-related stressors, and post-disaster perceived social support. We predicted that higher pre-disaster perceived social support would be predictive of lower pre-disaster psychological distress, lower hurricane-related stressors, and higher post-disaster perceived social support, and that these variables would, in turn, predict lower post-disaster psychologically distress. Results Our analyses provide partial support for the hypothesized model. Although pre-disaster perceived social support did not exert a direct effect on post-disaster psychological distress, the indirect effects of all 3 proposed mediators were significant. Conclusions Pre-disaster social support can decrease both exposure to natural disasters and the negative psychological effects of natural disaster exposure. These findings underscore the importance of bolstering the post-disaster social support networks of low-income mothers. PMID:20658811

Adopting a family approach to theory and practice: measuring distress in cancer patient-partner dyads with the distress thermometer.

PubMed

Zwahlen, Diana; Hagenbuch, Niels; Jenewein, Josef; Carley, Margaret I; Buchi, Stefan

2011-04-01

Significant others are central to patients' experience and management of their cancer illness. Building on our validation of the Distress Thermometer (DT) for family members, this investigation examines individual and collective distress in a sample of cancer patients and their matched partners, accounting for the aspects of gender and role. Questionnaires including the DT were completed by a heterogeneous sample of 224 couples taking part in a multisite study. Our investigation showed that male patients (34.2%), female patients (31.9%), and male partners (29.1%) exhibited very similar levels of distress, while female partners (50.5%) exhibited much higher levels of distress according to the DT. At the dyad level just over half the total sample contained at least one individual reporting significant levels of distress. Among dyads with at least one distressed person, the proportion of dyads where both individuals reported distress was greatest (23.6%). Gender and role analyses revealed that males and females were not equally distributed among the four categories of dyads (i.e. dyads with no distress; dyads where solely the patient or dyads where solely the partner is distressed; dyads where both are distressed). A remarkable number of dyads reported distress in one or both partners. Diverse patterns of distress within dyads suggest varying risks of psychosocial strain. Screening patients' partners in addition to patients themselves may enable earlier identification of risk settings. The support offered to either member of such dyads should account for their role- and gender-specific needs. Copyright © 2010 John Wiley & Sons, Ltd.

Biopsychological markers of distress in informal caregivers.

PubMed

Davis, Linda Lindsey; Weaver, Michael; Zamrini, Edward; Stevens, Alan; Kang, Duck-Hee; Parker, C Richard

2004-10-01

Thirty caregiving wives participated in a study of caregiving distress and negative mood (depressive symptoms) by making diary entries on stressful caregiving situations and collecting saliva samples 4 times a day. At the end of the 7-day study period, caregivers' salivary cortisol production was compared with their diary entries and correlated with pencil and paper self-report scores of caregiver distress and depressive symptoms. Despite the inability to control a number of factors thought to confound cortisol production (exercise, smoking, alcohol ingestion, and prescription medications), there was a statistically significant difference between No Caregiving and Caregiving cortisol, F(1,739) = 7.67, P = 0.006, with cortisol production higher when caregiving events occurred. However, efforts to code specific types of caregiving situations (e.g., 1 = indirect care; 4 = AD problem behavior care) did not further differentiate cortisol production. Although caregivers' self-reports for the same 7-day period indicated they were depressed, pencil-and-paper measures of distress and negative affect were not significantly correlated with cortisol production. The finding that this caregiving group was significantly stressed by caregiving, as evidenced by increased cortisol production during caregiving episodes, verifies the importance of further exploration of specific caregiving situations as contributory factors in caregiver health and well-being. In that saliva is a relatively economical and comparatively noninvasive biological data source for community-based stress studies, methodological limitations of the study are identified and 5 recommendations are made for future biological marker studies of caregiver distress in community-based settings. Copyright 2004 Sage Publications

Predictors of psychological distress in low-income populations of Montreal.

PubMed

Caron, Jean; Latimer, Eric; Tousignant, Michel

2007-01-01

THEORETICAL PERSPECTIVE: Many epidemiologic studies agree that low-income populations are the groups most vulnerable to mental health problems. However, not all people in economic difficulty show symptoms, and it appears that having a social support network plays a role in protecting against the chronic stress resulting from conditions such as poverty. The aim of the study is to clarify the relative contribution of social support to the mental health of low-income populations in two neighbourhoods in the southwest of Montreal: Pointe-Saint Charles and Saint-Henri. A random sample of 416 social assistance recipients in southwest Montreal and another sample of 112 people, drawn at random from the general population, were interviewed. The psychological distress scale used was the Indice de détresse psychologique--Enquête Santê Quêbec (IDPESQ). The availability of social support components was assessed by using the Social Provisions Scale. Data were collected during interviews in the respondents' homes. Social support measures were entered into a multidimensional model including many variables identified as being associated with mental health. Multiple regression analysis identified the best predictors of psychological distress for the low-income population. Among the 30 variables included in a multiple regression analysis, emotional support and the presence of persons perceived as stressful together accounted for most of the variance in distress predicted by the model. Although younger people, people experiencing food insecurity and people with poorer numeracy show a higher level of distress, these variables make a fairly marginal contribution compared with that of social relations.

Higher Psychological Distress is Associated with Unintentional Injuries in U.S. Adults

PubMed Central

McAninch, Jana; Greene, Christina; Sorkin, John D.; Lavoie, Marie-Claude; Smith, Gordon S.

2014-01-01

Background Links between mental illness, self-inflicted injury, and interpersonal violence are well recognized, but the association between poor mental health and unintentional injuries is not well understood. Methods We used the 2010 National Health Interview Survey to assess the association between psychological distress and unintentional non-occupational injuries among U.S. adults. Psychological distress was measured by the Kessler Psychological Distress Scale, a symptom scale shown to identify community-dwelling persons with mental illness. Multivariable logistic regression was used to estimate adjusted odds ratios (AOR) and 95% confidence intervals. Results Of the 26,776 individuals analyzed, 2.5% reported a medically-attended unintentional injury in the past three months. Those with moderate and severe psychological distress had 1.5 [1.2-1.8] and 2.0 [1.4 -2.8] times higher odds of injury, respectively, as compared to those with low distress levels, after adjusting for age, sex, race, marital status, education level, alcohol use, physical functional limitation, medical comorbidity, employment status, and health insurance status. Psychological distress was significantly associated with falls [AOR 1.4 (1.1-1.9)] and sprain/strain injuries [AOR 2.0 (1.5-2.8)], but not transportation-related injuries [AOR 1.2 (0.7-1.9)] or fractures [AOR 1.1 (0.8-1.6)]. Conclusion Among community-dwelling U.S. adults, psychological distress is significantly associated with unintentional non-occupational injury, and the magnitude of association increases with severity of distress. The association between psychological distress and injury may be particularly strong for falls and sprain/strain injuries. These findings draw attention to a large group of at-risk individuals that may merit further targeted research, including longitudinal studies. PMID:24174466

Psychological Distress Among Caregivers of Individuals With a Diagnosis of Schizophrenia or Schizoaffective Disorder.

PubMed

Lerner, Debra; Chang, Hong; Rogers, William H; Benson, Carmela; Lyson, Mercedes C; Dixon, Lisa B

2018-02-01

The aim was to quantify caregiver distress among informal caregivers of individuals with schizophrenia or schizoaffective disorder and identify its correlates. From December 2014 through April 2015, ads posted with mental health advocates and the media recruited informal caregivers, age ≥21 years, to complete an online questionnaire. It included the ten-item Perceived Stress Scale (PSS) (0, no distress; 39, highest) and hypothesized distress correlates in four groups: caregiver and care recipient characteristics; caregiver role demands; caregiver social supports; and caregiver cognitive appraisals of caregiving. Three hypotheses were tested: first, distress is significantly related to variables from each group; second, social supports moderate the effects of role demands on distress; and third, cognitive appraisals mediate the effects of role demands on distress. Hypotheses were tested with multiple linear regression equations and structural equation models (SEMs). Of 2,338 Web site "hits," 1,708 individuals consented, 1,398 were eligible, and 1,142 had complete data. Most caregivers were women (83%), white (89%), and college educated (59%), with a mean±SD age of 55.6±13.0. Compared with U.S. norms on the PSS (13.4±6.5), mean caregiver distress was high (18.9±7.1). According to SEMs, variables from each group were associated with distress. Contributing most to greater distress were caregiver health problems, providing frequent caregiving assistance, monitoring medication, having limited social support, and appraising caregiving negatively. Cognitive appraisals mediated the effects of demands on distress. Social support had a significant direct effect only. Caregiver distress was relatively high and related to multiple variables, some of which are potentially modifiable.

47 CFR 80.325 - Control of distress traffic.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

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

PubMed

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

2017-03-01

Moral distress is a common experience among critical care professionals, leading to frustration, withdrawal from patient care, and job abandonment. Most of the studies on moral distress have used the Moral Distress Scale or its revised version (Moral Distress Scale-Revised). However, these scales have never been validated through factor analysis. This article aims to explore the factorial structure of the Moral Distress Scale-Revised and develop a valid and reliable scale through factor analysis. Validation study using a survey design. Eight medical-surgical ICUs in the north of Italy. A total of 184 clinicians (64 physicians, 94 nurses, and 14 residents). The Moral Distress Scale-Revised was translated into Italian and administered along with a measure of depression (Beck Depression Inventory-Second Edition) to establish convergent validity. Exploratory factor analysis was conducted to explore the Moral Distress Scale-Revised factorial structure. Items with low (less than or equal to 0.350) or multiple saturations were removed. The resulting model was tested through confirmatory factor analysis. The Italian Moral Distress Scale-Revised is composed of 14 items referring to four factors: futile care, poor teamwork, deceptive communication, and ethical misconduct. This model accounts for 59% of the total variance and presents a good fit with the data (root mean square error of approximation = 0.06; comparative fit index = 0.95; Tucker-Lewis index = 0.94; weighted root mean square residual = 0.65). The Italian Moral Distress Scale-Revised evinces good reliability (α = 0.81) and moderately correlates with Beck Depression Inventory-Second Edition (r = 0.293; p < 0.001). No significant differences were found in the moral distress total score between physicians and nurses. However, nurses scored higher on futile care than physicians (t = 2.051; p = 0.042), whereas physicians scored higher on deceptive communication than nurses (t = 3.617; p < 0.001). Moral distress was

Psychological distress and the increased risk of falling into poverty: a longitudinal study of Australian adults.

PubMed

Callander, Emily J; Schofield, Deborah J

2015-10-01

To identify whether psychological distress is associated with an increased risk of falling into poverty, giving a more complete picture of how psychological distress affects living standards. Longitudinal analysis of the nationally representative Household Income and Labour Dynamics in Australian (HILDA) survey using Poisson regression models to estimate relative risk of falling into income poverty and multidimensional poverty between 2007 and 2012. The sample was limited to those who were not already in income poverty in 2007. Psychological distress was identified using the Kessler-10 (K10) scale. After adjusting for confounding factors, having moderate psychological distress increased the risk of falling into income poverty by 1.62 (95% CI 1.31-2.01, p < 0.0001) and the risk of falling into multidimensional poverty by 1.85 (95% CI 1.37-2.48, p < 0.0001); having very high psychological distress increased the risk of falling into income poverty by 2.40 (95% CI 1.80-3.20, p < 0.0001) and the risk of falling into multidimensional poverty by 3.68 (95% CI 2.63-5.15, p < 0.0001), compared to those with low psychological distress. Those who did experience income poverty (RR: 1.29, 95% CI 1.04-1.61, p = 0.0210) and those who experienced multidimensional poverty (RR: 1.69, 95% CI 1.32-2.17, p < 0.0001) had an increased risk of having their level of psychological distress increase further compared to those who did not experience poverty. To date, the increased risk of falling into poverty that is associated with elevated levels of psychological distress has been an overlooked burden of the condition.

Pediatric Food Allergies and Psychosocial Functioning: Examining the Potential Moderating Roles of Maternal Distress and Overprotection.

PubMed

Chow, Candice; Pincus, Donna B; Comer, Jonathan S

2015-01-01

Identify factors associated with maternal perceptions of health-related quality of life (QoL) among youth with food allergies (FA), and identify maternal factors that may moderate relationships between FA-related challenges and child QoL. In all, 533 mothers of children with FA completed measures assessing characteristics of their child's FA, maternal perceptions of child QoL, maternal psychological distress, and maternal overprotection. FA severity, maternal psychological distress, and overprotection were significantly associated with maternal reports of poorer child functioning and/or poorer QoL among youth with FA. Hierarchical linear regression analyses showed an FA severity by maternal distress interaction in the prediction of child FA-related anxiety; children of higher stress mothers showed a stronger link between auto-injector use and anxiety than children of lower stress mothers. When identifying youth with FA who are at risk for low QoL, it is important to assess history of FA-related challenges, parental psychological distress, and overprotection. © The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Orientation to the patient as a marketing strategy in the Romanian healthcare system.

PubMed

Coculescu, B I; Coculescu, E C; Purcărea, V L

2016-01-01

In the context of the European political and socio-economic changes of the early 90s, health care reform in Romania has become inevitable, both for patients and for health professionals in the system. The first stage of the health care reform in Romania is focused on decentralization and improving primary health care. The Romanian medical system is currently in the process of changing the mentality, which requires time, patience, and perseverance, despite the unforeseeable or resistance inevitably faced. It is a commonly known and recognized fact that in this painful period of transition, Romanian medicine, like other fields too, has traveled a winding road, with obstacles (medical malpractices, scandals in the press related to the misappropriation of funds or underfunding of the public health system, etc.) often hard to overcome.

Orientation to the patient as a marketing strategy in the Romanian healthcare system

PubMed Central

Coculescu, BI; Coculescu, EC; Purcărea, VL

2016-01-01

In the context of the European political and socio-economic changes of the early 90s, health care reform in Romania has become inevitable, both for patients and for health professionals in the system. The first stage of the health care reform in Romania is focused on decentralization and improving primary health care. The Romanian medical system is currently in the process of changing the mentality, which requires time, patience, and perseverance, despite the unforeseeable or resistance inevitably faced. It is a commonly known and recognized fact that in this painful period of transition, Romanian medicine, like other fields too, has traveled a winding road, with obstacles (medical malpractices, scandals in the press related to the misappropriation of funds or underfunding of the public health system, etc.) often hard to overcome. PMID:27974940

Dentist's distress in the management of chronic pain control

PubMed Central

Yokoyama, Yoko; Kakudate, Naoki; Sumida, Futoshi; Matsumoto, Yuki; Gordan, Valeria V.; Gilbert, Gregg H.

2018-01-01

Abstract We aimed to obtain greater understanding of dentists’ distress when they diagnose and treat patients with temporomandibular disorders (TMD), and to explore ways in which TMD can be better treated. We conducted a cross-sectional study based on a questionnaire survey of dentists (n = 148). Dentists were queried using an open-ended questionnaire about distress they experienced when treating patients with TMD. Survey responses were analyzed using mixed methods. Associations between specific dentist and patient characteristics and types of distress were analyzed by one way analysis of variance and residual analysis. One hundred thirteen clinicians responded to the questionnaire, giving a 76% response rate. Thematic analysis identified 6 major themes: difficulty in predicting therapeutic effect and prognosis; difficulty in diagnosis; difficulty in the decision about whether to do occlusal adjustment; difficulty in specifying a cause; difficulty in communicating with patients and mental factors; and health insurance system barriers. Clinicians who reported difficulty in deciding whether to do occlusal adjustment saw significantly more patients who experienced shoulder stiffness and headache (P = .008 and P = .022, respectively). Dentists’ knowledge of TMD guidelines was associated with a lower percentage of difficulty in predicting therapeutic effect and prognosis (residual analysis; P = .010). These findings provide important insights into clinician's perception of difficulties with patients experiencing TMD-related pain. Knowledge of the existence of TMD clinical practice guidelines may lower dentist distress, particularly with regard to prognosis. Further studies are needed to decrease dentist's distress and to overcome the evidence-practice gap in TMD treatment. PMID:29505535

Moral distress in Turkish intensive care nurses.

PubMed

Karagozoglu, Serife; Yildirim, Gulay; Ozden, Dilek; Çınar, Ziynet

2017-03-01

Moral distress is a common problem among professionals working in the field of healthcare. Moral distress is the distress experienced by a professional when he or she cannot fulfill the correct action due to several obstacles, although he or she is aware of what it is. The level of moral distress experienced by nurses working in intensive care units varies from one country/culture/institution to another. However, in Turkey, there is neither a measurement tool used to assess moral distress suffered by nurses nor a study conducted on the issue. The study aims to (a) validate the Turkish version of the Moral Distress Scale-Revised to be used in intensive care units and to examine the validity and reliability of the Turkish version of the scale, and (b) explore Turkish intensive care nurses' moral distress level. The sample of this methodological, descriptive, and cross-sectional design study comprises 200 nurses working in the intensive care units of internal medicine and surgical departments of four hospitals in three cities in Turkey. The data were collected with the Socio-Demographic Characteristics Form and The Turkish Version of Moral Distress Scale-Revised. Ethical considerations: The study proposal was approved by the ethics committee of the Faculty of Medicine, Cumhuriyet University. All participating nurses provided informed consent and were assured of data confidentiality. In parallel with the original scale, Turkish version of Moral Distress Scale-Revised consists of 21 items, and shows a one-factor structure. It was determined that the moral distress total and item mean scores of the nurses participating in the study were 70.81 ± 48.23 and 3.36 ± 4.50, respectively. Turkish version of Moral Distress Scale-Revised can be used as a reliable and valid measurement tool for the evaluation of moral distress experienced by nurses working in intensive care units in Turkey. In line with our findings, it can be said that nurses suffered low level of moral distress

Neglect and perceived stigmatization impact psychological distress of orphans in Tanzania

PubMed Central

Hermenau, Katharin; Eggert, Ina; Landolt, Markus A.; Hecker, Tobias

2015-01-01

Background Research has shown that orphans in sub-Saharan Africa are at increased risk for mental health problems. Exposure to maltreatment and HIV/AIDS-related stigmatization are related to orphans’ psychological distress. Yet, researchers stress the need for more research in low-income countries to identify which factors of being an orphan may lead to psychological distress. Objectives The present study aims to systematically investigate orphans’ experiences of maltreatment and stigmatization to identify factors that relate to their psychological distress. Methods In total, 89 Tanzanian children who had lost at least one parent were compared to 89 matched non-orphans (mean age: 11 years; 51% boys). We measured exposure to maltreatment and perceived stigmatization as an orphan. Mental health was assessed using the Strengths and Difficulties Questionnaire, the Children's Depression Inventory, the UCLA PTSD Index for Children, and the Reactive–Proactive Questionnaire. Results Orphans reported significantly more experiences of neglect, but not of abuse. A group comparison revealed more depressive symptoms, posttraumatic stress symptoms, and aggressive behavior among orphans. Neglect, abuse, and stigmatization correlated with orphans’ internalizing and externalizing problems, yet only neglect and stigmatization were related to orphans’ depression severity. Perceived stigmatization moderated the relationship between neglect and depression. Conclusions Our findings suggest that orphans in Tanzania are at increased risk of experiencing neglect. Maltreatment and perceived stigmatization may play a role in orphans’ psychological distress. Culturally appropriate and evidence-based interventions may help to prevent maltreatment and stigmatization of orphans. PMID:26589257

Neglect and perceived stigmatization impact psychological distress of orphans in Tanzania.

PubMed

Hermenau, Katharin; Eggert, Ina; Landolt, Markus A; Hecker, Tobias

2015-01-01

Research has shown that orphans in sub-Saharan Africa are at increased risk for mental health problems. Exposure to maltreatment and HIV/AIDS-related stigmatization are related to orphans' psychological distress. Yet, researchers stress the need for more research in low-income countries to identify which factors of being an orphan may lead to psychological distress. The present study aims to systematically investigate orphans' experiences of maltreatment and stigmatization to identify factors that relate to their psychological distress. In total, 89 Tanzanian children who had lost at least one parent were compared to 89 matched non-orphans (mean age: 11 years; 51% boys). We measured exposure to maltreatment and perceived stigmatization as an orphan. Mental health was assessed using the Strengths and Difficulties Questionnaire, the Children's Depression Inventory, the UCLA PTSD Index for Children, and the Reactive-Proactive Questionnaire. Orphans reported significantly more experiences of neglect, but not of abuse. A group comparison revealed more depressive symptoms, posttraumatic stress symptoms, and aggressive behavior among orphans. Neglect, abuse, and stigmatization correlated with orphans' internalizing and externalizing problems, yet only neglect and stigmatization were related to orphans' depression severity. Perceived stigmatization moderated the relationship between neglect and depression. Our findings suggest that orphans in Tanzania are at increased risk of experiencing neglect. Maltreatment and perceived stigmatization may play a role in orphans' psychological distress. Culturally appropriate and evidence-based interventions may help to prevent maltreatment and stigmatization of orphans.

Patient-reported symptom distress, and most bothersome issues, before and during cancer treatment

PubMed Central

Hong, Fangxin; Blonquist, Traci M; Halpenny, Barbara; Berry, Donna L

2016-01-01

Introduction Frequently reported symptoms and treatment side effects may not be the most bothersome issues to patients with cancer. The purpose of this study was to investigate patient-reported symptom distress and bothersome issues among participants with cancer. Methods Participants completed the Symptom Distress Scale-15 before treatment (T1) and during cancer treatment (T2) and reported up to two most bothersome issues among symptoms rated with moderate-to-severe distress. We compared symptom ratings and perceived bother and explored two approaches predicting patients’ most bothersome issues: worst absolute symptom score or worst change from pretreatment. Results Significantly, (P≤0.0002) more patients reported moderate-to-severe distress at T2 for eight of 13 symptoms. At T1, 81% of patients reported one and 56% reported multiple symptoms with moderate-to-severe distress, while at T2, 89% reported one and 69% reported multiple symptoms with moderate-to-severe distress. Impact on sexual activity/interest, pain, fatigue, and insomnia were the most prevalent symptoms with moderate-to-severe distress. Fatigue, pain, and insomnia were perceived most often as bothersome. When one symptom was rated moderate-to-severe, predictive accuracy of the absolute score was 46% and 48% (T1 & T2) and 38% with the change score (T2–T1). When two or more symptoms were rated moderate-to-severe, predictive accuracy of the absolute score was 76% and 79% (T1 & T2) and 70% with the change score (T2–T1). Conclusion More patients experienced moderate-to-severe symptom distress after treatment initiation. Patient identification of bothersome issues could not be assumed based on prevalence of symptoms reported with moderate-to-severe distress. The absolute symptom distress scores identified patients’ most bothersome issues with good accuracy, outperforming change scores. PMID:27672346

Caregiver distress and patient health-related quality of life: psychosocial screening during pediatric cancer treatment.

PubMed

Pierce, Lisa; Hocking, Matthew C; Schwartz, Lisa A; Alderfer, Melissa A; Kazak, Anne E; Barakat, Lamia P

2017-10-01

Reports of acceptability of psychosocial screening are limited, and the utility of screening in identifying risk factors for health-related quality of life (HRQL) of children with cancer has not been established. This study aimed to assess acceptability of screening for parents and evaluate associations between family risk factors and patient HRQL in the first year post-diagnosis. Sixty-seven parents of children with cancer completed the Psychosocial Assessment Tool (family risk), Distress Thermometer (caregiver distress), Posttraumatic Stress Disorder Checklist-Civilian 6 (caregiver traumatic stress), PedsQL 4.0 (parent-proxy report of patient HRQL) and four acceptability questions via a tablet (iPad). Patients (Mage = 9.5 SD = 5.5 years) were equally distributed across major pediatric cancer diagnoses. The majority of parents endorsed electronic screening as acceptable (70%-97%). Patient gender, diagnosis, intensity of treatment and time since diagnosis were not significantly correlated with family risk, caregiver distress, traumatic stress, or patient HRQL. The full regression model predicting total HRQL was significant (R 2  = .42, F(4,64) = 10.7, p = .000). Age (older) was a significant covariate, family risk and caregiver distress were significant independent predictors of poorer total HRQL. The full regression models for physical and psychosocial HRQL were significant; age and caregiver distress were independent predictors of physical HRQL, and age and family risk were independent predictors of psychosocial HRQL. Screening is acceptable for families and important for identifying risk factors associated with poorer patient HRQL during childhood cancer treatment. Targeted interventions addressing family resource needs as well as parent distress identified through screening may be effective in promoting patient HRQL. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Effects of Art Therapy on Distress Levels of Adults with Cancer: A Proxy Pretest Study

ERIC Educational Resources Information Center

Glinzak, Leara

2016-01-01

This study identified decreased distress after art therapy in a proxy pretest study with a convenience sample of 73 patients being treated for cancer. Art therapy outcomes from 4 settings (oncology unit, infusion clinic, individual sessions, and open studio) were measured via the self-report Distress Thermometer, which was collected as part of an…

Romanian Diaspora in the Making? An Online Ethnography of Romaniancommunity.net

ERIC Educational Resources Information Center

Macri, Gloria

2013-01-01

This chapter presents a case study of an online ethnography which examines the Romanian Community of Ireland forum. Apart from highlighting the main challenges and advantages of engaging with an ethnographic methodology online, this chapter also showcases the key findings emerging in relation to the meanings which members of this community…

The mitochondrial DNA makeup of Romanians: A forensic mtDNA control region database and phylogenetic characterization.

PubMed

Turchi, Chiara; Stanciu, Florin; Paselli, Giorgia; Buscemi, Loredana; Parson, Walther; Tagliabracci, Adriano

2016-09-01

To evaluate the pattern of Romanian population from a mitochondrial perspective and to establish an appropriate mtDNA forensic database, we generated a high-quality mtDNA control region dataset from 407 Romanian subjects belonging to four major historical regions: Moldavia, Transylvania, Wallachia and Dobruja. The entire control region (CR) was analyzed by Sanger-type sequencing assays and the resulting 306 different haplotypes were classified into haplogroups according to the most updated mtDNA phylogeny. The Romanian gene pool is mainly composed of West Eurasian lineages H (31.7%), U (12.8%), J (10.8%), R (10.1%), T (9.1%), N (8.1%), HV (5.4%),K (3.7%), HV0 (4.2%), with exceptions of East Asian haplogroup M (3.4%) and African haplogroup L (0.7%). The pattern of mtDNA variation observed in this study indicates that the mitochondrial DNA pool is geographically homogeneous across Romania and that the haplogroup composition reveals signals of admixture of populations of different origin. The PCA scatterplot supported this scenario, with Romania located in southeastern Europe area, close to Bulgaria and Hungary, and as a borderland with respect to east Mediterranean and other eastern European countries. High haplotype diversity (0.993) and nucleotide diversity indices (0.00838±0.00426), together with low random match probability (0.0087) suggest the usefulness of this control region dataset as a forensic database in routine forensic mtDNA analysis and in the investigation of maternal genetic lineages in the Romanian population. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Identification of Distress in Oncology Patients: A Comparison of the Hospital Anxiety and Depression Scale and a Thorough Clinical Assessment.

PubMed

Thalén-Lindström, Annika M; Glimelius, Bengt G; Johansson, Birgitta B

2016-01-01

Screening is recommended to identify cancer patients with distress, anxiety, and depression. The ability of current methods to identify distress in oncology patients is of high importance. We compared the Hospital Anxiety and Depression Scale (HADS) with a thorough clinical assessment. Furthermore, we explored the agreement of HADS with clinical assessment outcomes as a function of age, sex, and treatment intention. One hundred forty-six oncology patients, representing both sexes, different ages (<65/≥ 65 years), and treatment intention (curative/palliative), completed the HADS before the clinical assessment. Two study team members (blind to the HADS results) completed clinical assessments of anxiety, depression, and distress analogous to categories used in the HADS. The HADS identified 49 participants and the clinical assessment 71 participants as having anxiety, depression, or distress. The overall agreement between the HADS and the clinical assessment was moderate. The greatest differences were found to be a function of participant sex and age. Agreement between the methods was better for females than for males in relation to distress and anxiety and better for the older (≥ 65 years) than younger participants in relation to depression. By treatment intention, agreement was equal for all domains. Especially male and young participants appear to have potential problems that the HADS fails to identify. When the HADS is used for screening, nurses must be aware of psychosocial problems perceived by patients that are not covered by the HADS. Many patients identified as having distress have resources to manage problems without additional support.

Generalized psychological distress among HIV-infected patients enrolled in antiretroviral treatment in Dilla University Hospital, Gedeo zone, Ethiopia

PubMed Central

Tesfaye, Solomon H.; Bune, Girma T.

2014-01-01

Background Psychological disorders like depression and anxiety are potentially dangerous conditions. In the context of HIV/AIDS, this can influence health-seeking behavior or uptake of diagnosis and treatment for HIV/AIDS, add to the burden of disease for HIV patients, create difficulty in adherence to treatment, and increase the risk of mortality and morbidity. The objective of this study was to assess the prevalence and correlates of generalized psychological distress among HIV-infected subjects on antiretroviral treatment (ART). Design An institution-based cross-sectional study was conducted. Interviews were conducted with 500 patients initiating ART at Dilla Referral Hospital. Generalized psychological distress was measured using the Hospital Anxiety and Depression Scale (HADS). A cutoff score ≥19 was used to identify possible cases of patients with generalized psychological distress. Multivariable logistic regression analysis using SPSS Version 20 was performed to identify factors associated with psychological distress. Results The prevalence of generalized psychological distress among the population of this study was 11.2% (HADS≥19). Factors independently associated with generalized psychological distress were moderate stress (OR=6.87, 95% CI 2.27–20.81), low social support (OR=10.17, 95% CI 2.85–36.29), number of negative life events of six and above (OR=3.99, 95% CI 1.77–8.99), not disclosing HIV status (OR=5.24, 95% CI 1.33–20.62), and CD4 cell count of <200 cells/mm3 (OR=1.98, 95% CI 0.45–0.83) and 200–499 cells/mm3 (OR=3.53, 95% CI 1.62–7.73). Conclusions This study provides prevalence of psychological distress lower than the prevalence of common mental disorders in Ethiopia and comparable to some other studies in sub-Saharan Africa. The findings are important in terms of their relevance to identifying high-risk groups for generalized psychological distress and preventing distress through integrating mental health services with HIV

Generalized psychological distress among HIV-infected patients enrolled in antiretroviral treatment in Dilla University Hospital, Gedeo zone, Ethiopia.

PubMed

Tesfaye, Solomon H; Bune, Girma T

2014-01-01

Psychological disorders like depression and anxiety are potentially dangerous conditions. In the context of HIV/AIDS, this can influence health-seeking behavior or uptake of diagnosis and treatment for HIV/AIDS, add to the burden of disease for HIV patients, create difficulty in adherence to treatment, and increase the risk of mortality and morbidity. The objective of this study was to assess the prevalence and correlates of generalized psychological distress among HIV-infected subjects on antiretroviral treatment (ART). An institution-based cross-sectional study was conducted. Interviews were conducted with 500 patients initiating ART at Dilla Referral Hospital. Generalized psychological distress was measured using the Hospital Anxiety and Depression Scale (HADS). A cutoff score ≥19 was used to identify possible cases of patients with generalized psychological distress. Multivariable logistic regression analysis using SPSS Version 20 was performed to identify factors associated with psychological distress. The prevalence of generalized psychological distress among the population of this study was 11.2% (HADS≥19). Factors independently associated with generalized psychological distress were moderate stress (OR=6.87, 95% CI 2.27-20.81), low social support (OR=10.17, 95% CI 2.85-36.29), number of negative life events of six and above (OR=3.99, 95% CI 1.77-8.99), not disclosing HIV status (OR=5.24, 95% CI 1.33-20.62), and CD4 cell count of <200 cells/mm(3) (OR=1.98, 95% CI 0.45-0.83) and 200-499 cells/mm(3) (OR=3.53, 95% CI 1.62-7.73). This study provides prevalence of psychological distress lower than the prevalence of common mental disorders in Ethiopia and comparable to some other studies in sub-Saharan Africa. The findings are important in terms of their relevance to identifying high-risk groups for generalized psychological distress and preventing distress through integrating mental health services with HIV/AIDS care and support program.

Moral distress in rehabilitation professionals: results from a hospital ethics survey.

PubMed

Mukherjee, Debjani; Brashler, Rebecca; Savage, Teresa A; Kirschner, Kristi L

2009-05-01

Moral distress in the rehabilitation setting was examined in a follow-up survey. The survey had 3 goals: (1) to systematically and anonymously gather data about the ethical issues that employees struggle with in their daily work; (2) to raise the visibility of the hospital-based ethics program and resources available to employees; and (3) to prioritize and focus the direction of the program's educational seminars, quality improvement projects, and ethics consultation. Online survey of employees. Urban rehabilitation system of care. The survey was open to all employees; 207 completed the survey. N/A MAIN OUTCOME MEASUREMENTS: N/A CONCLUSIONS: Three broad categories of moral distress were identified: institutional ethics, professional practice, and clinical decision-making. Institutional ethics issues related to the health care environment, such as health care reimbursement pressures and corporate culture. Professional practice issues involved codes of behavior and concepts of professionalism, including patient confidentiality/privacy. Clinical decision-making included such practical dilemmas as conflicts around goal-setting, discharge planning, and assessment of decision-making capacity. An anonymous survey of staff members allowed the hospital ethics program to identify sources of moral distress and prioritize strategies to address them.

Systematic Review: Predisposing, Precipitating, Perpetuating, and Present Factors Predicting Anticipatory Distress to Painful Medical Procedures in Children.

PubMed

Racine, Nicole M; Riddell, Rebecca R Pillai; Khan, Maria; Calic, Masa; Taddio, Anna; Tablon, Paula

2016-03-01

To conduct a systematic review of the factors predicting anticipatory distress to painful medical procedures in children. A systematic search was conducted to identify studies with factors related to anticipatory distress to painful medical procedures in children aged 0-18 years. The search retrieved 7,088 articles to review against inclusion criteria. A total of 77 studies were included in the review. 31 factors were found to predict anticipatory distress to painful medical procedures in children. A narrative synthesis of the evidence was conducted, and a summary figure is presented. Many factors were elucidated that contribute to the occurrence of anticipatory distress to painful medical procedures. The factors that appear to increase anticipatory distress are child psychopathology, difficult child temperament, parent distress promoting behaviors, parent situational distress, previous pain events, parent anticipation of distress, and parent anxious predisposition. Longitudinal and experimental research is needed to further elucidate these factors. © The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Screening young adult cancer survivors for distress with the Distress Thermometer: Comparisons with a structured clinical diagnostic interview.

PubMed

Recklitis, Christopher J; Blackmon, Jaime E; Chang, Grace

2016-01-15

The validity of the Distress Thermometer (DT) as a screen for psychological distress in young adult cancer survivors was assessed by comparing it with the results of a psychiatric diagnostic interview, the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) (SCID), to evaluate the accuracy of the DT and identify optimal cutoff scores for this population. A total of 247 survivors aged 18 to 40 years completed the DT and SCID. Based on the SCID, participants were classified as having: 1) ≥ 1 SCID diagnoses; 2) significant symptoms, but no SCID diagnosis; or 3) no significant SCID symptoms. Receiver operating characteristic analyses determined the sensitivity and specificity of all possible DT cutoff scores for detecting survivors with a SCID diagnosis, and subsequently for survivors with significant SCID symptoms or a SCID diagnosis. The recommended DT cutoff score of ≥5 failed to identify 31.81% of survivors with a SCID diagnosis (sensitivity of 68.18% and specificity of 78.33%), and 32.81% of survivors with either significant SCID symptoms or a SCID diagnosis. No alternative DT cutoff score met the criteria for acceptable sensitivity (≥85%) and specificity (≥75%). The DT does not reliably identify young adult cancer survivors with psychiatric problems identified by a "gold standard" structured psychiatric interview. Therefore, the DT should not be used as a stand-alone psychological screen in this population. Cancer 2016;122:296-303. © 2015 American Cancer Society. © 2015 American Cancer Society.

Helping, mediating, and gaining recognition: The everyday identity work of Romanian health social workers.

PubMed

Ciocănel, Alexandra; Lazăr, Florin; Munch, Shari; Harmon, Cara; Rentea, Georgiana-Cristina; Gaba, Daniela; Mihai, Anca

2018-03-01

Health social work is a field with challenges, opportunities, and ways of professing social work that may vary between different national contexts. In this article, we look at how Romanian health social workers construct their professional identity through their everyday identity work. Drawing on a qualitative study based on interviews with 21 health social workers working in various organizational contexts, we analyze what health social workers say they do and how this shapes their self-conception as professionals. Four main themes emerged from participants' descriptions: being a helping professional, being a mediator, gaining recognition, and contending with limits. Through these themes, participants articulated the everyday struggles and satisfactions specific to working as recently recognized professionals in Romanian health and welfare systems not always supportive of their work.

Parenting a Child with Phenylketonuria: An Investigation into the Factors That Contribute to Parental Distress.

PubMed

Ambler, Olivia; Medford, Emma; Hare, Dougal J

2018-04-20

Phenylketonuria (PKU) is an inherited metabolic condition that can lead to the onset of intellectual disabilities if not strictly managed through a low-protein diet. Parents are responsible for supervising their child's treatment for PKU, which may impact on their experience of distress. This cross-sectional study aimed to identify the factors that contribute to distress in parents who care for a child with PKU, distinct from parents in the general population. Thirty-eight parents of children and adolescents with PKU and 32 parents in the general population completed the questionnaires measuring parental psychological resilience, child behaviour problems, perceived social support and distress. Parents of children with PKU also completed measures of their child's care dependency and behaviour related to developmental and intellectual disabilities. The findings revealed no statistically significant differences in distress between the groups, but parents of children with PKU reported more child behaviour problems. Multiple regression analysis identified that parental psychological resilience and child anxious behaviour explained 35% of the variance in distress for parents of children with PKU. By comparison, parental psychological resilience and generic child behaviour only accounted for 19% of the variance in distress for parents in the general population. This has implications for developing interventions in clinical settings that aim to reduce parents' distress by enhancing their psychological resilience and supporting them to manage child behaviour difficulties, particularly anxious behaviour. Future research should include larger, more diverse samples and use longitudinal study designs.

Response to Distress Varies by Social Impairment and Familiarity in Infants at Risk for Autism.

PubMed

Dowd, Alexandra C; Martinez, Kassandra; Davidson, Bridget C; Hixon, J Gregory; Neal-Beevers, A Rebecca

2018-06-21

Early impaired response to social partners' distress may negatively impact subsequent social development. Identifying factors contributing to successful responding may inform assessment and intervention. This study explores how: (1) social impairment, and (2) partner familiarity relate to response to partners' distress. Infants with and without older siblings with ASD were assessed at 12 (n = 29) and 15 (n = 35) months for social impairment markers, and responses to mother and experimenter each feigning distress. Infants with more social impairment showed less attention and affect at 15, but not 12 months. Infants attended more to the unfamiliar person, but exhibited greater affect toward the familiar person at 12 months. Results revealed social impairment and familiarity were separately related to infant response to partners' distress.

Psychological distress among re-education through labour camp detainees in Guangxi Autonomous Region, China.

PubMed

Yap, Lorraine; Shu, Su; Zhang, Lei; Liu, Wei; Chen, Yi; Wu, Zunyou; Li, Jianghong; Wand, Handan; Donovan, Basil; Butler, Tony

2017-02-01

There is currently no information about the prevalence of, and factors contributing to psychological distress experienced by re-education through labour camp detainees in China. A cross-sectional face-to-face survey was conducted in three labour camps in Guangxi, China. The questionnaire covered socio-demographic characteristics; sexually transmissible infections (STIs); drug use; psychological distress (K-10); and health service usage and access inside the labour camps. K-10 scores were categorised as ≤30 (low to moderate distress) and  >30 or more (highly distressed). Univariate and multivariate logistic regression models identified factors independently associated with high K-10 scores for men and women separately. In total, 755 detainees, 576 (76%) men and 179 (24%) women, participated in the health survey. The study found 11.6% men versus 11.2% women detainees experienced high psychological distress, but no significant gender differences were observed (p> 0.05). Multivariate logistic regression showed that multiple physical health problems were significantly associated with high psychological distress among men. Drug treatment and forensic mental health services need to be established in detention centres in China to treat more than 10% of detainees with drug use and mental health disorders.

A latent class regression analysis of men's conformity to masculine norms and psychological distress.

PubMed

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

2012-01-01

How are specific dimensions of masculinity related to psychological distress in specific groups of men? To address this question, the authors used latent class regression to assess the optimal number of latent classes that explained differential relationships between conformity to masculine norms and psychological distress in a racially diverse sample of 223 men. The authors identified a 2-class solution. Both latent classes demonstrated very different associations between conformity to masculine norms and psychological distress. In Class 1 (labeled risk avoiders; n = 133), conformity to the masculine norm of risk-taking was negatively related to psychological distress. In Class 2 (labeled detached risk-takers; n = 90), conformity to the masculine norms of playboy, self-reliance, and risk-taking was positively related to psychological distress, whereas conformity to the masculine norm of violence was negatively related to psychological distress. A post hoc analysis revealed that younger men and Asian American men (compared with Latino and White American men) had significantly greater odds of being in Class 2 versus Class 1. The implications of these findings for future research and clinical practice are examined. (c) 2012 APA, all rights reserved.

Reducing psychological distress in patients undergoing chemotherapy.

PubMed

Milanti, Ariesta; Metsälä, Eija; Hannula, Leena

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

Distress Behavior in Children With Leukemia Undergoing Medical Procedures.

ERIC Educational Resources Information Center

Katz, Ernest R.

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

Diabetes distress may adversely affect the eating styles of women with type 1 diabetes

PubMed Central

Quinn, Laurie; Hacker, Eileen; Park, Hanjong; Kujath, Amber S.

2015-01-01

The aim of this study was to determine the relationships among diabetes distress, fear of hypoglycemia, and eating styles in women with type 1 diabetes (T1DM). Fifteen women (mean age 37 ± 13.5 years) with T1DM completed surveys measuring diabetes distress, fear of hypoglycemia (FOH), and eating style. Height, weight, and A1C were obtained, and open-ended comments regarding hypoglycemic concerns and experiences were recorded. Diabetes distress was positively associated with A1C (r = .655, p = .008). High levels of external (73 %), emotional (47 %), and restrained (53 %) eating styles were reported. Emotional and external eating styles were positively associated with diabetes distress (r = .575 and r = .622; p <.05). Those with poorer glycemic control (A1C ≥ 7 %; 53 mmol/mol) had higher levels of restrained eating behavior (F = 10.69, p = .006) and greater interpersonal distress (F = 5.916, p = .03) than those with better glycemic control (A1C < 7 %; 53 mmol/mol). A nonlinear relationship was identified between interpersonal distress and FOH (behavior subscale, p = .0383) indicating that fewer behavioral approaches were employed to avoid hypoglycemia at higher distress levels. The women in this sample were emotionally burdened by their disease. Distress was associated with eating styles linked with overeating and poor glycemic control. High levels of emotional and external eating styles may have important clinical implications for those with T1DM. PMID:24615054

Behavior Problems in Postinstitutionalized Romanian Adoptees: Explanatory Parameters in the Adoptive Home

ERIC Educational Resources Information Center

Le Mare, Lucy; Audet, Karyn

2014-01-01

We examined behavior problems in 80 adolescents (39 male; mean age = 15.74 years) adopted in early childhood by Canadians from globally depriving Romanian institutions. Overall, rates of clinically significant behavior problems were comparable to rates found in younger postinstitutionalized adopted children. The association between duration of…

The international "Balint" Award--a rising opportunity for Romanian medical students.

PubMed

Lală, Adrian; Bobîrnac, Geo; Tipa, Raluca

2010-01-01

The International "Balint" Award for students, instituted by the Foundation for Psychosomatic and Social Medicine in honor of Michael and Enid Balint, has been a rising opportunity for Romanian medical and psychology students to achieve international fame. Romanian students have been among the winners of this award for the last 10 years, in competition with students from Ivy League and other illustrious universities. The "Ascona model" case presentation debates the psychological side of a medical case, while keeping in focus the diagnostic, pathology and treatment issues. This article focuses on explaining this type of case presentation in correlation with one of the papers submitted in the contest that has received this award in the 15th International Balint Congress. The exposed case is that of a 17-year-old boy presenting with apparent stupor encountered by an emergency mobile unit. The patient was suspected of substance abuse and overdose but these suspicions were denied by the clinical exam. Further encounters led to the conclusion that both the boy and his whole family needed psychotherapy counseling and were referred there with great success.

Maternal psychological distress and child decision-making.

PubMed

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

2017-08-15

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

Medical student depression, anxiety and distress outside North America: a systematic review.

PubMed

Hope, Valerie; Henderson, Max

2014-10-01

North American medical students are more depressed and anxious than their peers. In the UK, the regulator now has responsibility for medical students, which may potentially increase scrutiny of their health. This may either help or hinder medical students in accessing appropriate care. The prevalences of anxiety, depression and psychological distress in medical students outside North America are not clear. A better understanding of the prevalence of, risk factors for and results of psychological distress will guide the configuration of support services, increasingly available for doctors, for medical students too. The aim of this study was to examine the prevalences of depression, anxiety and psychological distress in students in medical schools in the UK, Europe and elsewhere in the English-speaking world outside North America. A systematic review was conducted using search terms encompassing psychological distress amongst medical students. OvidSP was used to search the following databases: Ovid MEDLINE (R) from 1948 to October 2013; PsycINFO from 1806 to October 2013, and EMBASE from 1980 to October 2013. Results were restricted to medical schools in Europe and the English-speaking world outside North America, and were evaluated against a set of inclusion criteria including the use of validated assessment tools. The searches identified 29 eligible studies. Prevalences of 7.7-65.5% for anxiety, 6.0-66.5% for depression and 12.2-96.7% for psychological distress were recorded. The wide range of results reflects the variable quality of the studies. Almost all were cross-sectional and many did not mention ethical approval. Better-quality studies found lower prevalences. There was little information on the causes or consequences of depression or anxiety. Prevalences of psychological distress amongst medical students outside North America are substantial. Future research should move on from simple cross-sectional studies to better-quality longitudinal work which can

Assessing and addressing moral distress and ethical climate Part II: neonatal and pediatric perspectives.

PubMed

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

2015-01-01

Moral distress remains a pervasive and, at times, contested concept in nursing and other health care disciplines. Ethical climate, the conditions and practices in which ethical situations are identified, discussed, and decided, has been shown to exacerbate or ameliorate perceptions of moral distress. The purpose of this mixed-methods study was to explore perceptions of moral distress, moral residue, and ethical climate among registered nurses working in an academic medical center. Two versions of the Moral Distress Scale in addition to the Hospital Ethical Climate Survey were used, and participants were invited to respond to 2 open-ended questions. Part I reported the findings among nurses working in adult acute and critical care units. Part II presents the results from nurses working in pediatric/neonatal units. Significant differences in findings between the 2 groups are discussed. Subsequent interventions developed are also presented.

The Longitudinal Impact of Parent Distress and Behavior on Functional Outcomes Among Youth With Chronic Pain.

PubMed

Chow, Erika T; Otis, John D; Simons, Laura E

2016-06-01

Accumulating evidence supports the concurrent association between parent distress and behavior and child functioning in the context of chronic pain, with existing longitudinal studies limited to a pediatric surgical context that identify parent catastrophizing as influential. In this study, we examined how parent factors assessed at a multidisciplinary pediatric pain clinic evaluation affect child psychological and functional outcomes over time. A cohort of 195 patients with chronic pain (ages 8-17 years) and their parents who presented for a multidisciplinary evaluation completed measures at baseline and at 4-month follow-up. Patients completed measures of pain catastrophizing, pain-related fear and avoidance, generalized anxiety, depressive symptoms, and functional disability. Parents completed measures of pain catastrophizing, pain-related fear and avoidance, and protective responses to child pain. Parent-reported child school functioning was also collected. Parent distress and behavior was concurrently associated with child distress and functioning at evaluation. After controlling for baseline child functioning, baseline parent avoidance and protective behavior emerged as significant predictors of child functioning at 4-month follow-up. Parent distress and behavior influence child distress and functioning over time and these findings identify key parent domains to target in the context of a child's pain treatment. Parent behavior, specifically avoidance and protective responses, influence child distress and functioning over time. Child pain treatment interventions should include influential parent factors to ensure successful outcomes. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

Psychological distress and work and home roles: a focus on socio-economic differences in distress.

PubMed

Matthews, S; Power, C; Stansfeld, S A

2001-05-01

Home and work factors have been linked to psychological status, but less is known about their contribution to social inequalities in psychological status. We examine whether social inequalities in psychological distress can be explained by work-home factors and whether the impact of these potential explanatory factors is similar for men and women. Data are from the 1958 British birth cohort study. We sought to explain social class differences in psychological distress at age 33. Explanatory factors were classified as work-home roles: i.e. employment, marital status, domestic responsibility, children and elderly care; and work-home characteristics: i.e. job-strain, insecurity, unsocial working hours, youngest child's age, number of children and level of involvement in childcare. A social gradient in psychological distress was found: odds ratios for classes IV and V v. I and II were 2.65 (men) and 3.02 (women). Work factors had consistently stronger associations with psychological distress and with social class among men than women. Work factors had a greater impact on class differences in psychological distress in men. Associations for home roles and characteristics were less consistent and their combined effect on class differences in distress was negligible for both sexes. Explanations for the social gradient differ for men and women. Work may be more important for men than women, but the impact of home factors was not strong during the early adulthood of this cohort.

A meta-analysis of the relationship between rational beliefs and psychological distress.

PubMed

Oltean, Horea-Radu; David, Daniel Ovidiu

2018-06-01

 Rational emotive behavior therapy (REBT) model of psychological health assumes that rational beliefs cause functional emotions and adaptive behavior, but the presumed role of rational beliefs as protective factor against psychological distress/disorders is still in debate. An important step in validating an evidence-based therapy is to investigate the underling theoretical assumptions. Thus, the aim of the present meta-analysis is to investigate the direction and magnitude of the relationship between rational beliefs and psychological distress.  Our search identified 26 studies that met our criteria. We evaluated the effect size using the random-effects model and we tested the moderator role of several variables. The overall results revealed a medium negative association between rational beliefs and psychological distress, r = -0.31. The strongest association was found for unconditional acceptance beliefs (r = -0.41). The results add empirical evidence for the underling theory of REBT and revealed that the strength of the association between rational beliefs and distress is robust for a wide range of emotional problems. Therefore, rational beliefs could be a trans-diagnostic protective factor against distress. Moreover, results emphasized that rational beliefs type is an important factor, suggesting an increased focus in therapy on the developing of unconditional acceptance and self-acceptance beliefs. © 2017 Wiley Periodicals, Inc.

The Romanian-English Contrastive Analysis Project; Reports and Studies, Vol. 1.

ERIC Educational Resources Information Center

Slama-Cazacu, Tatiana, Ed.; And Others

The first volume of this series is divided into reports, studies, and preliminary results of work in progress. All were presented at a meeting on contrastive linguistics held in Romania. The project is intended to reveal the specificity of the structures and systems of Romanian and English with a view to comparing them and, on that basis,…

Evaluation of a Peer-Led Smoking Prevention Programme for Romanian Adolescents

ERIC Educational Resources Information Center

Lotrean, L. M.; Dijk, F.; Mesters, I.; Ionut, C.; De Vries, H.

2010-01-01

The goal of this study was to assess the effects of a school-based smoking prevention programme that used both a video and peer-led discussion groups among Romanian junior high school students aged 13-14 years. The programme embraced the social influence approach and concentrated on enhancing self-efficacy and the acquisition of cigarette refusal…

Civil Society and Control of Corruption: Assessing Governance of Romanian Public Universities

ERIC Educational Resources Information Center

Mungiu-Pippidi, Alina; Dusu, Andra Elena

2011-01-01

Romania is perceived as the most corrupt EU member state according to Transparency International Corruption Perception Index. In 2008-2009, a grassroots coalition of civil society organizations and education stakeholders created the Coalition for Clean Universities which organized the first assessment of integrity of the Romanian higher education…

Higher education and psychological distress: a 27-year prospective cohort study in Sweden.

PubMed

Brännlund, Annica; Hammarström, Anne

2014-03-01

Research identifies a positive link between education and a reduction of psychological distress, but few studies have analysed the long-term impact of education on psychological distress. This study followed the same cohort for 27 years, investigating the association between education and adult psychological distress. Further, it discuss whether the link can be understood through the mediating mechanisms of social and labour-market resources, furthermore, if the mechanisms operate differently for men and women. A 27-year prospective cohort study was performed at ages 16, 18, 21, 30 and 43. The cohort consisted of all students (n = 1083, of which 1001 are included in this study) in their final year of compulsory school in Sweden. Data were collected through comprehensive questionnaires (response rate 96.4%), and analysed with OLS regression, with psychological distress at age 21, 30 and 43 as dependent variable. Baseline psychological distress, measures of social and labour-market resources, and possible educational selection factors were used as independent variables. To compare the overall magnitude of educational differences, a kappa index was calculated. A positive relation between higher education and less psychological distress was found. When becoming older this relation weakens and a link between social and labour-market resources and psychological distress is observed, indicating that education in a long-term perspective operates through the suggested mechanisms. Additionally, the mechanisms work somewhat differently for men than for women: labour-market resources were significant for men and social resources were important for women. higher education is positively linked to less psychological distress, and the link can somewhat be understood through the mechanisms of social and labour-market resources.

Psychological distress is associated with a range of high-priority health conditions affecting working Australians.

PubMed

Holden, Libby; Scuffham, Paul; Hilton, Michael; Vecchio, Nerina; Whiteford, Harvey

2010-06-01

Psychological distress is growing in prevalence in Australia. Comorbid psychological distress and/or depressive symptoms are often associated with poorer health, higher healthcare utilisation and decreased adherence to medical treatments. The Australian Work Outcomes Research Cost-benefit (WORC) study cross-sectional screening dataset was used to explore the association between psychological distress and a range of health conditions in a sample of approximately 78,000 working Australians. The study uses the World Health Organization Health and Productivity Questionnaire (HPQ), to identify self-reported health status. Within the HPQ is the Kessler 6 (K6), a six-item scale of psychological distress which strongly discriminates between those with and without a mental disorder. Potential confounders of age, sex, marital status, number of children, education level and annual income were included in multivariate logistic regression models. Psychological distress was significantly associated with all investigated health conditions in both crude and adjusted estimates. The conditions with the strongest adjusted association were, in order from highest: drug and alcohol problems, fatigue, migraine, CVD, COPD, injury and obesity. Psychological distress is strongly associated with all 14 health conditions or risk factors investigated in this study. Comorbid psychological distress is a growing public health issue affecting Australian workers.

Who Is Experiencing What Kind of Moral Distress? Distinctions for Moving from a Narrow to a Broad Definition of Moral Distress.

PubMed

Fourie, Carina

2017-06-01

Moral distress, according to Andrew Jameton's highly influential definition, occurs when a nurse knows the morally correct action to take but is constrained in some way from taking this action. The definition of moral distress has been broadened, first, to include morally challenging situations that give rise to distress but which are not necessarily linked to nurses feeling constrained, such as those associated with moral uncertainty. Second, moral distress has been broadened so that it is not confined to the experiences of nurses. However, such a broadening of the concept does not mean that the kind of moral distress being experienced, or the role of the person experiencing it, is morally irrelevant. I argue that differentiating between categories of distress-e.g., constraint and uncertainty-and between groups of health professionals who might experience moral distress is potentially morally relevant and should influence the analysis, measurement, and amelioration of moral distress in the clinic. © 2017 American Medical Association. All Rights Reserved.

Management of Psychosocial Distress by Oncologists

PubMed Central

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

2010-01-01

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

The outcomes of children with pediatric acute respiratory distress syndrome: proceedings from the Pediatric Acute Lung Injury Consensus Conference.

PubMed

Quasney, Michael W; López-Fernández, Yolanda M; Santschi, Miriam; Watson, R Scott

2015-06-01

To provide additional details and evidence behind the recommendations for outcomes assessment of patients with pediatric acute respiratory distress syndrome from the Pediatric Acute Lung Injury Consensus Conference. Consensus conference of experts in pediatric acute lung injury. A panel of 27 experts met over the course of 2 years to develop a taxonomy to define pediatric acute respiratory distress syndrome and to make recommendations regarding treatment and research priorities. The outcomes subgroup comprised four experts. When published data were lacking, a modified Delphi approach emphasizing strong professional agreement was used. The Pediatric Acute Lung Injury Consensus Conference experts developed and voted on a total of 151 recommendations addressing the topics related to pediatric acute respiratory distress syndrome, seven of which related to outcomes after pediatric acute respiratory distress syndrome. All seven recommendations had strong agreement. Children with acute respiratory distress syndrome continue to have a high mortality, specifically, in relation to certain comorbidities and etiologies related to pediatric acute respiratory distress syndrome. Comorbid conditions, such as an immunocompromised state, increase the risk of mortality even further. Likewise, certain etiologies, such as non-pulmonary sepsis, also place children at a higher risk of mortality. Significant long-term effects were reported in adult survivors of acute respiratory distress syndrome: diminished lung function and exercise tolerance, reduced quality of life, and diminished neurocognitive function. Little knowledge of long-term outcomes exists in children who survive pediatric acute respiratory distress syndrome. Characterization of the longer term consequences of pediatric acute respiratory distress syndrome in children is vital to help identify opportunities for improved therapeutic and rehabilitative strategies that will lessen the long-term burden of pediatric acute

Intermittent fasting could ameliorate cognitive function against distress by regulation of inflammatory response pathway.

PubMed

Shojaie, Marjan; Ghanbari, Farzane; Shojaie, Nasrin

2017-11-01

Undesirable and desirable effects of stressors on the body are assigned to distress and eustress, respectively. Immune system and brain are the most susceptible parts to stressful conditions, whereas long-lasting alterations in putative immune proteins involved in tension such as corticosterone (CORT), interleukin 6 (IL-6), and tumor necrosis factor-alpha (TNF-α) can impact learning and memory. Intermittent fasting (IF) is a repeated regular cycle of dietary restriction with well-known beneficial properties on the body. The aim of this study was to identify the eustress effects of IF on cognitive function by assessing the critical inflammatory factors in chronic distress. Forty male mice were divided into four groups (n = 10/group). Distress and control normally received food and water, whereas IF and IF with distress groups were daily deprived of food and water for two hours. In the second week, the electrical foot shock was induced to distress and IF with distress groups. Finally, the cognitive functions of all mice were evaluated by Barnes maze, their blood samples were taken to determine the plasma level of CORT, IL-6 and TNF-α, and the removed brain and adrenal glands were weighed in the third week. A significant gain in plasma level of CORT, IL-6 and TNF-α with a considerable brain hypotrophy and adrenal hypertrophy was found in distress group, whereas IF caused a remarkable reduction of the plasma inflammatory factors, especially in IF with distress mice ( P  ≤ 0.05). In conclusion, IF could improve cognitive function and preserve the brain against distress by regulation of inflammatory response pathway.

Work factors and psychological distress in nurses' aides: a prospective cohort study

PubMed Central

Eriksen, Willy; Tambs, Kristian; Knardahl, Stein

2006-01-01

Background Nurses' aides (assistant nurses), the main providers of practical patient care in many countries, are doing both emotional and heavy physical work, and are exposed to frequent social encounters in their job. There is scarce knowledge, though, of how working conditions are related to psychological distress in this occupational group. The aim of this study was to identify work factors that predict the level of psychological distress in nurses' aides. Methods The sample of this prospective study comprised 5076 Norwegian nurses' aides, not on leave when they completed a mailed questionnaire in 1999. Of these, 4076 (80.3 %) completed a second questionnaire 15 months later. A wide spectrum of physical, psychological, social, and organisational work factors were measured at baseline. Psychological distress (anxiety and depression) was assessed at baseline and follow-up by the SCL-5, a short version of Hopkins Symptom Checklist-25. Results In a linear regression model of the level of psychological distress at follow-up, with baseline level of psychological distress, work factors, and background factors as independent variables, work factors explained 2 % and baseline psychological distress explained 34 % of the variance. Exposures to role conflicts, exposures to threats and violence, working in apartment units for the aged, and changes in the work situation between baseline and follow-up that were reported to result in less support and encouragement were positively associated with the level of psychological distress. Working in psychiatric departments, and changes in the work situation between baseline and follow-up that gave lower work pace were negatively associated with psychological distress. Conclusion The study suggests that work factors explain only a modest part of the psychological distress in nurses' aides. Exposures to role conflicts and threats and violence at work may contribute to psychological distress in nurses' aides. It is important that

47 CFR 80.1114 - False distress alerts.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 5 2014-10-01 2014-10-01 false False distress alerts. 80.1114 Section 80.1114 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and Safety System (GMDSS) Operating Procedures for Distress and...

47 CFR 80.1114 - False distress alerts.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 5 2012-10-01 2012-10-01 false False distress alerts. 80.1114 Section 80.1114 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and Safety System (GMDSS) Operating Procedures for Distress and...

13 CFR 301.3 - Economic distress levels.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false Economic distress levels. 301.3 Section 301.3 Business Credit and Assistance ECONOMIC DEVELOPMENT ADMINISTRATION, DEPARTMENT OF COMMERCE ELIGIBILITY, INVESTMENT RATE AND APPLICATION REQUIREMENTS Economic Distress Criteria § 301.3 Economic distress...

13 CFR 301.3 - Economic distress levels.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 13 Business Credit and Assistance 1 2013-01-01 2013-01-01 false Economic distress levels. 301.3 Section 301.3 Business Credit and Assistance ECONOMIC DEVELOPMENT ADMINISTRATION, DEPARTMENT OF COMMERCE ELIGIBILITY, INVESTMENT RATE AND APPLICATION REQUIREMENTS Economic Distress Criteria § 301.3 Economic distress...

13 CFR 301.3 - Economic distress levels.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 13 Business Credit and Assistance 1 2014-01-01 2014-01-01 false Economic distress levels. 301.3 Section 301.3 Business Credit and Assistance ECONOMIC DEVELOPMENT ADMINISTRATION, DEPARTMENT OF COMMERCE ELIGIBILITY, INVESTMENT RATE AND APPLICATION REQUIREMENTS Economic Distress Criteria § 301.3 Economic distress...

13 CFR 301.3 - Economic distress levels.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 13 Business Credit and Assistance 1 2012-01-01 2012-01-01 false Economic distress levels. 301.3 Section 301.3 Business Credit and Assistance ECONOMIC DEVELOPMENT ADMINISTRATION, DEPARTMENT OF COMMERCE ELIGIBILITY, INVESTMENT RATE AND APPLICATION REQUIREMENTS Economic Distress Criteria § 301.3 Economic distress...

Piracetam for fetal distress in labour.

PubMed

Hofmeyr, G Justus; Kulier, Regina

2012-06-13

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

Perfectionism, procrastination, and psychological distress.

PubMed

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

2012-04-01

Using a cross-panel design and data from 2 successive cohorts of college students (N = 357), we examined the stability of maladaptive perfectionism, procrastination, and psychological distress across 3 time points within a college semester. Each construct was substantially stable over time, with procrastination being especially stable. We also tested, but failed to support, a mediational model with Time 2 (mid-semester) procrastination as a hypothesized mechanism through which Time 1 (early-semester) perfectionism would affect Time 3 (end-semester) psychological distress. An alternative model with Time 2 perfectionism as a mediator of the procrastination-distress association also was not supported. Within-time analyses revealed generally consistent strength of effects in the correlations between the 3 constructs over the course of the semester. A significant interaction effect also emerged. Time 1 procrastination had no effect on otherwise high levels of psychological distress at the end of the semester for highly perfectionistic students, but at low levels of Time 1 perfectionism, the most distressed students by the end of the term were those who were more likely to have procrastinated earlier in the semester. Implications of the stability of the constructs and their association over time, as well as the moderating effects of procrastination, are discussed in the context of maladaptive perfectionism and problematic procrastination.

High level of distress in long-term survivors of thyroid carcinoma: results of rapid screening using the distress thermometer.

PubMed

Roerink, Sean H P P; de Ridder, Mischa; Prins, Judith; Huijbers, Angelique; de Wilt, Hans J H; Marres, Henri; Repping-Wuts, Han; Stikkelbroeck, Nike M M L; Timmers, Henri J; Hermus, Ad R M M; Netea-Maier, Romana T

2013-01-01

Cancer patients are at increased risk for distress. The Distress Thermometer (DT) and problem list (PL) are short-tools validated and recommended for distress screening in cancer patients. To investigate the level of distress and problems experienced by survivors of differentiated non-medullary thyroid carcinoma (DTC), using the DT and PL and whether this correlates with clinical and demographical variables. All 205 DTC patients, under follow-up at the outpatient clinic of our university hospital, were asked to fill in the DT and PL, hospital anxiety and depression scale (HADS), illness cognition questionnaire (ICQ) and an ad hoc questionnaire. Receiver Operator Characteristic analysis (ROC) was used to establish the optimal DT cut-off score according to HADS. Correlations of questionnaires scores with data on diagnosis, treatment and follow-up collected from medical records were analyzed. Of the 159 respondents, 145 agreed to participate [118 in remission, median follow-up 7.2 years (range 3 months-41 years)]. Of these, 34.3% rated their distress score ≥5, indicating clinically relevant distress according to ROC analysis. Patients reported physical (86%) over emotional problems (76%) as sources of distress. DT scores correlated with HADS scores and ICQ subscales. No significant correlations were found between DT scores and clinical or demographical characteristics except for employment status. Prevalence of distress is high among patients with DTC even after long-term remission and cannot be predicted by clinical and demographical characteristics. DT and PL are useful screening instruments for distress in DTC patients and could easily be incorporated into daily practice.

Is Overall Mortality the Right Composite Endpoint in Clinical Trials of Acute Respiratory Distress Syndrome?

PubMed

Villar, Jesús; Martínez, Domingo; Mosteiro, Fernando; Ambrós, Alfonso; Añón, José M; Ferrando, Carlos; Soler, Juan A; Montiel, Raquel; Vidal, Anxela; Conesa-Cayuela, Luís A; Blanco, Jesús; Arrojo, Regina; Solano, Rosario; Capilla, Lucía; Del Campo, Rafael; Civantos, Belén; Fernández, María Mar; Aldecoa, César; Parra, Laura; Gutiérrez, Andrea; Martínez-Jiménez, Chanel; González-Martín, Jesús M; Fernández, Rosa L; Kacmarek, Robert M

2018-06-01

Overall mortality in patients with acute respiratory distress syndrome is a composite endpoint because it includes death from multiple causes. In most acute respiratory distress syndrome trials, it is unknown whether reported deaths are due to acute respiratory distress syndrome or the underlying disease, unrelated to the specific intervention tested. We investigated the causes of death after contracting acute respiratory distress syndrome in a large cohort. A secondary analysis from three prospective, multicenter, observational studies. A network of multidisciplinary ICUs. We studied 778 patients with moderate-to-severe acute respiratory distress syndrome treated with lung-protective ventilation. None. We examined death in the ICU from individual causes. Overall ICU mortality was 38.8% (95% CI, 35.4-42.3). Causes of acute respiratory distress syndrome modified the risk of death. Twenty-three percent of deaths occurred from refractory hypoxemia due to nonresolving acute respiratory distress syndrome. Most patients died from causes unrelated to acute respiratory distress syndrome: 48.7% of nonsurvivors died from multisystem organ failure, and cancer or brain injury was involved in 37.1% of deaths. When quantifying the true burden of acute respiratory distress syndrome outcome, we identified 506 patients (65.0%) with one or more exclusion criteria for enrollment into current interventional trials. Overall ICU mortality of the "trial cohort" (21.3%) was markedly lower than the parent cohort (relative risk, 0.55; 95% CI, 0.43-0.70; p < 0.000001). Most deaths in acute respiratory distress syndrome patients are not directly related to lung damage but to extrapulmonary multisystem organ failure. It would be challenging to prove that specific lung-directed therapies have an effect on overall survival.

Burnout, Moral Distress, Work-Life Balance, and Career Satisfaction among Hematopoietic Cell Transplantation Professionals.

PubMed

Neumann, Joyce L; Mau, Lih-Wen; Virani, Sanya; Denzen, Ellen M; Boyle, Deborah A; Boyle, Nancy J; Dabney, Jane; De KeselLofthus, Alexandra; Kalbacker, Marion; Khan, Tippu; Majhail, Navneet S; Murphy, Elizabeth A; Paplham, Pamela; Parran, Leslie; Perales, Miguel-Angel; Rockwood, Todd H; Schmit-Pokorny, Kim; Shanafelt, Tait D; Stenstrup, Elaine; Wood, William A; Burns, Linda J

2018-04-01

A projected shortage of hematopoietic cell transplantation (HCT) health professionals was identified as a major issue during the National Marrow Donor Program/Be The Match System Capacity Initiative. Work-related distress and work-life balance were noted to be potential barriers to recruitment/retention. This study examined these barriers and their association with career satisfaction across HCT disciplines. A cross-sectional, 90-item, web-based survey was administered to advanced practice providers, nurses, physicians, pharmacists, and social workers in 2015. Participants were recruited from membership lists of 6 professional groups. Burnout (measured with the Maslach Burnout Inventory subscales of emotional exhaustion and depersonalization) and moral distress (measured by Moral Distress Scale-Revised) were examined to identify work-related distress. Additional questions addressed demographics, work-life balance, and career satisfaction. Of 5759 HCT providers who received an individualized invitation to participate, 914 (16%) responded; 627 additional participants responded to an open link survey. Significant differences in demographic and practice characteristics existed across disciplines (P < .05). The prevalence of burnout differed across disciplines (P < .05) with an overall prevalence of 40%. Over one-half of pharmacists had burnout, whereas social workers had the lowest prevalence at less than one-third. Moral distress scores ranged from 0 to 336 and varied by discipline (P < .05); pharmacists had the highest mean score (62.9 ± 34.8) and social workers the lowest (42.7 ± 24.4). In multivariate and univariate analyses, variables contributing to burnout varied by discipline; however, moral distress was a significant contributing factor for all providers. Those with burnout were more likely to report inadequate work-life balance and a low level of career satisfaction; however, overall there was a high level of career satisfaction across

Competences in Romanian Higher Education--An Empirical Investigation for the Business Sector

ERIC Educational Resources Information Center

Deaconu, Adela; Nistor, Cristina Silvia

2017-01-01

This research study particularizes the general descriptions of the European Qualifications Framework for Lifelong Learning, as compiled and developed within the Romanian qualification framework, to the business and economics field in general and to the property economic analysis and valuation field in particular. By means of an empirical analysis,…

Factors associated with psychological distress amongst outpatient chemotherapy patients: An analysis of depression, anxiety and stress using the DASS-21.

PubMed

McMullen, Michelle; Lau, Peter K H; Taylor, Scott; McTigue, Joseph; Cook, Angus; Bamblett, Marion; Hasani, Arman; Johnson, Claire E

2018-04-01

This study sought to identify clinical, demographic and service-related factors associated with psychological distress amongst outpatient chemotherapy patients. Distress in cancer patients leads to increased risk of psychological comorbidity, contributing to sub-optimal treatment adherence and potentially leading to poorer health outcomes. Screening and recognition of distress and risk factors is an important aspect of holistic care within a multidisciplinary team environment. Data were obtained via survey and chart review of ambulatory chemotherapy patients at three public tertiary referral hospitals in Perth, Western Australia. The DASS-21 was used to screen for psychological distress. Regression analyses were used to assess the relationship between distress and a range of cancer, socioeconomic and treatment factors. Patients with a Karnofsky Performance Score≤80 (OR 3.8, 95% CI [1.7, 78.7]) and average waiting time (between oncology outpatient appointment and commencement of chemotherapy infusion) >60min (OR 2.4, 95% CI [1.04, 5.5]) were at increased risk of moderate-severe distress. Patients with a household income between $AU 50-75,000 p.a. had a lower risk of distress compared to <$25,000 p.a. (OR 0.05, 95% CI [0.01, 0.52]). On sub-scale analysis, depression and anxiety contributed more to overall distress than the stress subscales. Performance status, waiting times and household income were key predictors of distress. Findings could assist clinicians to identify higher-risk population subsets that could benefit from targeted screening and additional psychological and social work support. Findings could also assist administrators to consider the contribution of modifiable factors such as waiting times to patient distress. Copyright © 2017 Elsevier Inc. All rights reserved.

Pregnancy-specific distress: the role of maternal sense of coherence and antenatal mothering orientations.

PubMed

Staneva, Aleksandra; Morawska, Alina; Bogossian, Fiona; Wittkowski, Anja

2016-10-01

Maternal mental health during pregnancy has been identified as a key factor in the future physiological, emotional and social development of both the mother and her baby. Yet little is known about the factors that contribute to increased levels of pregnancy-specific distress. The present study investigated the role of two psychosocial and personality-based constructs, namely women's sense of coherence (SoC) and their mothering orientations, on their pregnancy-specific distress. During their second trimester of pregnancy, 293 Australian and New Zealand women participated in an online study. Hierarchical multiple regression analysis was used to determine the unique contribution of women's SoC (Sense of Coherence Scale, SoC 13) and their antenatal mothering orientation (Antenatal Mothering Orientation Measure-Revised, AMOM-R) to pregnancy-specific distress (Revised Prenatal Distress Questionnaire, NuPDQ). Low SoC was the best determinant of women's pregnancy-specific distress, accounting for over 45% of the variance (β = -0.33, p < 0.001, 95% CI [-0.43, -0.23]). A Regulator mothering orientation was correlated with distress but did not have a unique contribution in the final model. This study further highlights the importance of better understanding women's perceptions of emotional health and their mothering role while taking into consideration their wider social context.

Social support, marital adjustment, and psychological distress among women with primary infertility in Pakistan.

PubMed

Qadir, Farah; Khalid, Amna; Medhin, Girmay

2015-01-01

This study aimed to identify prevalence rates of psychological distress among Pakistani women seeking help for primary infertility. The associations of social support, marital adjustment, and sociodemographic factors with psychological distress were also examined. A total of 177 women with primary infertility were interviewed from one hospital in Islamabad using a Self-Reporting Questionnaire, the Multidimensional Scale of Perceived Social Support, and the Locke-Wallace Marital Adjustment Test. The data were collected between November 2012 and March 2013. The prevalence of psychological distress was 37.3 percent. The results of the logistic regression suggested that marital adjustment and social support were significantly negatively associated with psychological distress in this sample. These associations were not confounded by any of the demographic variables controlled in the multivariable regression models. The role of perceived social support and adjustment in marriage among women experiencing primary infertility are important factors in understanding their psychological distress. The results of this small-scale effort highlight the need for social and familial awareness to help tackle the psychological distress related to infertility. Future research needs to focus on the way the experience of infertility is conditioned by social structural realities. New ways need to be developed to better take into account the process and nature of the infertility experience.

Life after cancer: how does public stigma increase psychological distress of childhood cancer survivors?

PubMed

Kim, Min Ah; Yi, Jaehee

2014-12-01

Public stigma is a major source of stress for cancer survivors. However, factors that buffer or exacerbate the negative effects of public stigma on psychological distress have not been elucidated. This study examined how perceived public stigma affects psychological distress as mediated by cancer disclosure, internalized reactions to stigma, and social support availability. Cross-sectional study. The study was conducted in South Korea. The study sample was 223 adolescent and young adult survivors of childhood cancer diagnosed before the age of 19 and currently between 15 and 39 years old. Psychological distress was assessed using the Brief Symptom Inventory-18. Structural equation modeling was used with 1000 bootstrap samples. The goodness of model fit was acceptable. Public stigma perceived by cancer survivors influenced psychological distress via cancer disclosure, internalized shame, and social support availability. Higher levels of perceived public stigma predicted higher levels of internalized shame and self-blame and lower levels of social support availability, which subsequently increased psychological distress. Higher levels of perceived public stigma predicted lower levels of disclosure about cancer history and experiences. Cancer disclosure indirectly ameliorated psychological distress by reducing internalized shame. This study offers evidence that cognitive and social factors play important roles in mediating the effects of perceived public stigma on psychological distress in Korean cancer survivors. A greater understanding of factors that influence psychological distress may help psychosocial oncology service providers to identify childhood cancer survivors in need of psychosocial services and provide them with appropriate resources and interventions. Copyright © 2014 Elsevier Ltd. All rights reserved.

Acute respiratory distress syndrome: an audit of incidence and outcome in Scottish intensive care units.

PubMed

Hughes, M; MacKirdy, F N; Ross, J; Norrie, J; Grant, I S

2003-09-01

This prospective audit of incidence and outcome of the acute respiratory distress syndrome was conducted as part of the national audit of intensive care practice in Scotland. All patients with acute respiratory distress syndrome in 23 adult intensive care units were identified using the diagnostic criteria defined by the American-European Consensus Conference. Daily data collection was continued until death or intensive care unit discharge. Three hundred and sixty-nine patients were diagnosed with acute respiratory distress syndrome over the 8-month study period. The frequency of acute respiratory distress syndrome in the intensive care unit population was 8.1%; the incidence in the Scottish population was estimated at 16.0 cases.100,000(-1).year(-1). Intensive care unit mortality for acute respiratory distress syndrome was 53.1%, with a hospital mortality of 60.9%. In our national unselected population of critically ill patients, the overall outcome is comparable with published series (Acute Physiology and Chronic Health Evaluation II standardised mortality ratio = 0.99). However, mortality from acute respiratory distress syndrome in Scotland is substantially higher than in recent other series suggesting an improvement in outcome in this condition.

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

PubMed

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

2017-06-01

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

Perceived organizational support and moral distress among nurses.

PubMed

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

2018-01-01

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

46 CFR 169.553 - Pyrotechnic distress signals.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

46 CFR 169.553 - Pyrotechnic distress signals.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 7 2011-10-01 2011-10-01 false Pyrotechnic distress signals. 169.553 Section 169.553... Lifesaving and Firefighting Equipment Additional Lifesaving Equipment § 169.553 Pyrotechnic distress signals. (a) All pyrotechnic distress signals must be of an approved type. (b) Replacement must be made no...

46 CFR 169.553 - Pyrotechnic distress signals.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 7 2014-10-01 2014-10-01 false Pyrotechnic distress signals. 169.553 Section 169.553... Lifesaving and Firefighting Equipment Additional Lifesaving Equipment § 169.553 Pyrotechnic distress signals. (a) All pyrotechnic distress signals must be of an approved type. (b) Replacement must be made no...

46 CFR 169.553 - Pyrotechnic distress signals.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 7 2013-10-01 2013-10-01 false Pyrotechnic distress signals. 169.553 Section 169.553... Lifesaving and Firefighting Equipment Additional Lifesaving Equipment § 169.553 Pyrotechnic distress signals. (a) All pyrotechnic distress signals must be of an approved type. (b) Replacement must be made no...

46 CFR 169.553 - Pyrotechnic distress signals.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 7 2012-10-01 2012-10-01 false Pyrotechnic distress signals. 169.553 Section 169.553... Lifesaving and Firefighting Equipment Additional Lifesaving Equipment § 169.553 Pyrotechnic distress signals. (a) All pyrotechnic distress signals must be of an approved type. (b) Replacement must be made no...

Generational Differences in Internalized Transnegativity and Psychological Distress Among Feminine Spectrum Transgender People.

PubMed

Jackman, Kasey B; Dolezal, Curtis; Bockting, Walter O

2018-01-01

This study examined internalized transnegativity and psychological distress in two age groups of transgender individuals who identified their gender identity on the feminine spectrum (rather than congruent with their male sex assigned at birth). Due to greater visibility and acceptance of gender diversity in the United States, we hypothesized that internalized transnegativity would be lower in the younger compared with the older group, and that the younger generation would, therefore, report lower levels of psychological distress than the older generation. The study sample consisted of trans-feminine individuals (N = 440) who completed a online survey of the U.S. transgender population and comprised a younger group aged 18-24 years (n = 133) and an older group aged 40 years and older (n = 307). Internalized transnegativity was assessed using the Transgender Identity Survey, and psychological distress was assessed with the Brief Symptom Inventory 18. We used regression and mediation analysis to examine differences between the two groups. Contrary to our expectations, the older group reported significantly lower levels of both internalized transnegativity and psychological distress compared with the younger group. Internalized transnegativity partially mediated the relationship between age group and psychological distress. Despite greater visibility of transgender people and increasing acceptance of gender diversity in the United States, the younger trans-feminine individuals reported more psychological distress than the older transfeminine individuals, which was, in part, related to internalized transnegativity. Trans-feminine individuals may benefit from culturally sensitive and clinically competent mental health services to alleviate internalized transnegativity and psychological distress.

Generational Differences in Internalized Transnegativity and Psychological Distress Among Feminine Spectrum Transgender People

PubMed Central

Dolezal, Curtis; Bockting, Walter O.

2018-01-01

Abstract Purpose: This study examined internalized transnegativity and psychological distress in two age groups of transgender individuals who identified their gender identity on the feminine spectrum (rather than congruent with their male sex assigned at birth). Due to greater visibility and acceptance of gender diversity in the United States, we hypothesized that internalized transnegativity would be lower in the younger compared with the older group, and that the younger generation would, therefore, report lower levels of psychological distress than the older generation. Methods: The study sample consisted of trans-feminine individuals (N = 440) who completed a online survey of the U.S. transgender population and comprised a younger group aged 18–24 years (n = 133) and an older group aged 40 years and older (n = 307). Internalized transnegativity was assessed using the Transgender Identity Survey, and psychological distress was assessed with the Brief Symptom Inventory 18. We used regression and mediation analysis to examine differences between the two groups. Results: Contrary to our expectations, the older group reported significantly lower levels of both internalized transnegativity and psychological distress compared with the younger group. Internalized transnegativity partially mediated the relationship between age group and psychological distress. Conclusion: Despite greater visibility of transgender people and increasing acceptance of gender diversity in the United States, the younger trans-feminine individuals reported more psychological distress than the older transfeminine individuals, which was, in part, related to internalized transnegativity. Trans-feminine individuals may benefit from culturally sensitive and clinically competent mental health services to alleviate internalized transnegativity and psychological distress. PMID:29099335

From distress guidelines to developing models of psychosocial care: current best practices.

PubMed

Clark, Paul G; Bolte, Sage; Buzaglo, Joanne; Golant, Mitch; Daratsos, Louisa; Loscalzo, Matthew

2012-01-01

Psychological distress has been recognized as having a significant effect upon cognitive and emotional functioning, quality of life, and in some populations increased costs of care. Screening for distress and provision of psychosocial care in oncology treatment settings has been identified as a future accreditation standard by the American College of Surgeons Commission on Cancer (CoC). Because there are few available models of programs of distress screening and referral to inform oncology social workers and other members of the psychosocial support team with planning their own programs, this article seeks to provide exemplars of best practices that are currently in place in four different settings where psychosocial support is provided to people living with cancer and their families. Each program will provide an overview of how it was successfully established and its contribution toward evolving evidence-informed best practices.

Measuring Computer Science Knowledge Level of Hungarian Students Specialized in Informatics with Romanian Students Attending a Science Course or a Mathematics-Informatics Course

ERIC Educational Resources Information Center

Kiss, Gabor

2012-01-01

An analysis of Information Technology knowledge of Hungarian and Romanian students was made with the help of a self developed web based Informatics Test. The goal of this research is an analysis of the Computer Science knowledge level of Hungarian and Romanian students attending a Science course or a Mathematics-Informatics course. Analysed was…

Reorienting Higher Education Pedagogical and Professional Development Curricula toward Sustainability--A Romanian Perspective

ERIC Educational Resources Information Center

Dumitru, Daniela Elena

2017-01-01

Purpose: This paper tries to propose a pedagogical training program starting from the Romanian mandatory curriculum for higher education (HE) teachers, integrating education for sustainable development (ESD) competencies (UNECE, 2012) through infusion as a technique of curricular design dealing with cross-curricular subject integration. The…

Comparing the meanings of living with advanced breast cancer between women resilient to distress and women with persistent distress: a qualitative study.

PubMed

Lam, W W T; Yoon, S W; Sze, W K; Ng, A W Y; Soong, I; Kwong, A; Suen, D; Tsang, J; Yeo, W; Wong, K Y; Fielding, R

2017-02-01

Most women with advanced breast cancer (ABC) show little distress, but about one in ten show persistent distress over time. It remains unclear if meanings ascribed by patients to ABC differentiate these distress trajectories. This qualitative study (a) compared illness meanings of ABC between women with persistent psychological distress and those with low/transient distress, and (b) examined how illness meanings might influence coping strategies. The sample was drawn from a prior quantitative study exploring psychological distress trajectories following ABC diagnosis. Overall, 42 Cantonese- or Mandarin-speaking Chinese women diagnosed with locally advanced or metastatic ABC were recruited based on their distress trajectory status (low-stable, transient, or persistent distress). Interviews were recorded, transcribed, and analyzed following grounded theory approach using simultaneous analysis. Women with persistent distress viewed their diagnosis as another blow in life, the illness was global, permeating every aspect of their life. Maladaptive rumination and thought suppression were common responses to illness demands. These women had poor social support. A sense of demoralization stood out in their narratives. In contrast, women with transient/low-stable distress encapsulated the illness, with minimum impacts of their life. They did not evidence dysfunctional repetitive thoughts. Living in a supportive environment, they were able to accept and/or live in the present-moment. Rumination, thought suppression, social constraints, and pre-existing exposure to life stress may be potential risks for chronic distress in response to advanced breast cancer. Persistent and transient distress responses to cancer may have different underpinnings. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Trajectories of psychological distress after prison release: implications for mental health service need in ex-prisoners.

PubMed

Thomas, E G; Spittal, M J; Heffernan, E B; Taxman, F S; Alati, R; Kinner, S A

2016-02-01

Understanding individual-level changes in mental health status after prison release is crucial to providing targeted and effective mental health care to ex-prisoners. We aimed to describe trajectories of psychological distress following prison discharge and compare these trajectories with mental health service use in the community. The Kessler Psychological Distress Scale (K10) was administered to 1216 sentenced adult prisoners in Queensland, Australia, before prison release and approximately 1, 3 and 6 months after release. We used group-based trajectory modeling to identify K10 trajectories after release. Contact with community mental health services in the year following release was assessed via data linkage. We identified five trajectory groups, representing consistently low (51.1% of the cohort), consistently moderate (29.8%), high increasing (11.6%), high declining (5.5%) and consistently very high (1.9%) psychological distress. Mood disorder, anxiety disorder, history of self-harm and risky drug use were risk factors for the high increasing, very high and high declining trajectory groups. Women were over-represented in the high increasing and high declining groups, but men were at higher risk of very high psychological distress. Within the high increasing and very high groups, 25% of participants accessed community mental health services in the first year post-release, for a median of 4.4 contact hours. For the majority of prisoners with high to very high psychological distress, distress persists after release. However, contact with mental health services in the community appears low. Further research is required to understand barriers to mental health service access among ex-prisoners.

Psychological distress of adolescents exposed to Hurricane Hugo.

PubMed

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

1994-07-01

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

Using Moral Distress for Organizational Improvement.

PubMed

Sabin, James E

2017-01-01

Moral distress is a major problem for nurses, other clinicians, and the health system itself. But if properly understood and responded to, it is also a promising guide for healthcare improvement. When individuals experience moral distress or burnout, their reports must be seen as crucial data requiring careful attention to the individuals and to the organization. Distress and burnout will often point to important opportunities for system improvements, which may in turn reduce the experience of distress. For this potential virtuous cycle to happen, individuals must be able to articulate their concerns without fear of retribution, and organizational leaders must be able to listen in an undefensive, improvement-oriented manner. Copyright 2016 The Journal of Clinical Ethics. All rights reserved.

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

PubMed Central

Chiou, Yu-Jie; Chiu, Nien-Mu; Wang, Liang-Jen; Li, Shau-Hsuan; Lee, Chun-Yi; Wu, Ming-Kung; Chen, Chien-Chih; Wu, Yi-Shan; Lee, Yu

2016-01-01

Background Clinical practice guidelines suggest routine screening for distress among cancer patients for immediate early psychiatric care. However, previous studies focusing on routine screening for psychological distress among cancer inpatients in Taiwan are scant. Thus, the aim of this study was to evaluate the prevalence and related factors of psychological distress and mental illness among cancer inpatients in Taiwan. Patients and methods This study was conducted as a retrospective chart review in a general hospital in southern Taiwan. Cancer inpatients were regularly screened by nursing staff using the Distress Thermometer and the 12-item Chinese Health Questionnaire. Positive screening results on either instrument were followed by a non-commanded referral to psychiatrists for clinical psychiatric diagnosis and treatment. Results Of the 810 participants in this study, 179 (22.1%) were recognized as having psychological distress. Younger age (odds ratio [OR] =1.82), having head and neck cancer (OR =2.43), and having not received chemotherapy (OR =1.58) were significantly related to psychological distress. Among the 56 patients (31.3%) with psychological distress who were referred to psychiatrists, the most common mental illness was adjustment disorder (n=22, 39.2%), followed by major depressive disorder (n=13, 23.2%), depressive disorder not otherwise specified (n=6, 10.7%), and anxiety disorder not otherwise specified (n=4, 7.1%). Conclusion Our study indicated that cancer inpatients with psychological distress were more likely to be younger in age, have head and neck cancer, and have not received chemotherapy. The most common psychiatric disorder was adjustment disorder. Early detection of psychological distress and prompt psychiatric consultation and management are very important for cancer inpatients. PMID:27822049

Telephone Crisis Support Workers' Psychological Distress and Impairment.

PubMed

Kitchingman, Taneile A; Wilson, Coralie J; Caputi, Peter; Wilson, Ian; Woodward, Alan

2018-01-01

In order to respond to crises with appropriate intervention, crisis workers are required to manage their own needs as well as the needs of those they respond to. A systematic review of the literature was conducted to examine whether telephone crisis support workers experience elevated symptoms of psychological distress and are impaired by elevated symptoms. Studies were identified in April 2015 by searching three databases, conducting a gray literature search, and forward and backward citation chaining. Of 113 identified studies, seven were included in the review. Results suggest that that telephone crisis support workers experience symptoms of vicarious traumatization, stress, burnout, and psychiatric disorders, and that they may not respond optimally to callers when experiencing elevated symptoms of distress. However, definitive conclusions cannot be drawn due to the paucity and methodological limitations of available data. While the most comprehensive search strategy possible was adopted, resource constraints meant that conference abstracts were not searched and authors were not contacted for additional unpublished information. There is an urgent need to identify the impact of telephone crisis support workers' role on their well-being, the determinants of worker well-being in the telephone crisis support context, and the extent to which well-being impacts their performance and caller outcomes. This will help inform strategies to optimize telephone crisis support workers' well-being and their delivery of support to callers.

Sensitivity and specificity of the Distress Impact Thermometer for the detection of psychological distress among CRC survivors.

PubMed

Craike, Melinda J; Livingston, Patricia M; Warne, Charles

2011-01-01

This study assessed the relative screening performance of the Distress Impact Thermometer (DIT) and cutoff levels with the established clinical case threshold of the Hospital Anxiety and Depression Scale (HADS) among a sample of colorectal cancer (CRC) survivors. Fifty-nine CRC survivors completed the DIT, HADS, and provided demographic information at baseline, and 45 of these patients completed the same measures at follow-up, giving a total of 104 participant data. Receiver operating characteristic (ROC) analysis was performed to determine the accuracy of the DIT compared to the HADS, with a cutoff score ≥8 on each HADS subscale (depression and anxiety) and ≥15 on the HADS total scale used to identify patients with psychological distress. The sample comprised slightly more males (63%) than females, with an average age of 59 years (SD = 9.53) and ranging from 33 to 77 years. The optimum DT cutoff score of ≥5 yielded a sensitivity of 60% and specificity of 86.1%; the area under the curve was 0.771 (95% confidence interval [CI] [0.646, 0.896]). For the depression subscale, the DT performed better on specificity than sensitivity, however the opposite was true for the anxiety subscale. The addition of an impact thermometer did not enhance screening performance. The results of this study provide support for a DT score of ≥5 for detecting psychological distress among CRC survivors and do not support the addition of an impact thermometer. The use of the DT might underestimate depression but overestimate anxiety.

47 CFR 80.334 - False distress alerts.

Code of Federal Regulations, 2013 CFR

2013-10-01

....S. Coast Guard; (d) Was repeated; or (e) Was transmitted using a false identity. [68 FR 46968, Aug... § 80.334 False distress alerts. A distress alert is false if it was transmitted without any indication that a mobile unit or person was in distress and required immediate assistance. Transmitting a false...

47 CFR 80.334 - False distress alerts.

Code of Federal Regulations, 2014 CFR

2014-10-01

....S. Coast Guard; (d) Was repeated; or (e) Was transmitted using a false identity. [68 FR 46968, Aug... § 80.334 False distress alerts. A distress alert is false if it was transmitted without any indication that a mobile unit or person was in distress and required immediate assistance. Transmitting a false...

47 CFR 80.334 - False distress alerts.

Code of Federal Regulations, 2011 CFR

2011-10-01

....S. Coast Guard; (d) Was repeated; or (e) Was transmitted using a false identity. [68 FR 46968, Aug... § 80.334 False distress alerts. A distress alert is false if it was transmitted without any indication that a mobile unit or person was in distress and required immediate assistance. Transmitting a false...

47 CFR 80.334 - False distress alerts.

Code of Federal Regulations, 2010 CFR

2010-10-01

....S. Coast Guard; (d) Was repeated; or (e) Was transmitted using a false identity. [68 FR 46968, Aug... § 80.334 False distress alerts. A distress alert is false if it was transmitted without any indication that a mobile unit or person was in distress and required immediate assistance. Transmitting a false...

47 CFR 80.334 - False distress alerts.

Code of Federal Regulations, 2012 CFR

2012-10-01

....S. Coast Guard; (d) Was repeated; or (e) Was transmitted using a false identity. [68 FR 46968, Aug... § 80.334 False distress alerts. A distress alert is false if it was transmitted without any indication that a mobile unit or person was in distress and required immediate assistance. Transmitting a false...

Children's memory and suggestibility about a distressing event: the role of children's and parents' attachment.

PubMed

Chae, Yoojin; Goodman, Gail S; Larson, Rakel P; Augusti, Else-Marie; Alley, Deborah; VanMeenen, Kirsten M; Culver, Michelle; Coulter, Kevin P

2014-07-01

Our goal was to identify individual difference predictors of children's memory and suggestibility for distressing personally experienced events. Specifically, we examined children's and parents' attachment orientations and children's observable levels of distress, as well as other individual difference factors, as predictors of children's memory and suggestibility. Children (N=91) aged 3 to 6years were interviewed about inoculations received at medical clinics. For children whose parents scored as more avoidant, higher distress levels during the inoculations predicted less accuracy, whereas for children whose parents scored as less avoidant, higher distress levels predicted greater accuracy. Children with more rather than less positive representations of parents and older rather than younger children answered memory questions more accurately. Two children provided false reports of child sexual abuse. Implications for theory, research, and practice are discussed. Copyright © 2014 Elsevier Inc. All rights reserved.

Intimacy, sexual satisfaction, and sexual distress in vulvodynia couples: An observational study.

PubMed

Bois, Katy; Bergeron, Sophie; Rosen, Natalie; Mayrand, Marie-Hélène; Brassard, Audrey; Sadikaj, Gentiana

2016-06-01

Vulvodynia is a prevalent idiopathic pain condition with deleterious consequences for the sexuality of affected women and their spouses. Intimacy has been identified as a facilitator of adjustment to health difficulties in couples. Two components of intimacy were examined among couples with vulvodynia-empathic response and disclosure-in relation to their sexual satisfaction and sexual distress. Using an observational design, 50 women (Mage = 24.50 years, SD = 4.03) diagnosed with vulvodynia and their spouses (Mage = 26.10 years, SD = 5.70) participated in a filmed discussion focusing on the impact of vulvodynia on their lives. Empathic response and disclosure were assessed by a trained observer and self-reported by participants after engaging in the discussion. The actor-partner interdependence model guided the data analyses. Women's and spouses' higher observed and perceived empathic responses were associated with their own and their partners' greater sexual satisfaction. Women's and spouses' higher perceived disclosures were associated with their own and their partners' greater sexual satisfaction. Women's and spouses' higher observed empathic responses were associated with their own lower sexual distress. Women's higher observed empathic responses were associated with their spouses' lower sexual distress. Women and spouses' perceived greater empathic responses were associated with their own lower sexual distress. Women's and spouses' greater perceived disclosures during the discussion were associated with their own and their partners' lower sexual distress. Promoting empathic response and disclosure through couple interventions may buffer against the sexual distress and sexual dissatisfaction of couples coping with vulvodynia. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Distress in Caregivers Accompanying Patients to an Emergency Department: A Scoping Review.

PubMed

Ringer, Thom; Moller, Daniel; Mutsaers, Adam

2017-10-01

Despite substantial research interest in caregiver distress in the emergency department (ED), no recent review of the literature exists. Our aims were to map primary research on caregiver distress in the ED, synthesize key concepts underpinning the literature, identify gaps, and provide guidance for future work. We used a five-stage scoping review with tandem screening and data extraction. Of 2121 records, 29 studies were included. The majority were small, conducted in North America or Europe, and published after 2000. Numerous methodologies and definitions of distress were represented. The majority involved children, with just five studies restricted to adults. Many involved higher-acuity scenarios, such as resuscitations or invasive procedures. The most common research topic was anxiety of parents of children undergoing procedures. Effects of witnessed resuscitation were also addressed. Parental presence may reduce anxiety during venipuncture, while only waiting room music reduced anxiety in parents of children not undergoing a procedure. No study explored interventions to reduce distress in caregivers of adults. While heterogeneity precluded evidence-based recommendations, clinically relevant observations emerged, including that anxiety can be worsened if a caregiver believes their patient has been forgotten; that parents are sensitive about being perceived as neglectful; and that sympathy and confidence ease distress, as does sensitivity toward end-of-life issues. Several studies suggested that negative staff behaviors affect caregiver anxiety. Future studies should use validated measures of distress; include larger samples; and capture adult, geriatric, and rural populations. A focused systematic review might yield evidence-based guidance for clinicians. Copyright © 2017 Elsevier Inc. All rights reserved.

Distressed Couples and Marriage Education

ERIC Educational Resources Information Center

DeMaria, Rita M.

2005-01-01

Professionals generally believe that couples who choose to attend marriage education programs are not as distressed as are clinical couples and that distressed couples are not good candidates for marriage education. We examined these assumptions in 129 married couples who enrolled in a PAIRS, Practical Application of Intimate Relationship Skills…

Conflict of interest from a Romanian geneticist's perspective.

PubMed

Ispas, Ioana

2002-07-01

This paper examines Romanian bioethics regulations for biomedical sciences, looking in particular at the genetics area as a source for conflict of interest. The analysis is focused on the organizational level, national regulations, the sources for generating conflicts of interest, and management of conflicts. Modern biotechnology and gene technology are among the key technologies of the twenty-first century. The application of gene technology for medical and pharmaceutical purposes is widely accepted by society, but the same cannot be said of the development and application of gene technology in agriculture and food processing. Because the use of a technology in the production and processing of food is regarded more sceptically than in the production of biomedical products, there can be areas of conflict in many cases when communication is undertaken about gene technology in the agro-food sector. Ethical concerns play an important factor in this, but a society's attitude to a developing technology is an amalgam of many effects which are beyond ethics as such. This paper contains a study carried out by the author for the Romanian Association for Consumer Protection about the attitudes of consumers towards genetically modified (GM) foods. This study revealed that in Romania more than 98% of consumers did not know anything about GM foods and frequently were confused about the definitions of these terms. In conclusion, it is necessary to say that there is a low level of knowledge regarding biotechnology in Romania and this is an important reason why there is neither public acceptance of gene technology products nor is there a rejection.

BABY EMPATHY: INFANT DISTRESS AND PEER PROSOCIAL RESPONSES.

PubMed

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

2015-01-01

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

The relationship between unmet needs and distress amongst young people with cancer.

PubMed

Dyson, Gavin J; Thompson, Kate; Palmer, Susan; Thomas, David M; Schofield, Penelope

2012-01-01

Most psychosocial research in cancer has been restricted to paediatric or older adult populations. This study aimed to explore psychological distress and unmet needs in adolescents and young adults (AYA) with cancer and identify predictors of distress among demographic and illness characteristics and supportive care needs. Fifty-three patients between 16 and 30 years completed a cross-sectional survey, administered shortly after presentation to an AYA oncology service and within 4 months of diagnosis. Measures included the Beck Depression Inventory-Fast Screen (BDI-FS), State-Trait Anxiety Inventory-State Form (STAI-S) and the Supportive Care Needs Survey. Level of distress-related sypmtomatology in this population was based on previous work, whereby a cut-off score of 4 or greater was used for the BDI-FS, and one standard deviation above the sample population mean was used for the STAI-S. Prevalence of distress (25%) was lower than that found previously in AYA with cancer. Physical and daily living needs were the most frequently unmet needs overall, followed by psychological needs, health system and information needs and care and support needs. Lastly, being pre-treatment predicted increased depression and state anxiety, while having treatment post-surgery predicted reduced state anxiety. After controlling for treatment status, however, the main predictors of depression and state anxiety were physical and daily living needs and health system and information needs, respectively. Lower levels of distress and unmet psychological needs were related to the few participants (17%) in this study who were pre-treatment, when distress was most likely. However, physical needs and information needs, which are almost inevitable throughout treatment and beyond, were more important predictors of distress. Further exploration must consider the psychosocial difficulties underlying this association and the needs of AYA at transitions between critical periods in their cancer journey

Acute respiratory distress syndrome 40 years later: time to revisit its definition.

PubMed

Phua, Jason; Stewart, Thomas E; Ferguson, Niall D

2008-10-01

Acute respiratory distress syndrome is a common disorder associated with significant mortality and morbidity. The aim of this article is to critically evaluate the definition of acute respiratory distress syndrome and examine the impact the definition has on clinical practice and research. Articles from a MEDLINE search (1950 to August 2007) using the Medical Subject Heading respiratory distress syndrome, adult, diagnosis, limited to the English language and human subjects, their relevant bibliographies, and personal collections, were reviewed. The definition of acute respiratory distress syndrome is important to researchers, clinicians, and administrators alike. It has evolved significantly over the last 40 years, culminating in the American-European Consensus Conference definition, which was published in 1994. Although the American-European Consensus Conference definition is widely used, it has some important limitations that may impact on the conduct of clinical research, on resource allocation, and ultimately on the bedside management of such patients. These limitations stem partially from the fact that as defined, acute respiratory distress syndrome is a heterogeneous entity and also involve the reliability and validity of the criteria used in the definition. This article critically evaluates the American-European Consensus Conference definition and its limitations. Importantly, it highlights how these limitations may contribute to clinical trials that have failed to detect a potential true treatment effect. Finally, recommendations are made that could be considered in future definition modifications with an emphasis on the significance of accurately identifying the target population in future trials and subsequently in clinical care. How acute respiratory distress syndrome is defined has a significant impact on the results of randomized, controlled trials and epidemiologic studies. Changes to the current American-European Consensus Conference definition are

Predictors of early postpartum mental distress in mothers with midwifery home care--results from a nested case-control study.

PubMed

Staehelin, Katharina; Kurth, Elisabeth; Schindler, Christian; Schmid, Monika; Zemp Stutz, Elisabeth

2013-08-27

The prevalence of early postpartum mental health conditions is high. Midwives and other health professionals visiting women at home may identify mothers at risk. This seems crucial given decreasing trends of length of hospital stay after childbirth. This study aimed to identify predictors of maternal mental distress in a midwifery home care setting. Using the statistical database of independent midwives' services in Switzerland in 2007, we conducted a matched nested case-control study. Out of a source population of 34,295 mothers with midwifery home care in the first ten days after childbirth, 935 mothers with maternal distress and 3,645 controls, matched by midwife, were included. We analysed whether socio-demographic, maternal and neonatal factors predict maternal mental distress by multivariable conditional logistic regression analysis. Infant crying problems and not living with a partner were the strongest predictors for maternal distress, whereas higher parity was the most protective factor. Significantly elevated risks were also found for older age, lower educational levels, breast/breastfeeding problems, infant weight gain concerns, neonatal pathologies and use of midwifery care during pregnancy. A lower likelihood for maternal distress was seen for non-Swiss nationality, full-time employment before birth, intention to return to work after birth and midwife-led birth. The study informs on predictors of maternal mental distress identified in a home care setting in the early postpartum period. Midwives and other health care professionals should pay particular attention to mothers of excessively crying infants, single mothers and primipara, and assess the need for support of these mothers.

New Opportunities and Old Challenges: Romanian Denominational Higher Education in the Bologna Process

ERIC Educational Resources Information Center

Szolar, Eva

2010-01-01

The Europeanization process has created new opportunities for Romanian Christian higher education institutions, but these are coupled with new waves of secularization. The secularization and the transformation of institutional identity are the result of inner institutional decisions only apparently, since these decisions were undertaken in order…

Metal contamination in environmental media in residential areas around Romanian mining sites.

PubMed

Neamtiu, Iulia A; Al-Abed, Souhail R; McKernan, John L; Baciu, Calin L; Gurzau, Eugen S; Pogacean, Anca O; Bessler, Scott M

2017-03-01

Hard-rock mining for metals, such as gold, silver, copper, zinc, iron and others, is recognized to have a significant impact on the environmental media, soil and water, in particular. Toxic contaminants released from mine waste to surface water and groundwater is the primary concern, but human exposure to soil contaminants either directly, via inhalation of airborne dust particles, or indirectly, via food chain (ingestion of animal products and/or vegetables grown in contaminated areas), is also, significant. In this research, we analyzed data collected in 2007, as part of a larger environmental study performed in the Rosia Montana area in Transylvania, to provide the Romanian governmental authorities with data on the levels of metal contamination in environmental media from this historical mining area. The data were also considered in policy decision to address mining-related environmental concerns in the area. We examined soil and water data collected from residential areas near the mining sites to determine relationships among metals analyzed in these different environmental media, using the correlation procedure in the SAS statistical software. Results for residential soil and water analysis indicate that the average values for arsenic (As) (85 mg/kg), cadmium (Cd) (3.2 mg/kg), mercury (Hg) (2.3 mg/kg) and lead (Pb) (92 mg/kg) exceeded the Romanian regulatory exposure levels [the intervention thresholds for residential soil in case of As (25 mg/kg) and Hg (2 mg/kg), and the alert thresholds in case of Pb (50 mg/kg) and Cd (3 mg/kg)]. Average metal concentrations in drinking water did not exceed the maximum contaminant level (MCL) imposed by the Romanian legislation, but high metal concentrations were found in surface water from Rosia creek, downstream from the former mining area.

Psychological distress associated with cancer screening: A systematic review.

PubMed

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

2017-10-15

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

Distress call-induced gene expression in the brain of the Indian short-nosed fruit bat, Cynopterus sphinx.

PubMed

Ganesh, Ambigapathy; Raghuram, Hanumanthan; Nathan, Parthasarathy T; Marimuthu, Ganapathy; Rajan, Koilmani Emmanuvel

2010-02-01

Individuals in distress emit audible vocalizations to either warn or inform conspecifics. The Indian short-nosed fruit bat, Cynopterus sphinx, emits distress calls soon after becoming entangled in mist nets, which appear to attract conspecifics. Phase I of these distress calls is longer and louder, and includes a secondary peak, compared to phase II. Activity-dependent expression of egr-1 was examined in free-ranging C. sphinx following the emissions and responses to a distress call. We found that the level of expression of egr-1 was higher in bats that emitted a distress call, in adults that responded, and in pups than in silent bats. Up-regulated cDNA was amplified to identify the target gene (TOE1) of the protein Egr-1. The observed expression pattern Toe1 was similar to that of egr-1. These findings suggest that the neuronal activity related to recognition of a distress call and an auditory feedback mechanism induces the expression of Egr-1. Co-expression of egr-1 with Toe1 may play a role in initial triggering of the genetic mechanism that could be involved in the consolidation or stabilization of distress call memories.

Childhood callous-unemotional traits moderate the relation between parenting distress and conduct problems over time.

PubMed

Fanti, Kostas A; Centifanti, Luna C Munoz

2014-01-01

The present short-term longitudinal study examines the bidirectional effects among paternal-reported and maternal-reported involvement, distress and conduct-problems (CP) in children ages 7–12 years with callous-unemotional (CU) traits as a potential moderator. Latent profile analysis revealed four groups: high, moderate, decreasing, and low on CU traits. Findings suggested that children high on CU traits were at higher risk to exhibit CP and were more likely to experience low parental-involvement and high parental-distress compared to children with low, decreasing, and moderate CU traits. Findings from the cross-lagged structural equation model suggested that high levels of CP predicted increases in parenting distress, and this was shown for youth with high levels of CU traits. In turn, parental-reported distress predicted increases in CP for children in the low and decreasing CU groups. A negative bidirectional association between maternal-involvement and CP was also identified. Findings extend cross-sectional research showing parents become distressed by CP behaviors, particularly when accompanied by high CU traits.

Attachment to God, Images of God, and Psychological Distress in a Nationwide Sample of Presbyterians.

PubMed

Bradshaw, Matt; Ellison, Christopher G; Marcum, Jack P

2010-01-01

Drawing broadly on insights from attachment theory, the present study outlines a series of theoretical arguments linking styles of attachment to God, perceptions of the nature of God (i.e., God imagery), and stressful life events with psychological distress. Main effects and potential stress-moderator effects are then evaluated using data from a nationwide sample of elders and rank-and-file members of the Presbyterian Church (U.S.A.). Key findings indicate that secure attachment to God is inversely associated with distress, whereas both anxious attachment to God and stressful life events are positively related to distress. Once variations in patterns of attachment to God are controlled, there are no net effects of God imagery on levels of distress. There is only modest support for the hypothesis that God images moderate the effects of stressful life events on psychological distress, but no stress-moderator effects were found for attachment to God. Study limitations are identified, and findings are discussed in terms of their implications for religion-health research, as well as recent extensions of attachment theory.

Attachment to God, Images of God, and Psychological Distress in a Nationwide Sample of Presbyterians

PubMed Central

Bradshaw, Matt; Ellison, Christopher G.; Marcum, Jack P.

2012-01-01

Drawing broadly on insights from attachment theory, the present study outlines a series of theoretical arguments linking styles of attachment to God, perceptions of the nature of God (i.e., God imagery), and stressful life events with psychological distress. Main effects and potential stress-moderator effects are then evaluated using data from a nationwide sample of elders and rank-and-file members of the Presbyterian Church (U.S.A.). Key findings indicate that secure attachment to God is inversely associated with distress, whereas both anxious attachment to God and stressful life events are positively related to distress. Once variations in patterns of attachment to God are controlled, there are no net effects of God imagery on levels of distress. There is only modest support for the hypothesis that God images moderate the effects of stressful life events on psychological distress, but no stress-moderator effects were found for attachment to God. Study limitations are identified, and findings are discussed in terms of their implications for religion-health research, as well as recent extensions of attachment theory. PMID:23329878

Celebrities' Memorial Afterlives: Obituaries, Tributes, and Posthumous Gossip in the Romanian Media Deathscape.

PubMed

Rusu, Mihai S

2017-01-01

Cross-culturally, dead are protected from posthumous negative evaluations by the universal "nil nisi bonum" precept that governs the ethics within the community of mourners. In this study, we set out to test the observance of this injunction against posthumous gossiping in the Romanian public deathscape. Obituaries and other posthumous articles ( N = 1,148) were collected that covered the deaths of 63 celebrities who passed away between 2013 and 2016. Materials were gathered from the digital archives of three Romanian news sources (a news agency, a "quality" newspaper, and a tabloid), published one week after the moment of death. The findings show that 22% of the articles do contain negative evaluations of the deceased. The percentage rises to 36.4% if we restrict the sample to only those celebrities with a controversial anthumous reputation (19 of 63). These results indicate that celebrities are not spared from critical assessments after they pass away.

47 CFR 2.402 - Control of distress traffic.

Code of Federal Regulations, 2010 CFR

2010-10-01

... distress traffic. The control of distress traffic is the responsibility of the mobile station in distress or of the mobile station which, by the application of the provisions of § 2.403, has sent the...

Predictors of severe psychological distress trajectory after nuclear disaster: evidence from the Fukushima Health Management Survey

PubMed Central

Oe, Misari; Maeda, Masaharu; Nagai, Masato; Yasumura, Seiji; Yabe, Hirooki; Suzuki, Yuriko; Harigane, Mayumi; Ohira, Tetsuya; Abe, Masafumi

2016-01-01

Objectives The Fukushima Daiichi Nuclear Power Plant accident, which occurred after the Great East Japan Earthquake and Tsunami in March 2011, may have a considerable long-term impact on the lives of area residents. The aims of this study were to determine the trajectories of psychological distress using 3-year consecutive data, and to find predictive factors of severe distress that may also prove useful for public health intervention. Methods Data were obtained on 12 371 residents who were registered in the municipalities categorised as complete evacuation areas for 3 years after the disaster and who completed an assessment in each of the 3 years. Results Using group-based trajectory modelling, we identified four trajectory patterns distinguished by the levels of psychological distress, which gradually improved over time in all trajectories. Subjective sleep insufficiency, problem drinking, poor social support and perception of radiation risk 3 years after the accident were associated with the severity of psychological distress, according to the multivariate analysis. Conclusions The identified factors may be useful for community-based mental healthcare over the long term following a nuclear disaster. PMID:27798033

Identification and prevalence of swine pasivirus 1 in eastern Romanian pig farms.

PubMed

Zaulet, Mihaela; Petrovan, Vlad; Birladeanu, Andrada M; Stoian, Ana Maria M; Kevorkian, Steliana E M; Nichita, Cornelia; Eloit, Marc; Buburuzan, Laura

2017-05-01

Swine pasivirus 1 (SPaV-1) was first detected in the feces of healthy pigs in France as a new species in family Picornaviridae. We investigated the presence, distribution, and genetic variability of this virus in 7 geographic areas with intensive pig breeding farms in eastern Romania. A total of 564 porcine specimens, including 82 fecal specimens and 482 pools of organs, were collected from healthy pigs in different stages of production from pathogen-free swine farming units. The virus was found in 6 of 7 areas investigated. Of the 564 samples analyzed, 218 were positive for SPaV-1, with the highest prevalence of the virus in organ homogenates (39% positive) followed by feces (37% positive). The highest susceptibility to infection was found in nurseries (50% positive in both the first and second months of feeding). Sequencing analysis of VP0 revealed 3 different Romanian sequences. The phylogenetic investigations suggest that the Romanian sequences cluster with other Pasivirus strains selected from the GenBank database, forming a separate clade from other Picornaviridae genera and defining the described Pasivirus.

What's in a Name? The Case of Emotional Disclosure of Pain-Related Distress.

PubMed

Cano, Annmarie; Goubert, Liesbet

2017-08-01

Pain behavior plays a key role in many theoretical models of pain, with many of these models conceptualizing pain behaviors as potentially detrimental to patient functioning. We propose that a certain class of behaviors-talking to others about one's pain-related distress (ie, emotional disclosures of pain-related distress)-can be distinguished from other behaviors traditionally conceptualized as pain behaviors. Emotional disclosures of pain-related distress include verbally disclosing one's anger, sadness, or worry about the pain and its effects to another person. In this article, conceptual and empirical evidence is offered to indicate that these verbal behaviors are distinct from other pain behaviors such as bodily expressions and motions, facial expressions, pain ratings, and paraverbal expressions. Emotion and relationships models are also applied to assert that disclosures of pain-related distress may have functions that are not shared with other pain behaviors. In addition to an expanded conceptualization of these verbal expressions of distress about pain, further directions are provided to spur new research as well as clinical recommendations concerning appropriate responses to these behaviors. This article offers an expanded conceptualization of one type of pain behavior-emotional disclosure of pain-related distress-by showing the theoretical and empirical distinctions between this behavior and other pain behaviors. This perspective may enhance clinical work and research aimed at identifying adaptive responses to these behaviors to improve pain adjustment. Copyright © 2017 American Pain Society. Published by Elsevier Inc. All rights reserved.

Distress and Its Effect on Adherence to Antidiabetic Medications Among Type 2 Diabetes Patients in Coastal South India

PubMed Central

Kumar, Nithin; Unnikrishnan, Bhaskaran; Thapar, Rekha; Mithra, Prasanna; Kulkarni, Vaman; Holla, Ramesh; Bhagawan, Darshan; Kumar, Avinash; Aithal, Shodhan

2017-01-01

Background: Distress can bring about an unfavorable attitude among the patients toward tackling their disease which can affect adherence to medications. The purpose of this study was to assess the effect of distress on adherence to medication among patients with diabetes. Methodology: In this cross-sectional study, 124 type 2 diabetes patients above 18 years, attending the hospitals affiliated to Kasturba Medical College, Mangalore, selected using nonprobability sampling were interviewed to assess the presence of diabetes-related distress (DRD) and their level of adherence to medications. Distress was assessed using diabetes distress scale. Morisky Adherence Questionnaire was used to assess the level of adherence. Approval was obtained from the Institutional Ethics Committee. Multivariate logistic regression was conducted to assess the influence of domains of distress on adherence to antidiabetic medication and P < 0.05 was considered statistically significant. Results: In our study, 41.9% (n = 52) of the participants had high diabetes distress. Exactly 43.5% (n = 54) of the participants had low adherence to antidiabetic medications. On univariate analysis, participants with low regimen distress, low physician distress, and low interpersonal distress were found to have good adherence to antidiabetic medication. However, on multivariate analysis, only low regimen distress was found to be significantly associated with good adherence to medication among the study participants. Conclusion: DRD is a problem in our study participants which affects the adherence to medications. Identifying distress at an early stage can help doctors formulate and implement remedial measures, thereby improving adherence to medications. PMID:28781491

Psychotic-Like Experiences in Nonpsychotic Help-Seekers: Associations With Distress, Depression, and Disability

PubMed Central

Yung, Alison R; Buckby, Joe A; Cotton, Sue M; Cosgrave, Elizabeth M; Killackey, Eoin J; Stanford, Carrie; Godfrey, Katherine; McGorry, Patrick D

2006-01-01

Psychotic-like experiences (PLEs) increase the risk of schizophrenia and other psychotic disorders yet are common in the community. Some PLEs, such as those associated with depression, distress, and poor functioning, may confer increased risk. The aim of this study is to determine the prevalence of PLEs in a nonpsychotic clinical sample and to investigate whether any subtypes of PLEs are associated with the above factors. Consecutive referrals to a youth psychiatric service (N = 140) were assessed to measure PLEs, depression, and functioning. PLE data were factor analyzed, and the associations of psychotic subtypes and distress, depression, and disability were analyzed. Three subtypes of PLEs were identified: Bizarre Experiences, Persecutory Ideas, and Magical Thinking. Bizarre Experiences and Persecutory Ideas were associated with distress, depression, and poor functioning. Magical Thinking was not, unless accompanied by distress. Bizarre Experiences and Persecutory Ideas may be more malignant forms of psychotic symptoms, as they are associated with current disability, and may confer increased risk of development of full-blown psychotic disorder. PMID:16254060

Stress and Psychological Distress among Trainee Secondary Teachers in England

ERIC Educational Resources Information Center

Chaplain, Roland P.

2008-01-01

The relationships between stress and psychological distress were investigated among a cohort of trainee secondary school teachers in England. Specifically, the study examined the structure of a Teacher Stress Scale and its relationship to mental health as measured by the 12-item General Health Questionnaire. Three factors were identified:…

Preoperative psychological distress, coping and quality of life in Chinese patients with newly diagnosed gastric cancer.

PubMed

Hong, Jingfang; Wei, Zengzeng; Wang, Weili

2015-09-01

The purpose of this study was to investigate the prevalence of preoperative psychological distress and its relationship with coping style and quality of life in Chinese patients with newly diagnosed gastric cancer. Being newly diagnosed with cancer can be a source of psychological distress. Understanding the preoperative psychological distress may contribute to the development of appropriate interventions. This is a descriptive correlational survey study. The study was conducted in two teaching hospitals in Anhui province, China. A total of 165 patients with gastric cancer completed a battery of self-report questionnaires including the Distress Thermometer, the revised Chinese version of the Quality of Life Questionnaire-Stomach 22 and the Cancer Coping Modes Questionnaire. The prevalence of clinically significant preoperative psychological distress was 76·97% in this group. Statistically significant correlations were identified between the distress score and stomach pain, eating restrictions and anxiety subscale. Positive associations were found between the distress scores and four subdimensions of coping (avoidance and suppression, resignation, fantasy and catharsis), whereas a negative association was found between the distress scores and one subdimension of coping (Confrontation). There were also significant differences in the quality of life and coping style of patients who had different psychological distress statuses. These findings indicate a relatively high prevalence of preoperative psychological distress among Chinese patients with gastric cancer. Patients with clinically psychological distress were more likely to have poor quality of life and to demonstrate negative coping styles. Nursing professionals need to carefully assess the psychological status of patients with gastric cancer. Tailored interventions can be administered to help these patients appropriately cope with the disease and to enhance their quality of life. © 2015 John Wiley & Sons Ltd.

Prevalence and correlates of psychological distress among drug users in Phnom Penh, Cambodia.

PubMed

Yi, Siyan; Tuot, Sovannary; Chhoun, Pheak; Pal, Khuondyla; Choub, Sok Chamreun; Mburu, Gitau

2016-10-01

Compared to the general population, drug users are at increased risk of both poor mental health and HIV infection. The aim of this study was to determine the prevalence and correlates of high psychological distress among drug users in Cambodia. In April 2014, a two-stage cluster sampling method was used to randomly select 169 drug users from hotspots in Phnom Penh. Psychological distress was measured using General Health Questionnaire (GHQ-12). Bivariate and multivariable analyses were conducted to identify factors associated with levels of psychological distress among this population. Our study found high prevalence of attempted suicide (15.3%), drug related arrests (46.2%), and incarceration (31.4%). Of the 169 participants, 42.0% were found to have high levels of psychological distress, indicating poor mental health. After adjustment, high levels of psychological distress were independently associated with suicidal ideation (p<0.001), higher frequency of drug use (p=0.02), sharing of needles or syringes (p=0.005), and having been sent to a rehabilitation centre (p=0.02). In addition, participants who perceived their overall health as being poor or very poor were more likely to have high levels of psychological distress (p=0.002). Integration of mental health within HIV and needle and syringe exchange programmes is required to address psychological distress among drug users in Cambodia. Health system interventions, such as screening, referral, and training of health providers, need to be strengthened. In addition, interventions addressing social determinants of mental health and mitigation of frequent arrests and improving conditions in rehabilitation centres are required. Copyright © 2016 Elsevier B.V. All rights reserved.

The Management Of Intellectual Property In A Romanian State University Where Research Represents A Strength

NASA Astrophysics Data System (ADS)

Tîţu, Aurel Mihail; Oprean, Constantin; Răulea, Andreea Simina

2015-07-01

The transition to the knowledge-based economy and society requires adaptation to constant change that implies intellectual property as a multidimensional concept that continually leaves its mark on generations contributing to their well-being in obvious and undeniable ways. The main objective of this article was to assess the present level of the management of intellectual property in a state university in Romania displaying their strengths and weaknesses. The overall objective of the work is to analyze the state of the art in a Romanian state university in order to find solutions to the current problems that the Romanian scientific environment is facing. The conclusions drawn in the study converge in directions and proposals for improving the way in which the intellectual property is regarded and its management in the state universities of Romania.

Somatic awareness in the clinical care of patients with body distress symptoms

PubMed Central

Bakal, Donald; Coll, Patrick; Schaefer, Jeffrey

2008-01-01

The purpose of this paper is to provide primary care physicians and medical specialists with an experiential psychosomatic framework for understanding patients with body distress symptoms. The framework relies on somatic awareness, a normal part of consciousness, to resolve the dualism inherent in conventional multidisciplinary approaches. Somatic awareness represents a guiding healing heuristic which acknowledges the validity of the patient's physical symptoms and uses body sensations to identify the psychological, physiological, and social factors needed for symptom self-regulation. The experiential approach is based on psychobiologic concepts which include bodily distress disorder, central sensitization, dysfunctional breathing, and contextual nature of mood. PMID:18291028

Discrimination, religious and cultural factors, and Middle Eastern/Arab Americans' psychological distress.

PubMed

Ikizler, Ayse S; Szymanski, Dawn M

2018-01-11

We investigated (1) the moderating role of religiosity in the link between religious affiliation and ethnic discrimination and (2) the moderating roles of religiosity, ethnic identity, and family connectedness in the relations between ethnic discrimination and psychological distress. Our sample consisted of 122 (60% women, 40% men) Middle Eastern/Arab Americans (MEAAs), ranging in age from 18 to 82 years old, who completed an online survey. Muslim identification predicted discrimination for MEAAs with high but not low religiosity. Higher levels of discrimination, more family connectedness, the interaction of discrimination and religiosity, and the interaction of discrimination and family connectedness were unique predictors of psychological distress. Religiosity is a risk factor for experiencing ethnic discrimination among Muslim identified MEAAs. MEAAs who have high religiosity and low to moderate levels of family connectedness are vulnerable to psychological distress associated with ethnic discrimination. © 2018 Wiley Periodicals, Inc.

Psychological distress screening in cancer patients: psychometric properties of tools available in Italy.

PubMed

Muzzatti, Barbara; Annunziata, Maria Antonietta

2012-01-01

The main national and international organisms recommend continuous monitoring of psychological distress in cancer patients throughout the disease trajectory. The reasons for this concern are the high prevalence of psychological distress in cancer patients and its association with a worse quality of life, poor adherence to treatment, and stronger assistance needs. Most screening tools for psychological distress were developed in English-speaking countries. To be fit for use in different cultural contexts (like the Italian), they need to undergo accurate translation and specific validation. In the present work we summarized the validation studies for psychological distress screening tools available in Italian that are most widely employed internationally, with the aim of helping clinicians choose the adequate instrument. With knowledge of the properties of the corresponding Italian versions, researchers would be better able to identify the instruments that deserve further investigation. We carried out a systematic review of the literature. Results. Twenty-nine studies of eight different instruments (five relating to psychological distress, three to its depressive component) were identified. Ten of these studies involved cancer patients and 19 referred to the general population or to non-cancer, non-psychiatric subjects. For seven of the eight tools, data on concurrent and discriminant validity were available. For five instruments data on criterion validity were available, for four there were data on construct validity, and for one tool divergent and cross-cultural validity data were provided. For six of the eight tools the literature provided data on reliability (mostly about internal consistency). Since none of the eight instruments for which we found validation studies relative to the Italian context had undergone a complete and organic validation process, their use in the clinical context must be cautious. Italian researchers should be proactive and make a valid

Plasmodium vivax malaria in a Romanian traveller returning from Greece, August 2011.

PubMed

Florescu, S A; Popescu, C P; Calistru, P; Ceausu, E; Nica, M; Toderan, A; Zaharia, M; Parola, P

2011-09-01

In August 2011, a Plasmodium vivax malaria infection was diagnosed in a Romanian traveller returning from Greece. This case together with several reports over the past decade of autochthonous cases in Greece highlight that malaria should be considered as differential diagnosis in symptomatic travellers returning from this country. Travellers may serve as sentinels of emerging vector-borne diseases.

Perpetual transitions in Romanian healthcare.

PubMed

Spiru, Luiza; Traşcu, Răzvan Ioan; Turcu, Ileana; Mărzan, Mircea

2011-12-01

Although Romania has a long-lasting tradition in organized medical healthcare, in the last two decades the Romanian healthcare system has been undergoing a perpetual transition with negative effects on all parties involved. The lack of long-term strategic vision, the implementation of initiatives without any impact studies, hence the constant short-term approach from the policy makers, combined with the "inherited" low allocation from GDP to the healthcare system have contributed significantly to its current evolution. Currently, most measures taken are of the "fire-fighting" type, rather than looking to the broader, long time perspective. There should be no wonder then, that predictive and preventive services do not get the proper attention and support. Patient and physicians should step in and take action in regulating a system that was originally designed for them. But until this happens, the organizations with leadership skills and vision need to take action-and this has already started.

Refining the Measurement of Distress Intolerance

PubMed Central

McHugh, R. Kathryn; Otto, Michael W.

2012-01-01

Distress intolerance is an important transdiagnostic variable that has long been implicated in the development and maintenance of psychological disorders. Self-report measurement strategies for distress intolerance have emerged from several different models of psychopathology and these measures have been applied inconsistently in the literature in the absence of a clear gold standard. The absence of a consistent assessment strategy has limited the ability to compare across studies and samples, thus hampering the advancement of this research agenda. This study evaluated the latent factor structure of existing measures of DI to examine the degree to which they are capturing the same construct. Results of confirmatory factor analysis in 3 samples totaling 400 participants provided support for a single factor latent structure. Individual items of these four scales were then correlated with this factor to identify those that best capture the core construct. Results provided consistent supported for 10 items that demonstrated the strongest concordance with this factor. The use of these 10 items as a unifying measure in the study of DI and future directions for the evaluation of its utility are discussed. PMID:22697451

Long working hours and psychological distress among school teachers in Japan.

PubMed

Bannai, Akira; Ukawa, Shigekazu; Tamakoshi, Akiko

2015-01-01

Long working hours have the possibility to influence human health. In Japan, it is well known that teachers have long working hours, and the number of leaves of absence due to mental disorders among public school teachers increased from 2,687 in 2002 to 4,960 in 2012. The aim of this study was to investigate the association between long working hours and psychological distress among school teachers. This cross-sectional study was conducted from mid-July to September in 2013 in Hokkaido Prefecture, Japan. Questionnaires were distributed to 1,245 teachers in public junior high schools. Information about basic characteristics, including working hours, and responses to the General Health Questionnaire-28 were collected anonymously. Multiple logistic regression analysis was used to calculate odds ratios (ORs) for the association between long working hours and psychological distress by gender. Of the 1,245 teachers contacted, 558 (44.8%) responded. After excluding responses with missing data, the final sample included 522 teachers (337 males and 185 females). Psychological distress was identified in 47.8% of males and 57.8% of females. Our results showed a significantly increased risk only in males working >60 hours per week (adjusted OR=4.71 [95% CI 2.04-11.56]) compared with those working ≤40 hours per week. There were no significant associations between long working hours and psychological distress for females. There is a significant association between long working hours and psychological distress in male teachers. However, the causal relationship remains unclear. Further studies such as cohort studies with large sample sizes are needed.

Self-care strategies for emotional distress among young adults in Catalonia: a qualitative study.

PubMed

Martorell-Poveda, Maria-Antonia; Martinez-Hernáez, Angel; Carceller-Maicas, Natalia; Correa-Urquiza, Martin

2015-01-01

Emotional distress is common in adolescence, and self-care strategies are frequently preferred to address it. The aim of this article is to analyze the self-care strategies among adolescents and young people diagnosed with depression or with self-perceived depressive distress in Catalonia using a qualitative design. We analyzed the self-care strategies of 105 young people (17-21 years of age) in Catalonia who had participated in a national survey on adolescents. The sample was divided into thirds, with 37 who had a previous diagnosis of depression, 33 who had self-perceived emotional distress, and 35 controls. The participants' narratives on self-care strategies for emotional distress were elicited through in-depth semi-structured interviews. The data were managed using ATLAS-Ti 6.5 software18. We applied hermeneutic theory and the ethnographic method to analyze the interviews. The ten self-care strategies identified in the analysis were grouped into four areas covering the various pathways the young people followed according to whether they had a diagnosis of depression or their depressive distress was self-perceived. The young people feel responsible for their emotional distress and consider that they are capable of resolving it through their own resources. Their strategies ranged from their individuality to sociability expressed through their relationships with others, membership of groups or other self-care strategies (relaxation, meditation, naturopathy, etc.). The study results highlight the importance of sensitivity in considering young people's self-care strategies as another option in the care of emotional distress.

Management of respiratory distress syndrome: an update.

PubMed

Rodriguez, Ricardo J

2003-03-01

Respiratory distress syndrome is the most common respiratory disorder in preterm infants. Over the last decade, because of improvements in neonatal care and increased use of antenatal steroids and surfactant replacement therapy, mortality from respiratory distress syndrome has dropped substantially. However, respiratory morbidity, primarily bronchopulmonary dysplasia, remains unacceptably high. The management of respiratory distress syndrome in preterm infants is based on various modalities of respiratory support and the application of fundamental principles of neonatal care. To obtain best results, a multidisciplinary approach is crucial. This review discusses surfactant replacement therapy and some of the current strategies in ventilatory management of preterm infants with respiratory distress syndrome. Copyright 2003 Daedalus Enterprises

Predictors of Psychological Distress among Infertility Clinic Patients.

ERIC Educational Resources Information Center

Morrow, Kelly A.; And Others

1995-01-01

Investigated predictors of psychological distress among infertility clinic patients. Analyses indicated that infertile men and women reported greater psychological distress than the general population. Self-blame and avoidance coping significantly predicted psychological distress among men and women. Increased age and childlessness added to…

[Gender violence and other factors associated with emotional distress in female users of public health services in Mexico].

PubMed

Valdez-Santiago, Rosario; Juárez-Ramírez, Clara; Salgado-de Snyder, V Nelly; Agoff, Carolina; Avila-Burgos, Leticia; Híjar, Martha C

2006-01-01

To identify and describe the factors associated with emotional distress in a national sample of women users of public health services in Mexico, such a Secretaria de Salud (SSA), Instituto Mexicano del Seguro Social (IMSS), Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE). This research study was conducted using the database of the National Survey of Violence against Women that consisted of the responses of a total of 26 042 female users of health care services provided by the Mexican government health agencies. The Personal Health Scale (ESP per its initials in Spanish) was used to assess emotional distress. To measure violence a 19-item scale which explores different types of violence as well as severity was used. The relationship between emotional distress and gender violence was determined through a binary logistic regression model, as were economic status and demographic variables. One of the most important findings of this study is the high prevalence of emotional distress (15.3%) among women seeking health care services from the public sector and the relationship of such emotional distress with the experience of marital physical, psychological, and sexual violence. Factors associated with emotional distress among female users of health care services were age (26 and older); activity (laborer); working hours (71 hours a week or more); alcohol intake (greater intake); abuse during childhood (frequency and types of abuse); severity of marital violence (severe violence); socioeconomic status (very low SES); and type of dwelling (urban). The principal predictor of emotional distress was intimate partner abuse, especially in severe expression. The next predictor was violence in childhood. Taking into consideration these predictors it is recommended to use screening instruments to identify emotional distress and gender violence in health setting. It is important to design and implement attention and reference programs in public

Factors associated with psychological distress in women with breast cancer-related lymphoedema.

PubMed

Alcorso, Jessica; Sherman, Kerry A

2016-07-01

Previous research has shown that lymphoedema impacts negatively on an individual, including psychological distress and body image disturbance, particularly for younger women. This study identified psychological factors associated with distress in women with breast cancer-related lymphoedema and determined whether age moderated the specific relationship between body image disturbance and distress. Australian women (n = 166) diagnosed with breast cancer-related lymphoedema were recruited through a community-based breast cancer organisation and lymphoedema treatment clinics. Participants completed an online survey assessing lymphoedema-related cognitions (personal control, perceived treatment effectiveness, and consequences of lymphoedema), perceived ability to self-regulate lymphoedema-related negative affect, body image disturbance, psychological distress (depression, anxiety and stress), and demographic/medical information. Beliefs about the consequences, perceived effectiveness of treatment and controllability of lymphoedema, perceived ability to self-regulate negative affect, body image disturbance, and number of lymphoedema symptoms were correlated with depression, anxiety, and stress scores. Multivariate regression analyses indicated that body image disturbance was significantly associated with depression, anxiety, and stress, and perceived treatment effectiveness was associated with stress. Age was a significant moderator of the relationship between body image disturbance and depression and anxiety, with older women with greater body image disturbance more distressed. Health professionals need to be aware that women diagnosed with lymphoedema are at risk of experiencing psychological distress, particularly arising from body image disturbance and beliefs that treatment cannot control lymphoedema. Furthermore, older women may be at an increased risk of anxiety and depression arising from body image disturbance. Copyright © 2015 John Wiley & Sons, Ltd

Longitudinal relationships between workplace bullying and psychological distress.

PubMed

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

2012-01-01

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

Effectiveness of the Neonatal Discharge Program for Very Low-Birth-Weight Infants on Parental Efficacy and Psychological Distress.

PubMed

Shandra Bos, Lakshmi; Shorey, Shefaly; Kulantaipian, Tamill Salvee; Sng, Jane S P; Tam, Wilson W S; Koh, Serena S L

2018-05-17

This pilot study aimed to (i) evaluate the effectiveness of a neonatal discharge program, (ii) identify relationships between parent and infant factors and parental efficacy and psychological distress, and (iii) identify ways to improve the neonatal discharge program. A quasiexperimental 1-group pretest/posttest design was used. Through consecutive sampling, 42 participants were recruited. Data were collected using self-report questionnaires. Self-administering instruments gathered data on parental efficacy and psychological distress as well as feedback and recommendations on the intervention. A significant increase in parental efficacy and a reduction in psychological distress were observed from pre- to postdischarge intervention. Significant relationships were found between parental efficacy and infants' gestational age, birth weight, gender, and participants' level of education, and a significant relationship was found between psychological distress and number of children from previous pregnancies. Moreover, an Internet-based program, in addition to the face-to-face teaching, was identified as a preferred option to aid in information retention. It is important to evaluate and enhance the neonatal discharge program to suit the parents of today while providing them with informational and emotional support. Future studies should explore parental coping and the long-term effects of their infant's birth and the intervention.

Nursing Diagnosis of "Spiritual Distress" in Women With Breast Cancer: Prevalence and Major Defining Characteristics.

PubMed

Caldeira, Sílvia; Timmins, Fiona; de Carvalho, Emília C; Vieira, Margarida

2016-01-01

Spirituality and spiritual needs of cancer patients are frequently mentioned in the nursing literature, but the most significant defining characteristics of spiritual distress in the context of clinical reasoning and nursing diagnosis are rarely explored. Understanding of these is important for effective spiritual intervention. The aim of this study was to identify the prevalence and the defining characteristics of the nursing diagnosis "spiritual distress," as classified according to NANDA International, among women with breast cancer. This was a quantitative and cross-sectional study, comprising the third phase of a larger study investigating the clinical validation of spiritual distress in cancer patients undergoing chemotherapy. Fehring's clinical diagnostic validation model was used to identify the prevalence and the major defining characteristics of the diagnosis. A convenience sample was used, and data were collected by structured interview. A total of 70 women participated; most were married (62.9%) and had a mean age of 54 years, and 55.7% reported having at least 1 person depending on them. The average length of time since the cancer diagnosis was 30.9 months. Twenty-seven participants were experiencing spiritual distress (38.6%). Eleven defining characteristics were classified as major. The prevalence of spiritual distress and the major defining characteristics give clinical evidence about the nurse's role in providing spiritual care. The results are useful for the improved use of the NANDA International diagnoses within this domain. The findings highlight the importance of assessing the defining characteristics of the diagnosis as an objective strategy to improve clinical reasoning related to spirituality and to facilitate more effective interventions.

Stories of Hell and Healing: Internet Users' Construction of Benzodiazepine Distress and Withdrawal.

PubMed

Fixsen, Alison M; Ridge, Damien

2017-11-01

Benzodiazepines are a group of drugs used mainly as sedatives, hypnotics, antiepileptics, and muscle relaxants. Consumption is recommended for 2 to 4 weeks only, due to fast onset of dependency and potentially distressing withdrawal symptoms. Few peer-review studies have drawn on the user experiences and language to appreciate firsthand experiences of benzodiazepine withdrawal or discontinuation syndrome. We looked extensively at patient stories of benzodiazepine withdrawal and recovery on Internet support sites and YouTube. Our analysis indicated that users employ rich metaphors to portray the psychologically disturbing and protracted nature of their suffering. We identified seven major themes: hell and isolation, anxiety and depression, alienation, physical distress, anger and remorse, waves and windows, and healing and renewal. By posting success stories, ex-users make known that "healing" can be a long, unpredictable process, but distress does lessen, and recovery can happen.

The protective role of self-esteem, perceived social support and job satisfaction against psychological distress among Chinese nurses.

PubMed

Feng, Danjun; Su, Shan; Wang, Lu; Liu, Fang

2018-05-01

To determine the prevalence of psychological distress, and to explore the combined protective roles of self-esteem, perceived social support and job satisfaction against psychological distress. Few studies have explored the combined protective effect of self-esteem, perceived social support and job satisfaction on nurses' mental health in the same theoretical framework. The Rosenberg Self-Esteem Scale, the Multidimensional Scale of Perceived Social Support, a self-developed Job Satisfaction Questionnaire and the Kessler Psychological Distress Scale were used to survey 581 nurses. The hypothesized model of the relationships among self-esteem, perceived social support, job satisfaction and psychological distress was tested with structural equation modelling. The prevalence of psychological distress was 92.3%. Job satisfaction exerted the strongest direct protective effect against psychological distress, with perceived social support and self-esteem exerting the second and third strongest direct protective effects, respectively. Additionally, self-esteem had an indirect protective effect. Chinese nurses showed a surprisingly high prevalence of psychological distress. Job satisfaction, self-esteem and perceived social support were identified, in this order of importance, as protective factors against psychological distress. Nurse administrators should take measures to improve nurses' job satisfaction and social support, and hire individuals with high self-esteem as nurses. © 2018 John Wiley & Sons Ltd.

Protective Factors Based Model for Screening for Posttraumatic Distress in Adolescents

ERIC Educational Resources Information Center

Pat-Horenczyk, Ruth; Kenan, Avraham Max; Achituv, Michal; Bachar, Eytan

2014-01-01

Background: There is growing application of school-based screening to identify post-traumatic distress in students following exposure to trauma. The consensus method is based on self-report questionnaires that assess posttraumatic symptoms, functional impairment, depression or anxiety. Objective: The current research explored the possibility of…

Spiritual well-being and moral distress among Iranian nurses.

PubMed

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

2016-06-16

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

Cortico-limbic morphology separates tinnitus from tinnitus distress

PubMed Central

Leaver, Amber M.; Seydell-Greenwald, Anna; Turesky, Ted K.; Morgan, Susan; Kim, Hung J.; Rauschecker, Josef P.

2012-01-01

Tinnitus is a common auditory disorder characterized by a chronic ringing or buzzing “in the ear.”Despite the auditory-perceptual nature of this disorder, a growing number of studies have reported neuroanatomical differences in tinnitus patients outside the auditory-perceptual system. Some have used this evidence to characterize chronic tinnitus as dysregulation of the auditory system, either resulting from inefficient inhibitory control or through the formation of aversive associations with tinnitus. It remains unclear, however, whether these “non-auditory” anatomical markers of tinnitus are related to the tinnitus signal itself, or merely to negative emotional reactions to tinnitus (i.e., tinnitus distress). In the current study, we used anatomical MRI to identify neural markers of tinnitus, and measured their relationship to a variety of tinnitus characteristics and other factors often linked to tinnitus, such as hearing loss, depression, anxiety, and noise sensitivity. In a new cohort of participants, we confirmed that people with chronic tinnitus exhibit reduced gray matter in ventromedial prefrontal cortex (vmPFC) compared to controls matched for age and hearing loss. This effect was driven by reduced cortical surface area, and was not related to tinnitus distress, symptoms of depression or anxiety, noise sensitivity, or other factors. Instead, tinnitus distress was positively correlated with cortical thickness in the anterior insula in tinnitus patients, while symptoms of anxiety and depression were negatively correlated with cortical thickness in subcallosal anterior cingulate cortex (scACC) across all groups. Tinnitus patients also exhibited increased gyrification of dorsomedial prefrontal cortex (dmPFC), which was more severe in those patients with constant (vs. intermittent) tinnitus awareness. Our data suggest that the neural systems associated with chronic tinnitus are different from those involved in aversive or distressed reactions to

Perceptions of friendship among youth with distressed friends.

PubMed

Hill, Erin N; Swenson, Lance P

2014-02-01

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

Factors associated with financial distress of nonprofit hospitals.

PubMed

Kim, Tae Hyun

2010-01-01

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

Removing the Stress from Selecting Instruments: Arming Social Workers to Take Leadership in Routine Distress Screening Implementation

PubMed Central

Rohan, Elizabeth A.

2015-01-01

Quality cancer care requires identifying and addressing the psychosocial needs of cancer patients. Oncology social workers have long been on the forefront of this endeavor. Although there has been longstanding interest in screening cancer patients for distress, it has recently been included as a quality of care metric in institutions accredited by the American College of Surgeons. Implementing routine screening for distress in oncology settings requires thoughtful planning, including assessing various screening instruments and considering a host of variables within each practice setting. Oncology social workers are best positioned to provide leadership in operationalizing this mandate and to lead their team in the choice of a distress measure for compliance with the screening guideline. This article highlights the most popular distress screening measures used in oncology and their psychometric properties. PMID:23101550

Removing the stress from selecting instruments: arming social workers to take leadership in routine distress screening implementation.

PubMed

Rohan, Elizabeth A

2012-01-01

Quality cancer care requires identifying and addressing the psychosocial needs of cancer patients. Oncology social workers have long been on the forefront of this endeavor. Although there has been longstanding interest in screening cancer patients for distress, it has recently been included as a quality of care metric in institutions accredited by the American College of Surgeons. Implementing routine screening for distress in oncology settings requires thoughtful planning, including assessing various screening instruments and considering a host of variables within each practice setting. Oncology social workers are best positioned to provide leadership in operationalizing this mandate and to lead their team in the choice of a distress measure for compliance with the screening guideline. This article highlights the most popular distress screening measures used in oncology and their psychometric properties.

Understanding the Areas and Correlates of Diabetes-Related Distress in Parents of Teens With Type 1 Diabetes.

PubMed

Hessler, Danielle; Fisher, Lawrence; Polonsky, William; Johnson, Nicole

2016-08-01

To identify the unique areas of diabetes-related distress (DD) for parents of teens with type 1 diabetes and parent and teen characteristics associated with DD. Areas of DD were developed from structured interviews and translated into 46 survey items. Items were analyzed with exploratory factor analysis (EFA). An EFA with 332 parents (88% mothers) reduced items to four Parent Diabetes Distress Scale (PDDS) factors (20 items, α = .94): Personal, Teen Management, Parent/Teen Relationship, and Healthcare Team Distress. Parent DD was higher among fathers, younger or single parents, parents of teens with higher hemoglobin A1c or severe low blood glucose levels, authoritarian parenting, depressive symptoms, and low emotional support. 4 areas of parent DD were identified using a newly developed measure, the PDDS. DD was associated with family demographic, teen diabetes status, and parent contextual factors, and can help identify parents who may be more vulnerable to DD. © The Author 2016. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Dusukasi-The Heart That Cries: An Idiom of Mental Distress Among Perinatal Women in Rural Mali.

PubMed

Lasater, Molly E; Beebe, Madeleine; Warren, Nicole E; Souko, Fatoumata; Keita, Mariam; Murray, Sarah E; Bass, Judith K; Surkan, Pamela J; Winch, Peter J

2018-04-25

Perinatal mental health problems such as depression and anxiety are prevalent in low and middle-income countries. In Mali, the lack of mental health care is compounded by few studies on mental health needs, including in the perinatal period. This paper examines the ways in which perinatal women experience and express mental distress in rural Mali. We describe a process, relying on several different qualitative research methods, to identify understandings of mental distress specific to the Malian context. Participants included perinatal women, maternal health providers, and community health workers in rural southwest Mali. Participants articulated several idioms of distress, including gèlèya (difficulties), tôôrô (pain, suffering), hamin (worries, concerns), and dusukasi (crying heart), that occur within a context of poverty, interpersonal conflict, and gender inequality. These idioms of distress were described as sharing many key features and operating on a continuum of severity that could progress over time, both within and across idioms. Our findings highlight the context dependent nature of experiences and expressions of distress among perinatal women in Mali.

Analysis of the barriers of mental distress disclosure in medical inpatients in Taiwan.

PubMed

Han, Der-Yan; Lin, Yi-Yin; Liao, Shih-Cheng; Lee, Ming-Been; Thornicroft, Graham; Wu, Chia-Yi

2015-08-01

Disclosure of mental distress to physicians is important for mental illness identification, early referrals and proper treatment to prevent suicide. Little is known about what affects mental health communication in the clinical settings in the Chinese societies. The study aimed to identify the demographic, psychosocial and medical factors related to people with non-disclosure of their mental distress. We interviewed a series of consecutive inpatients from two medical wards of a general hospital in northern Taiwan. We collected depressive symptoms (the Patient Health Questionnaire, PHQ-9), living arrangement, threatening life events, suicide risks (i.e. past self-harm history, lifetime suicide ideas and hopelessness) and recent experience of mental distress disclosure. Furthermore, we explored the reasons of non-disclosure. A total of 230 medical inpatients agreed to participate (53.5% males). The results indicated that only 5.7% actually communicated their mental health concerns, and that 12.3% were willing to talk about their mental health problems. Among the 69 (30%) depressed participants (PHQ-9 score ≥ 10 points), the disclosure rate was low (8.7%) and the wish to talk about mental distress was also low (10.3%). After adjustment, living alone (OR = 7.58, 95% CI =  1.56-36.91) and having stressful life events (OR = 3.68, 95% CI = 1.09-12.46) remained significant in predicting disclosure of mental distress. The 109 participants attributed their refusal of communicating mental distress as medical-related attributes, subjective perceptions or sociocultural factors. Communication of mental distress in medical settings was uncommon due to medical or psychosocial barriers in Taiwan. Skill training to facilitate disclosure in medical education and public campaigns to improve knowledge of depression and enhance help-seeking deserve more attention, particularly under the influence of stigma in the Chinese societies. © The Author(s) 2014.

Pediatric acute respiratory distress syndrome: definition, incidence, and epidemiology: proceedings from the Pediatric Acute Lung Injury Consensus Conference.

PubMed

Khemani, Robinder G; Smith, Lincoln S; Zimmerman, Jerry J; Erickson, Simon

2015-06-01

Although there are similarities in the pathophysiology of acute respiratory distress syndrome in adults and children, pediatric-specific practice patterns, comorbidities, and differences in outcome necessitate a pediatric-specific definition. We sought to create such a definition. A subgroup of pediatric acute respiratory distress syndrome investigators who drafted a pediatric-specific definition of acute respiratory distress syndrome based on consensus opinion and supported by detailed literature review tested elements of the definition with patient data from previously published investigations. International PICUs. Children enrolled in published investigations of pediatric acute respiratory distress syndrome. None. Several aspects of the proposed pediatric acute respiratory distress syndrome definition align with the Berlin Definition of acute respiratory distress syndrome in adults: timing of acute respiratory distress syndrome after a known risk factor, the potential for acute respiratory distress syndrome to coexist with left ventricular dysfunction, and the importance of identifying a group of patients at risk to develop acute respiratory distress syndrome. There are insufficient data to support any specific age for "adult" acute respiratory distress syndrome compared with "pediatric" acute respiratory distress syndrome. However, children with perinatal-related respiratory failure should be excluded from the definition of pediatric acute respiratory distress syndrome. Larger departures from the Berlin Definition surround 1) simplification of chest imaging criteria to eliminate bilateral infiltrates; 2) use of pulse oximetry-based criteria when PaO2 is unavailable; 3) inclusion of oxygenation index and oxygen saturation index instead of PaO2/FIO2 ratio with a minimum positive end-expiratory pressure level for invasively ventilated patients; 4) and specific inclusion of children with preexisting chronic lung disease or cyanotic congenital heart disease. This

Analysis and evaluation of the moral distress theory.

PubMed

Wilson, Melissa A

2018-04-01

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

Understanding patient outcomes after acute respiratory distress syndrome: identifying subtypes of physical, cognitive and mental health outcomes.

PubMed

Brown, Samuel M; Wilson, Emily L; Presson, Angela P; Dinglas, Victor D; Greene, Tom; Hopkins, Ramona O; Needham, Dale M

2017-12-01

With improving short-term mortality in acute respiratory distress syndrome (ARDS), understanding survivors' posthospitalisation outcomes is increasingly important. However, little is known regarding associations among physical, cognitive and mental health outcomes. Identification of outcome subtypes may advance understanding of post-ARDS morbidities. We analysed baseline variables and 6-month health status for participants in the ARDS Network Long-Term Outcomes Study. After division into derivation and validation datasets, we used weighted network analysis to identify subtypes from predictors and outcomes in the derivation dataset. We then used recursive partitioning to develop a subtype classification rule and assessed adequacy of the classification rule using a kappa statistic with the validation dataset. Among 645 ARDS survivors, 430 were in the derivation and 215 in the validation datasets. Physical and mental health status, but not cognitive status, were closely associated. Four distinct subtypes were apparent (percentages in the derivation cohort): (1) mildly impaired physical and mental health (22% of patients), (2) moderately impaired physical and mental health (39%), (3) severely impaired physical health with moderately impaired mental health (15%) and (4) severely impaired physical and mental health (24%). The classification rule had high agreement (kappa=0.89 in validation dataset). Female Latino smokers had the poorest status, while male, non-Latino non-smokers had the best status. We identified four post-ARDS outcome subtypes that were predicted by sex, ethnicity, pre-ARDS smoking status and other baseline factors. These subtypes may help develop tailored rehabilitation strategies, including investigation of combined physical and mental health interventions, and distinct interventions to improve cognitive outcomes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use

Midlife personality and risk of Alzheimer disease and distress: a 38-year follow-up.

PubMed

Johansson, Lena; Guo, Xinxin; Duberstein, Paul R; Hällström, Tore; Waern, Margda; Ostling, Svante; Skoog, Ingmar

2014-10-21

To study the association between midlife neuroticism and extraversion and development of late-life dementia and long-standing distress in a sample of women followed for 38 years. A population-based sample of 800 women, aged 38 to 54 years, was examined in 1968, with subsequent examinations in 1974, 1980, 1992, 2000, and 2005. Neuroticism and extraversion were assessed using the Eysenck Personality Inventory at baseline. Distress was measured according to a standardized question at each study wave. Dementia was diagnosed according to DSM-III-R criteria based on information from neuropsychiatric examinations, informant interviews, hospital records, and registry data. During the 38-year follow-up, 153 women developed dementia; Alzheimer disease (AD) dementia was diagnosed in 104 of these. A higher degree of neuroticism in midlife was associated with increased risk of AD dementia and long-standing distress over 38 years. The association between neuroticism and AD dementia diminished after adjusting for long-standing distress. Extraversion was associated with a lower degree of long-standing distress, but had no impact on AD dementia. When the 2 personality dimensions were combined, high neuroticism/low extraversion showed the highest risk of AD dementia. Our study suggests that midlife neuroticism is associated with increased risk of AD dementia, and that distress mediates this association. The results have clinical implications because a group of women at risk of AD dementia is identified. © 2014 American Academy of Neurology.

Predictors of severe psychological distress trajectory after nuclear disaster: evidence from the Fukushima Health Management Survey.

PubMed

Oe, Misari; Maeda, Masaharu; Nagai, Masato; Yasumura, Seiji; Yabe, Hirooki; Suzuki, Yuriko; Harigane, Mayumi; Ohira, Tetsuya; Abe, Masafumi

2016-10-19

The Fukushima Daiichi Nuclear Power Plant accident, which occurred after the Great East Japan Earthquake and Tsunami in March 2011, may have a considerable long-term impact on the lives of area residents. The aims of this study were to determine the trajectories of psychological distress using 3-year consecutive data, and to find predictive factors of severe distress that may also prove useful for public health intervention. Data were obtained on 12 371 residents who were registered in the municipalities categorised as complete evacuation areas for 3 years after the disaster and who completed an assessment in each of the 3 years. Using group-based trajectory modelling, we identified four trajectory patterns distinguished by the levels of psychological distress, which gradually improved over time in all trajectories. Subjective sleep insufficiency, problem drinking, poor social support and perception of radiation risk 3 years after the accident were associated with the severity of psychological distress, according to the multivariate analysis. The identified factors may be useful for community-based mental healthcare over the long term following a nuclear disaster. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

33 CFR 175.130 - Visual distress signals accepted.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Visual distress signals accepted... (CONTINUED) BOATING SAFETY EQUIPMENT REQUIREMENTS Visual Distress Signals § 175.130 Visual distress signals accepted. (a) Any of the following signals, when carried in the number required, can be used to meet the...

33 CFR 175.130 - Visual distress signals accepted.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Visual distress signals accepted... (CONTINUED) BOATING SAFETY EQUIPMENT REQUIREMENTS Visual Distress Signals § 175.130 Visual distress signals accepted. (a) Any of the following signals, when carried in the number required, can be used to meet the...

33 CFR 175.130 - Visual distress signals accepted.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Visual distress signals accepted... (CONTINUED) BOATING SAFETY EQUIPMENT REQUIREMENTS Visual Distress Signals § 175.130 Visual distress signals accepted. (a) Any of the following signals, when carried in the number required, can be used to meet the...

Conflict in Maritally Distressed Military Couples.

ERIC Educational Resources Information Center

Griffin, William A.; Morgan, Allison R.

1988-01-01

Investigated whether 30 maritally distressed military couples differed from 30 distressed civilian couples using marital satisfaction questionnaires. Found same-sex differences across groups, and cross-sex differences within groups. Found military wives were more likely to be physically abused than were civilian wives, and more often requested…

Food addiction associations with psychological distress among people with type 2 diabetes.

PubMed

Raymond, Karren-Lee; Lovell, Geoff P

2016-01-01

To assess the relationship between a food addiction (FA) model and psychological distress among a type 2 diabetes (t2d) sample. A cross-sectional study of 334 participants with t2d diagnoses were invited to complete a web-based questionnaire. We measured variables of psychological distress implementing the Depression Anxiety and Stress Scale (DASS-21), the Yale Food Addiction Scale (YFAS), and other factors associated with t2d. In our study a novel finding highlighted people with t2d meeting the FA criterion had significantly higher depression, anxiety, and stress scores as compared to participants who did not meet the FA criterion. Moreover, FA symptomology explained 35% of the unique variance in depression scores, 34% of the unique variance in anxiety scores, and 34% of the unique variance in stress scores, while surprisingly, BMI explained less than 1% of the unique variance in scores. We identified that psychological distress among people with t2d was associated with the FA model, apparently more so than BMI, thereby indicating further research being necessary lending support for future research in this realm. Moreover the FA model may be beneficial when addressing treatment approaches for psychological distress among people with t2d. Copyright © 2016 Elsevier Inc. All rights reserved.

Predictors of maternal psychological distress in rural India: a cross-sectional community-based study.

PubMed

Prost, Audrey; Lakshminarayana, Rashmi; Nair, Nirmala; Tripathy, Prasanta; Copas, Andrew; Mahapatra, Rajendra; Rath, Shibanand; Gope, Raj Kumar; Rath, Suchitra; Bajpai, Aparna; Patel, Vikram; Costello, Anthony

2012-05-01

Maternal common mental disorders are prevalent in low-resource settings and have far-reaching consequences for maternal and child health. We assessed the prevalence and predictors of psychological distress as a proxy for common mental disorders among mothers in rural Jharkhand and Orissa, eastern India, where over 40% of the population live below the poverty line and access to reproductive and mental health services is low. We screened 5801 mothers around 6 weeks after delivery using the Kessler-10 item scale, and identified predictors of distress using multiple hierarchical logistic regression. 11.5% (95% CI: 10.7-12.3) of mothers had symptoms of distress (K10 score >15). High maternal age, low asset ownership, health problems in the antepartum, delivery or postpartum periods, caesarean section, an unwanted pregnancy for the mother, small perceived infant size and a stillbirth or neonatal death were all independently associated with an increased risk of distress. The loss of an infant or an unwanted pregnancy increased the risk of distress considerably (AORs: 7.06 95% CI: 5.51-9.04 and 1.49, 95% CI: 1.12-1.97, respectively). We did not collect data on antepartum depression, domestic violence or a mother's past birth history, and were therefore unable to examine the importance of these factors as predictors of psychological distress. Mothers living in underserved areas of India who experience infant loss, an unwanted pregnancy, health problems in the perinatal and postpartum periods and socio-economic disadvantage are at increased risk of distress and require access to reproductive healthcare with integrated mental health interventions. Copyright © 2012 Elsevier B.V. All rights reserved.

Predictors of maternal psychological distress in rural India: A cross-sectional community-based study

PubMed Central

Prost, Audrey; Lakshminarayana, Rashmi; Nair, Nirmala; Tripathy, Prasanta; Copas, Andrew; Mahapatra, Rajendra; Rath, Shibanand; Gope, Raj Kumar; Rath, Suchitra; Bajpai, Aparna; Patel, Vikram; Costello, Anthony

2012-01-01

Background Maternal common mental disorders are prevalent in low-resource settings and have far-reaching consequences for maternal and child health. We assessed the prevalence and predictors of psychological distress as a proxy for common mental disorders among mothers in rural Jharkhand and Orissa, eastern India, where over 40% of the population live below the poverty line and access to reproductive and mental health services is low. Method We screened 5801 mothers around 6 weeks after delivery using the Kessler-10 item scale, and identified predictors of distress using multiple hierarchical logistic regression. Results 11.5% (95% CI: 10.7–12.3) of mothers had symptoms of distress (K10 score > 15). High maternal age, low asset ownership, health problems in the antepartum, delivery or postpartum periods, caesarean section, an unwanted pregnancy for the mother, small perceived infant size and a stillbirth or neonatal death were all independently associated with an increased risk of distress. The loss of an infant or an unwanted pregnancy increased the risk of distress considerably (AORs: 7.06 95% CI: 5.51–9.04 and 1.49, 95% CI: 1.12–1.97, respectively). Limitations We did not collect data on antepartum depression, domestic violence or a mother's past birth history, and were therefore unable to examine the importance of these factors as predictors of psychological distress. Conclusions Mothers living in underserved areas of India who experience infant loss, an unwanted pregnancy, health problems in the perinatal and postpartum periods and socio-economic disadvantage are at increased risk of distress and require access to reproductive healthcare with integrated mental health interventions. PMID:22342117

Prevalence of diabetes mellitus and prediabetes in the adult Romanian population: PREDATORR study.

PubMed

Mota, Maria; Popa, Simona Georgiana; Mota, Eugen; Mitrea, Adina; Catrinoiu, Doina; Cheta, Dan Mircea; Guja, Cristian; Hancu, Nicolae; Ionescu-Tirgoviste, Constantin; Lichiardopol, Radu; Mihai, Bogdan Mircea; Popa, Amorin Remus; Zetu, Cornelia; Bala, Cornelia Gabriela; Roman, Gabriela; Serafinceanu, Cristian; Serban, Viorel; Timar, Romulus; Veresiu, Ioan Andrei; Vlad, Adrian Radu

2016-05-01

The PREDATORR (PREvalence of DiAbeTes mellitus, prediabetes, overweight, Obesity, dyslipidemia, hyperuricemia and chronic kidney disease in Romania) study is the first national study analyzing the prevalence of diabetes mellitus (DM) and prediabetes, and their association with cardiometabolic, sociodemographic, and lifestyle risk factors in the Romanian population aged 20-79 years. This was an epidemiological study with a stratified, cross-sectional, cluster random sampling design. Sociodemographic, lifestyle, and anamnestic data were collected through self- and interviewer-administered questionnaires, and biochemical assays and oral glucose tolerance tests were performed. In all, 2728 participants from 101 clinics of general practitioners were randomly selected, with a probability proportional to population size according to the 2002 Romanian Census. The participation rate was 99.6%. Impaired glucose regulation (prediabetes, known and unknown DM) was found in 28.1% of the study population. The overall age- and sex-adjusted prevalence of DM was 11.6% (95% CI 9.6%-13.6%), of which 2.4% (95% CI 1.7%-3.1%) had unknown DM. The prevalence of DM increased with age and was higher in men than in women. The age- and sex-adjusted prevalence of prediabetes was 16.5% (95%CI 14.8%-18.2%), with the highest percentage in the 60-79 year age group and in women. Obesity, abdominal obesity, dyslipidemia, low education level, and a family history of diabetes were associated with glucose metabolism disorders. The PREDATORR study shows a high prevalence of impaired glucose regulation in the adult Romanian population, providing data on the prevalence of DM and prediabetes and their association with several risk factors. © 2015 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley Sons & Australia, Ltd.

Cyberbullying, School Bullying, and Psychological Distress: A Regional Census of High School Students

PubMed Central

O'Donnell, Lydia; Stueve, Ann; Coulter, Robert W. S.

2012-01-01

Objectives. Using data from a regional census of high school students, we have documented the prevalence of cyberbullying and school bullying victimization and their associations with psychological distress. Methods. In the fall of 2008, 20 406 ninth- through twelfth-grade students in MetroWest Massachusetts completed surveys assessing their bullying victimization and psychological distress, including depressive symptoms, self-injury, and suicidality. Results. A total of 15.8% of students reported cyberbullying and 25.9% reported school bullying in the past 12 months. A majority (59.7%) of cyberbullying victims were also school bullying victims; 36.3% of school bullying victims were also cyberbullying victims. Victimization was higher among nonheterosexually identified youths. Victims report lower school performance and school attachment. Controlled analyses indicated that distress was highest among victims of both cyberbullying and school bullying (adjusted odds ratios [AORs] were from 4.38 for depressive symptoms to 5.35 for suicide attempts requiring medical treatment). Victims of either form of bullying alone also reported elevated levels of distress. Conclusions. Our findings confirm the need for prevention efforts that address both forms of bullying and their relation to school performance and mental health. PMID:22095343

Cyberbullying, school bullying, and psychological distress: a regional census of high school students.

PubMed

Schneider, Shari Kessel; O'Donnell, Lydia; Stueve, Ann; Coulter, Robert W S

2012-01-01

Using data from a regional census of high school students, we have documented the prevalence of cyberbullying and school bullying victimization and their associations with psychological distress. In the fall of 2008, 20,406 ninth- through twelfth-grade students in MetroWest Massachusetts completed surveys assessing their bullying victimization and psychological distress, including depressive symptoms, self-injury, and suicidality. A total of 15.8% of students reported cyberbullying and 25.9% reported school bullying in the past 12 months. A majority (59.7%) of cyberbullying victims were also school bullying victims; 36.3% of school bullying victims were also cyberbullying victims. Victimization was higher among nonheterosexually identified youths. Victims report lower school performance and school attachment. Controlled analyses indicated that distress was highest among victims of both cyberbullying and school bullying (adjusted odds ratios [AORs] were from 4.38 for depressive symptoms to 5.35 for suicide attempts requiring medical treatment). Victims of either form of bullying alone also reported elevated levels of distress. Our findings confirm the need for prevention efforts that address both forms of bullying and their relation to school performance and mental health.

33 CFR 175.110 - Visual distress signals required.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Visual distress signals required... (CONTINUED) BOATING SAFETY EQUIPMENT REQUIREMENTS Visual Distress Signals § 175.110 Visual distress signals... signals selected from the list in § 175.130 or the alternatives in § 175.135, in the number required, are...

46 CFR 25.25-19 - Visual distress signals.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 1 2010-10-01 2010-10-01 false Visual distress signals. 25.25-19 Section 25.25-19... Other Lifesaving Equipment § 25.25-19 Visual distress signals. Each uninspected passenger vessel must meet the visual distress signal requirements of 33 CFR part 175 applicable to the vessel. [USCG-1999...

46 CFR 25.25-19 - Visual distress signals.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 1 2011-10-01 2011-10-01 false Visual distress signals. 25.25-19 Section 25.25-19... Other Lifesaving Equipment § 25.25-19 Visual distress signals. Each uninspected passenger vessel must meet the visual distress signal requirements of 33 CFR part 175 applicable to the vessel. [USCG-1999...

46 CFR 25.25-19 - Visual distress signals.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 1 2012-10-01 2012-10-01 false Visual distress signals. 25.25-19 Section 25.25-19... Other Lifesaving Equipment § 25.25-19 Visual distress signals. Each uninspected passenger vessel must meet the visual distress signal requirements of 33 CFR part 175 applicable to the vessel. [USCG-1999...

46 CFR 25.25-19 - Visual distress signals.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 1 2013-10-01 2013-10-01 false Visual distress signals. 25.25-19 Section 25.25-19... Other Lifesaving Equipment § 25.25-19 Visual distress signals. Each uninspected passenger vessel must meet the visual distress signal requirements of 33 CFR part 175 applicable to the vessel. [USCG-1999...

33 CFR 175.110 - Visual distress signals required.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Visual distress signals required... (CONTINUED) BOATING SAFETY EQUIPMENT REQUIREMENTS Visual Distress Signals § 175.110 Visual distress signals... signals selected from the list in § 175.130 or the alternatives in § 175.135, in the number required, are...

33 CFR 175.110 - Visual distress signals required.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Visual distress signals required... (CONTINUED) BOATING SAFETY EQUIPMENT REQUIREMENTS Visual Distress Signals § 175.110 Visual distress signals... signals selected from the list in § 175.130 or the alternatives in § 175.135, in the number required, are...

33 CFR 175.110 - Visual distress signals required.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Visual distress signals required... (CONTINUED) BOATING SAFETY EQUIPMENT REQUIREMENTS Visual Distress Signals § 175.110 Visual distress signals... signals selected from the list in § 175.130 or the alternatives in § 175.135, in the number required, are...

Discriminant biomarkers of acute respiratory distress syndrome associated to H1N1 influenza identified by metabolomics HPLC-QTOF-MS/MS platform.

PubMed

Ferrarini, Alessia; Righetti, Laura; Martínez, Ma Paz; Fernández-López, Mariano; Mastrangelo, Annalaura; Horcajada, Juan P; Betbesé, Antoni; Esteban, Andrés; Ordóñez, Jordi; Gea, Joaquín; Cabello, Jesús Ruiz; Pellati, Federica; Lorente, José A; Nin, Nicolás; Rupérez, Francisco J

2017-09-01

Acute respiratory distress syndrome (ARDS) is a serious complication of influenza A (H1N1) virus infection. Its pathogenesis is unknown and biomarkers are lacking. Untargeted metabolomics allows the analysis of the whole metabolome in a biological compartment, identifying patterns associated with specific conditions. We hypothesized that LC-MS could help identify discriminant metabolites able to define the metabolic alterations occurring in patients with influenza A (H1N1) virus infection that developed ARDS. Serum samples from patients diagnosed with 2009 influenza A (H1N1) virus infection with (n = 25) or without (n = 32) ARDS were obtained on the day of hospital admission and analyzed by LC-MS/MS. Metabolite identification was determined by MS/MS analysis and analysis of standards. The specificity of the patterns identified was confirmed in patients without 2009 influenza A(H1N1) virus pneumonia (15 without and 17 with ARDS). Twenty-three candidate biomarkers were found to be significantly different between the two groups, including lysophospholipids and sphingolipids related to inflammation; bile acids, tryptophan metabolites, and thyroxine, related to the metabolism of the gut microflora. Confirmation results demonstrated the specificity of major alterations occurring in ARDS patients with influenza A (H1N1) virus infection. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Rank, job stress, psychological distress and physical activity among military personnel.

PubMed

Martins, Lilian Cristina X; Lopes, Claudia S

2013-08-03

Physical fitness is one of the most important qualities in armed forces personnel. However, little is known about the association between the military environment and the occupational and leisure-time dimensions of the physical activity practiced there. This study assessed the association of rank, job stress and psychological distress with physical activity levels (overall and by dimensions). This a cross-sectional study among 506 military service personnel of the Brazilian Army examined the association of rank, job stress and psychological distress with physical activity through multiple linear regression using a generalized linear model. The adjusted models showed that the rank of lieutenant was associated with most occupational physical activity (β = 0.324; CI 95% 0.167; 0.481); "high effort and low reward" was associated with more occupational physical activity (β = 0.224; CI 95% 0.098; 0.351) and with less physical activity in sports/physical exercise in leisure (β = -0.198; CI 95% -0.384; -0.011); and psychological distress was associated with less physical activity in sports/exercise in leisure (β = -0.184; CI 95% -0.321; -0.046). The results of this study show that job stress and rank were associated with higher levels of occupational physical activity. Moreover job stress and psychological distress were associated with lower levels of physical activity in sports/exercises. In the military context, given the importance of physical activity and the psychosocial environment, both of which are related to health, these findings may offer input to institutional policies directed to identifying psychological distress early and improving work relationships, and to creating an environment more favorable to increasing the practice of leisure-time physical activity.

War and Bereavement: Consequences for Mental and Physical Distress

PubMed Central

Morina, Nexhmedin; von Lersner, Ulrike; Prigerson, Holly G.

2011-01-01

Background Little is known about the long-term impact of the killing of a parent in childhood or adolescence during war on distress and disability in young adulthood. This study assessed current prevalence rates of mental disorders and levels of dysfunction among young adults who had lost their father due to war-related violence in childhood or adolescence. Methods 179 bereaved young adults and 175 non-bereaved young adults were interviewed a decade after experiencing the war in Kosovo. Prevalence rates of Major Depressive Episode (MDE), anxiety, and substance use disorders, and current suicide risk were assessed using the Mini–International Neuropsychiatric Interview. The syndrome of Prolonged Grief Disorder (PGD) was assessed with the Prolonged Grief Disorder Interview (PG-13). Somatic symptoms were measured with the Patient Health Questionnaire. General health distress was assessed with the General Health Questionnaire. Findings Bereaved participants were significantly more likely to suffer from either MDE or any anxiety disorder than non-bereaved participants (58.7% vs. 40%). Among bereaved participants, 39.7% met criteria for Post-Traumatic Stress Disorder, 34.6% for PGD, and 22.3% for MDE. Bereaved participants with PGD were more likely to suffer from MDE, any anxiety disorder, or current suicide risk than bereaved participants without PGD. Furthermore, these participants reported significantly greater physical distress than bereaved participants without PGD. Conclusion War-related loss during middle childhood and adolescence presents significant risk for adverse mental health and dysfunction in young adulthood in addition to exposure to other war-related traumatic events. Furthermore, the syndrome of PGD can help to identify those with the greatest degree of distress and dysfunction. PMID:21765944

War and bereavement: consequences for mental and physical distress.

PubMed

Morina, Nexhmedin; von Lersner, Ulrike; Prigerson, Holly G

2011-01-01

Little is known about the long-term impact of the killing of a parent in childhood or adolescence during war on distress and disability in young adulthood. This study assessed current prevalence rates of mental disorders and levels of dysfunction among young adults who had lost their father due to war-related violence in childhood or adolescence. 179 bereaved young adults and 175 non-bereaved young adults were interviewed a decade after experiencing the war in Kosovo. Prevalence rates of Major Depressive Episode (MDE), anxiety, and substance use disorders, and current suicide risk were assessed using the Mini-International Neuropsychiatric Interview. The syndrome of Prolonged Grief Disorder (PGD) was assessed with the Prolonged Grief Disorder Interview (PG-13). Somatic symptoms were measured with the Patient Health Questionnaire. General health distress was assessed with the General Health Questionnaire. Bereaved participants were significantly more likely to suffer from either MDE or any anxiety disorder than non-bereaved participants (58.7% vs. 40%). Among bereaved participants, 39.7% met criteria for Post-Traumatic Stress Disorder, 34.6% for PGD, and 22.3% for MDE. Bereaved participants with PGD were more likely to suffer from MDE, any anxiety disorder, or current suicide risk than bereaved participants without PGD. Furthermore, these participants reported significantly greater physical distress than bereaved participants without PGD. War-related loss during middle childhood and adolescence presents significant risk for adverse mental health and dysfunction in young adulthood in addition to exposure to other war-related traumatic events. Furthermore, the syndrome of PGD can help to identify those with the greatest degree of distress and dysfunction.

Respiratory Distress

NASA Technical Reports Server (NTRS)

1976-01-01

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

[Psychological distress of children with progressive diseases and multiple disabilities: A crossed analysis].

PubMed

Perifano, A; Scelles, R

2015-09-01

In this paper, we present the results of research conducted on the psychological distress of lysosomal-disease-affected children. Lysosomal diseases are rare genetic diseases most often leading to severe disabilities, both psychological and physiological. As frequently reported by their relatives, affected children experience nervous breakdowns, which are sometimes treated with antidepressant prescriptions. However, mental impairment as well physical disabilities can prevent children from making their pain noticed and identified by their relatives. This raises a new research question: when disabilities are severe, how should the psychological distress of affected children be identified? Recent studies on the care of children with multiple disabilities (San Salavadour 2000; Scelles 2003; Camelio 2006; Pautrel, 2009) have used the children's family and caregivers to access their feelings, considered to be translators of children's feelings because they understand their nonverbal language (Camelio, 2006). Using this methodology, four parents from the French not-for-profit association called "VML" (Vaincre les maladies lysosomales) and four professionals were involved in semi-structured interviews. The goal of these interviews was to identify signs of possible psychological suffering, the context in which those signs were expressed, the meaning and the value attributed to it by the family and caregivers, and the reaction as well as an evaluation of that reaction. Thirteen children were involved, 12 of whom were described as having shown signs of psychological distress. Six lysosomal diseases were represented. Two types of signs were reported: active signs (e.g., agitation, screaming, crying) and passive signs (e.g., no communication, withdrawal, lack of facial expression). Most of the time, passive signs were interpreted by the family and caregivers as evidence of deep psychological distress. The meanings of both types of sign were the following: fear, anxiety

Genetic characterization of some Romanian red wine grapevine varieties

NASA Astrophysics Data System (ADS)

Ghetea, Ligia Gabriela; Motoc, Rozalia Magda; Niculescu, Ana-Maria; Litescu, Simona Carmen; Duma, Virgil-Florin; Popescu, Carmen Florentina

2008-04-01

In our study we have considered three of the most valuable Romanian red wine grapevine cultivars: Feteasca neagra, Feteasca alba and Novac. We have chosen to study grapevine because grapes and wine are an important part of a healthy diet, and because red grapes have the highest content of proanthocyanidins, that act as antioxidants (free radical scavengers) in the human body. Proanthocyanidins possess anti-mutagenic, anti-tumor, anti-viral activities and they present many other confirmed or potential benefits. Genotyping method was applied in order to asses the genetic profile at 14 microsatellite loci, for two cultivars: Feteasca neagra and Feteasca alba. In order to achieve this, the HPLC-DAD method was used. The content of anthocyans in grape skin from two cultivars - Feteasca neagra and Novac - was measured. Microsatellite markers have been certified as powerful tools for assessing genetic identities and genetic relationships between grapevine gene pools. Genetic characterization of grapevine cultivars can certify their authenticity and purity, two features that have a direct effect on the quality and value of the finished product, the wine. In our country, this is the first attempt in order to establish a genetic profile for valuable Romanian origin grapevine varieties. In some of the 14 microsatellitic loci, Feteasca neagra and Feteasca alba cultivars presented allele size variants different from the values cited in the literature, proving that these cultivars belong to a geographical distinct gene pool. The content of anthocyans in Feteasca neagra grape skin was significantly higher than in Novac.

Distress and depression in men who have sex with men: the Urban Men's Health Study.

PubMed

Mills, Thomas C; Paul, Jay; Stall, Ron; Pollack, Lance; Canchola, Jesse; Chang, Y Jason; Moskowitz, Judith T; Catania, Joseph A

2004-02-01

This study estimates the prevalence of depression and describes the correlates and independent associations of distress and depression among U.S. men who have sex with men. A household-based probability sample of men who have sex with men (N=2,881) was interviewed between 1996 and 1998 in four large American cities. With cutoff points of 15 and 22 for the Center for Epidemiological Studies Depression Scale, individual correlates and predictors of distress and depression were examined, and multinomial logistic regression was performed. The 7-day prevalence of depression in men who have sex with men was 17.2%, higher than in adult U.S. men in general. Both distress and depression were associated with lack of a domestic partner; not identifying as gay, queer, or homosexual; experiencing multiple episodes of antigay violence in the previous 5 years; and very high levels of community alienation. Distress was also associated with being of other than Asian/Pacific Islander ethnicity and experiencing early antigay harassment. Depression was also associated with histories of attempted suicide, child abuse, and recent sexual dysfunction. Being HIV positive was correlated with distress and depression but not significantly when demographic characteristics, developmental history, substance use, sexual behavior, and current social context were controlled by logistic regression. Rates of distress and depression are high in men who have sex with men. These high rates have important public health ramifications. The predictors of distress and depression suggest prevention efforts that might be effective when aimed at men who have sex with men.

Quality of life in pediatric cancer survivors: contributions of parental distress and psychosocial family risk.

PubMed

Racine, N M; Khu, M; Reynolds, K; Guilcher, G M T; Schulte, F S M

2018-02-01

Pediatric survivors of childhood cancer are at increased risk of poor quality of life and social-emotional outcomes following treatment. The relationship between parent psychological distress and child adjustment in pediatric cancer survivors has been well established. However, limited research has examined the factors that may buffer this association. The current study examined the associations between psychosocial family risk factors, parental psychological distress, and health-related quality of life (hrql) in pediatric cancer survivors. Fifty-two pediatric cancer survivors (34 males, 18 females, mean age = 11.92) and their parents were recruited from a long-term cancer survivor clinic. Children and their parents who consented to participate completed the Pediatric Quality of Life Inventory 4.0. Parents completed a demographic information form, the Psychosocial Assessment Tool (pat 2.0) and the Brief Symptom Inventory (bsi). The Intensity of Treatment Rating (itr-3) was evaluated by the research team. Multiple regression analyses revealed that parental psychological distress negatively predicted parent-reported hrql, while treatment intensity, gender, and psychosocial risk negatively predicted parent and child-reported hrql. Psychosocial risk moderated the association between parent psychological distress and parent-reported child hrql ( p = 0.03), whereby parents with high psychological distress but low levels of psychosocial risk reported their children to have higher hrql. Low levels of family psychosocial risk buffer the impact of parent psychological distress on child hrql in pediatric cancer survivors. The findings highlight the importance of identifying parents and families with at-risk psychological distress and psychosocial risk in order to provide targeted support interventions to mitigate the impact on hrql.

Grandparents of children with cancer: a controlled study of distress, support, and barriers to care.

PubMed

Wakefield, Claire E; Drew, Donna; Ellis, Sarah J; Doolan, Emma L; McLoone, Jordana K; Cohn, Richard J

2014-08-01

For families under stress, positive grandparental relationships provide a valued 'safety net'. However, coping with family stressors can place a heavy burden on older individuals who may be experiencing declining health/energy themselves. This mixed-methods study assessed the prevalence of distress in grandparents of children with, and without, cancer, aiming to identify predictors of grandparental distress and quantify their barriers to care. Two hundred twenty-one grandparents [87 cancer group; 134 controls; mean age 65.47 years (SD = 6.97); 33.5% male] completed self-report questionnaires assessing distress, anxiety, depression, anger, 'need for help', support use, and barriers to psychosocial care. A higher proportion of grandparents in the cancer group reported clinically relevant distress (32.9% vs. 12.7%; p < 0.001), anxiety (48.8% vs. 23.9%; p < 0.001), depression (24.4% vs. 6.0%; p < 0.001), and anger (23.5% vs. 6.8%; p = 0.001). In the cancer group, distress was higher in grandmothers and in families with fewer siblings. Grandparents rarely accessed evidence-based psychosocial support (<5% in both groups), although grandparents of children with cancer were more likely to seek religious/spiritual support. Barriers to help seeking included lack of knowledge and rurality. Grandparents of children with cancer qualitatively described undisclosed feelings of uncertainty and helplessness and provided advice to other grandparents to facilitate their coping. Grandparents of children with cancer were clearly more distressed than controls. Grandparents' capacity to support their families may be limited by their own, untreated, distress. Copyright © 2014 John Wiley & Sons, Ltd.

Pulling the heartstrings, arguing the case: a narrative response to the issue of moral agency in moral distress.

PubMed

Walsh, Aileen

2010-12-01

In this paper it is argued that moral distress is an emotional response to an ethical dilemma, and that to date, the literature has largely failed to address the fundamental questions that need to be answered in response to this emotional response. Firstly, does moral distress accurately identify a wrong being done to patients? Secondly, if it does, can nurses carry out this 'wrong doing', but not be responsible for the consequences of their actions? A narrative that reflects the emotional nature of moral distress is presented, with the aim of providing some answers to these questions.

33 CFR 83.37 - Distress signals (Rule 37).

Code of Federal Regulations, 2010 CFR

2010-07-01

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

33 CFR 83.37 - Distress signals (Rule 37).

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Distress signals (Rule 37). 83.37... NAVIGATION RULES RULES Sound and Light Signals § 83.37 Distress signals (Rule 37). When a vessel is in distress and requires assistance she shall use or exhibit the signals described in Annex IV to these Rules. ...

33 CFR 83.37 - Distress signals (Rule 37).

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Distress signals (Rule 37). 83.37... NAVIGATION RULES RULES Sound and Light Signals § 83.37 Distress signals (Rule 37). When a vessel is in distress and requires assistance she shall use or exhibit the signals described in Annex IV to these Rules. ...

33 CFR 83.37 - Distress signals (Rule 37).

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Distress signals (Rule 37). 83.37... NAVIGATION RULES RULES Sound and Light Signals § 83.37 Distress signals (Rule 37). When a vessel is in distress and requires assistance she shall use or exhibit the signals described in Annex IV to these Rules. ...

33 CFR 83.37 - Distress signals (Rule 37).

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Distress signals (Rule 37). 83.37... NAVIGATION RULES RULES Sound and Light Signals § 83.37 Distress signals (Rule 37). When a vessel is in distress and requires assistance she shall use or exhibit the signals described in Annex IV to these Rules. ...

Analysing the Management of Challenging Behaviour in Romanian Orphanages: Looking for Ways Forward

ERIC Educational Resources Information Center

Hardman, Claire

2004-01-01

In this article Claire Hardman reflects on her work on behaviour management in two Romanian orphanages. Quite apart from the intrinsic interest of the topic, the article serves as a reminder of the number of professionals in this country who regularly take time out to work abroad in unfamiliar and often challenging circumstances and who come back…

Lived Religion as Reproductive Decision-Making Resource Among Romanian Women Who Use Abortion as Contraception.

PubMed

Pop, Cristina A

2017-05-30

This article draws upon qualitative ethnographic data collected between 2005 and 2013 in southern Romania among women who have been consistently using abortion as a contraceptive method. It particularly considers the role that lived religion might have played in some individuals' strategies to render abortion a justifiable practice. Over the last seven decades, Romanian women's experiences of abortion have often been at odds with both secular and religious regulations. This study shifts the perspective from the biopolitics and the bioethics of abortion toward women's own reproductive decision-making strategies in a context of enduring traditional patriarchy. It explores the fluid and pragmatic ways in which some Romanians use the notions of "God's will," "sin," "redemption," "afterlife," and "Godparenting" to redefine abortion as a partially disembodied reproductive event. As a reproductive decision-making resource, lived religion empowers women to navigate the lived complexities of conception and contraception.

Psychological distress through immigration: the two-phase temporal pattern?

PubMed

Ritsner, M; Ponizovsky, A

1999-01-01

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

The effectiveness of bibliotherapy in alleviating tinnitus-related distress.

PubMed

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

2010-03-01

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

Hearts and minds: Agency and discourse on distress.

PubMed

Kemp, Martin

2003-01-01

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

Professionalism dilemmas, moral distress and the healthcare student: insights from two online UK-wide questionnaire studies

PubMed Central

Monrouxe, Lynn V; Rees, Charlotte E; Dennis, Ian; Wells, Stephanie E

2015-01-01

Objective To understand the prevalence of healthcare students’ witnessing or participating in something that they think unethical (professionalism dilemmas) during workplace learning and examine whether differences exist in moral distress intensity resulting from these experiences according to gender and the frequency of occurrence. Design Two cross-sectional online questionnaires of UK medical (study 1) and nursing, dentistry, physiotherapy and pharmacy students (study 2) concerning professionalism dilemmas and subsequent distress for (1) Patient dignity and safety breaches; (2) Valid consent for students’ learning on patients; and (3) Negative workplace behaviours (eg, student abuse). Participants and setting 2397 medical (67.4% female) and 1399 other healthcare students (81.1% female) responded. Main results The most commonly encountered professionalism dilemmas were: student abuse and patient dignity and safety dilemmas. Multinomial and logistic regression identified significant effects for gender and frequency of occurrence. In both studies, men were more likely to classify themselves as experiencing no distress; women were more likely to classify themselves as distressed. Two distinct patterns concerning frequency were apparent: (1) Habituation (study 1): less distress with increased exposure to dilemmas ‘justified’ for learning; (2) Disturbance (studies 1 and 2): more distress with increased exposure to dilemmas that could not be justified. Conclusions Tomorrow's healthcare practitioners learn within a workplace in which they frequently encounter dilemmas resulting in distress. Gender differences could be respondents acting according to gendered expectations (eg, males downplaying distress because they are expected to appear tough). Habituation to dilemmas suggests students might balance patient autonomy and right to dignity with their own needs to learn for future patient benefit. Disturbance contests the ‘accepted’ notion that students become

Sexual orientation and sexual behavior among Latino and Asian Americans: implications for unfair treatment and psychological distress.

PubMed

Chae, David H; Ayala, George

2010-09-01

Research on the sexuality of Asians and Latinos in the United States has been sparse, and the studies that have been done suffer from a number of limitations. Using data from the National Latino and Asian American Study (2002-2003), this study examined self-identified sexual orientation and self-reported sexual behavior among Latinos (n = 2,554; age: M = 38.1, SE = 0.5) and Asians (n = 2,095; age: M = 41.5, SE = 0.8). This study also investigated implications for unfair treatment and psychological distress among sexual minorities identified in the sample. Results indicated heterogeneity in responses to items assessing sexual orientation and sexual behavior including differences in the adoption of lesbian, gay, or bisexual (LGB) identity by gender, ethnicity, nativity, and socioeconomic status. LGB sexual minorities reported higher levels of unfair treatment and psychological distress compared to their non-LGB-identified sexual minority counterparts, and unfair treatment was positively associated with psychological distress. Results highlight the need to consider multiple demographic factors in assessing sexuality, and also suggest that measures of both self-identified sexual orientation and sexual behavior should be collected. In addition, findings provide support for the deleterious influence of unfair treatment among Asians and Latinos in the United States.

A pavement Moisture Accelerated Distress (MAD) identification system, volume 2

NASA Astrophysics Data System (ADS)

Carpenter, S. H.; Darter, M. I.; Dempsey, B. J.

1981-09-01

A users manual is designed which provides the engineer with a rational method of examining a pavement and determining rehabilitation needs that are related to the causes of the existing distress, particularly moisture related distress. The key elements in this procedure are the MAD Index developed in Volume 1, the Pavement Condition Index (PCI) and the Moisture Distress Index (MDI). Step by step procedures are presented for calculating each parameter. Complete distress identification manuals are included for asphalt surfaced highways and jointed reinforced concrete highways with pictures and descriptions of all major distress types. Descriptions of the role moisture plays in the development of each distress type are included.

Moral distress and its contribution to the development of burnout syndrome among critical care providers.

PubMed

Fumis, Renata Rego Lins; Junqueira Amarante, Gustavo Adolpho; de Fátima Nascimento, Andréia; Vieira Junior, José Mauro

2017-12-01

Burnout appears to be common among critical care providers. It is characterized by three components: emotional exhaustion, depersonalization and personal accomplishment. Moral distress is the inability of a moral agent to act according to his or her core values and perceived obligations due to internal and external constraints. We aimed to estimate the correlation between moral distress and burnout among all intensive care unit (ICU) and the step-down unit (SDU) providers (physicians, nurses, nurse technicians and respiratory therapists). A survey was conducted from August to September 2015. For data collection, a self-administered questionnaire for each critical care provider was used including basic demographic data, the Maslach Burnout Inventory (MBI) and the Moral Distress Scale-Revised (MDS-R). Correlation analysis between MBI domains and moral distress score and regression analysis to assess independent variables associated with burnout were performed. A total of 283 out of 389 (72.7%) critical care providers agreed to participate. The same team of physicians attended both ICU and SDU, and severe burnout was identified in 18.2% of them. Considering all others critical care providers of both units, we identified that overall 23.1% (95% CI 18.0-28.8%) presented severe burnout, and it did not differ between professional categories. The mean MDS-R rate for all ICU and SDU respondents was 111.5 and 104.5, respectively, p = 0.446. Many questions from MDS-R questionnaire were significantly associated with burnout, and those respondents with high MDS-R score (>100 points) were more likely to suffer from burnout (28.9 vs 14.4%, p = 0.010). After regression analysis, moral distress was independently associated with burnout (OR 2.4, CI 1.19-4.82, p = 0.014). Moral distress, resulting from therapeutic obstinacy and the provision of futile care, is an important issue among critical care providers' team, and it was significantly associated with severe burnout.

Optimizing romanian maritime coastline using mathematical model Litpack

NASA Astrophysics Data System (ADS)

Anton, I. A.; Panaitescu, M.; Panaitescu, F. V.

2017-08-01

There are many methods and tools to study shoreline change in coastal engineering. LITPACK is a numerical model included in MIKE software developed by DHI (Danish Hydraulic Institute). With this matehematical model we can simulate coastline evolution and profile along beach. Research and methodology: the paper contents location of the study area, the current status of Midia-Mangalia shoreline, protection objectives, the changes of shoreline after having protected constructions. In this paper are presented numerical and graphycal results obtained with this model for studying the romanian maritime coastline in area MIDIA-MANGALIA: non-cohesive sediment transport, long-shore current and littoral drift, coastline evolution, crossshore profile evolution, the development of the coastline position in time.

46 CFR 28.145 - Distress signals.

Code of Federal Regulations, 2010 CFR

2010-10-01

... day and night requirement. [CGD 88-079, 56 FR 40393, Aug. 14, 1991, as amended at 60 FR 48048, Sept... Great Lakes; or within 3 miles of the coastline on the Great Lakes Night visual distress signals consisting of one electric distress light, approval series 161.013 or 3 approved flares; plus Day visual...

Predicting Financial Distress and Closure in Rural Hospitals.

PubMed

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

2017-06-01

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

Tailored online cognitive behavioural therapy with or without therapist support calls to target psychological distress in adults receiving haemodialysis: A feasibility randomised controlled trial.

PubMed

Hudson, Joanna L; Moss-Morris, Rona; Norton, Sam; Picariello, Federica; Game, David; Carroll, Amy; Spencer, Jonathan; McCrone, Paul; Hotopf, Matthew; Yardley, Lucy; Chilcot, Joseph

2017-11-01

Psychological distress is prevalent in haemodialysis (HD) patients yet access to psychotherapy remains limited. This study assessed the feasibility and acceptability of online cognitive-behavioural therapy (CBT) tailored for HD patients, with or without therapist support, for managing psychological distress. This feasibility randomised controlled trial recruited patients from a UK HD centre. Following psychological distress screens, patients with mild-moderate psychological distress (Patient Health Questionnaire PHQ-9; score: 5-19 and/or Generalised Anxiety Disorder; GAD-7 score: 5-14) who met remaining inclusion criteria were approached for consent. Consenters were individually randomised (1:1) to online-CBT or online-CBT plus three therapist support calls. Outcomes included recruitment, retention, and adherence rates. Exploratory change analyses were performed for: psychological distress, quality of life (QoL), illness perceptions, and costs. The statistician was blinded to allocation. 182 (44%) out of 410 patients approached completed psychological distress screens. 26% found screening unacceptable; a further 30% found it unfeasible. Psychological distress was detected in 101 (55%) patients, 60 of these met remaining inclusion criteria. The primary reason for ineligibility was poor computer literacy (N=17, 53%). Twenty-five patients were randomised to the supported (N=18) or unsupported arm (N=7); 92% were retained at follow-up. No differences in psychological distress or cost-effectiveness were observed. No trial adverse events occurred. Online CBT appears feasible but only for computer literate patients who identify with the label psychological distress. A definitive trial using the current methods for psychological distress screening and online care delivery is unfeasible. ClinicalTrials.gov Identifier: NCT02352870. Copyright © 2017 Elsevier Inc. All rights reserved.

Socio-cultural factors surrounding mental distress during the perinatal period in Zambia: a qualitative investigation

PubMed Central

2012-01-01

Background The presence of mental distress during pregnancy and after childbirth imposes detrimental developmental and health consequences for families in all nations. In Zambia, the Ministry of Health (MoH) has proposed a more comprehensive approach towards mental health care, recognizing the importance of the mental health of women during the perinatal period. Aim The study explores factors contributing to mental distress during the perinatal period of motherhood in Zambia. Methods A qualitative study was conducted in Lusaka, Zambia with nineteen focus groups comprising 149 women and men from primary health facilities and schools respectively. Findings There are high levels of mental distress in four domains: worry about HIV status and testing; uncertainty about survival from childbirth; lack of social support; and vulnerability/oppression. Conclusion Identifying mental distress and prompt referral for interventions is critical to improving the mental health of the mother and prevent the effects of mental distress on the baby. Recommendation Strategies should be put in place to ensure pregnant women are screened for possible perinatal mental health problems during their visit to antenatal clinic and referral made to qualified mental health professionals. In addition further research is recommended in order to facilitate evidence based mental health policy formulation and implementation in Zambia. PMID:22954173

Validation of a moral distress instrument in nurses of primary health care 1

PubMed Central

Barth, Priscila Orlandi; Ramos, Flávia Regina Souza; Barlem, Edison Luiz Devos; Dalmolin, Graziele de Lima; Schneider, Dulcinéia Ghizoni

2018-01-01

ABSTRACT Objective: to validate an instrument to identify situations that trigger moral distress in relation to intensity and frequency in primary health care nurses. Method: this is a methodological study carried out with 391 nurses of primary health care, applied to the Brazilian Scale of Moral Distress in Nurses with 57 questions. Validation for primary health care was performed through expert committee evaluation, pre-test, factorial analysis, and Cronbach’s alpha. Results: there were 46 questions validated divided into six constructs: Health Policies, Working Conditions, Nurse Autonomy, Professional ethics, Disrespect to patient autonomy and Work Overload. The instrument had satisfactory internal consistency, with Cronbach’s alpha 0.98 for the instrument, and between 0.96 and 0.88 for the constructs. Conclusion: the instrument is valid and reliable to be used in the identification of the factors that trigger moral distress in primary care nurses, providing subsidies for new research in this field of professional practice. PMID:29791671

Resilience, loneliness, and psychological distress among homeless youth.

PubMed

Perron, Jeff L; Cleverley, Kristin; Kidd, Sean A

2014-08-01

Extant quantitative research on loneliness among homeless youth has grouped loneliness with other elements of psychological distress. The current study seeks to determine if loneliness has a different relationship with resilience than does psychological distress among street youth. Using data from 47 participants, linear regression was conducted. Results indicate that homeless youth experiencing higher psychological distress reported lower resilience scores. However, levels of resilience are not significantly associated with feelings of loneliness when psychological distress was accounted for. This study has implications for how researchers and clinicians conceptualize and address feelings of loneliness among homeless youth. Copyright © 2014 Elsevier Inc. All rights reserved.

Association between weight perception and psychological distress.

PubMed

Atlantis, E; Ball, K

2008-04-01

Obesity is a well-known cause of cardiovascular disease burden and premature death, but effects on depressive symptoms remain equivocal. Depressive symptoms may be more common among the obese individuals who perceive themselves as overweight, rather than those who perceive themselves as having an acceptable weight. Our aim was to determine whether weight status and weight perceptions are independently associated with psychological distress. We conducted a cross-sectional study using data from the Australian National Health Survey 2004-2005 (N=17 253). All variables were collected by self-report. Adjusted multinomial logistic regression analysis was conducted to generate prevalence odds ratios with 95% confidence intervals (95% CI) for medium (Kessler Psychological Distress Scale (K10) scores of 20-29) and high (K10 scores of 30-50) psychological distress (compared with K10 scores of 10-19 as the reference) associated with weight status (standard body mass index (BMI) cutoffs for underweight, overweight and obesity vs normal weight), weight perception (perceived underweight and overweight vs acceptable weight) and weight misperception (incorrect with BMI vs correct with BMI) adjusting for numerous important covariates. Overweight and underweight perception increased the odds of medium (40 and 50%) and high (50 and 120%) psychological distress, whereas weight status and weight misperception were not associated with psychological distress in adjusted analysis. Gender, alcohol consumed per week and post-school education were not significant covariates (at P<0.10 level). Overweight and underweight perception rather than weight status or weight misperception are significant risk factors associated with medium and high psychological distress prevalence and effects appear to be uniform for men and women. Well-designed prospective studies are still needed to determine whether weight perceptions cause psychological distress, and if so, whether symptoms are significantly

Distress and Coping Self-Efficacy in Inpatient Oncology Nurses.

PubMed

Wahlberg, Lara; Nirenberg, Anita; Capezuti, Elizabeth

2016-11-01

To examine distress and coping self-efficacy in inpatient oncology nurses. 
. Cross-sectional survey design.
. Oncology Nursing Society (ONS) chapter meetings and Hunter-Bellevue School of Nursing, both in New York, New York, as well as social media.
. 163 oncology nurses who work with an inpatient adult population.
. Participants were recruited through the ONS New York, New York, area chapter meetings, Hunter College, and ONS Facebook pages. An adapted Nurse Distress Thermometer (NDT) measured distress levels. The Occupational Coping Self-Efficacy Questionnaire for Nurses (OCSE-N) used a Likert-type scale to measure coping self-efficacy. Open-ended questions elicited additional perceptions of nurse respondents. 
. Descriptive statistics summarized sample demographics. A Pearson correlation between distress levels and coping self-efficacy scores was calculated. Low, normal, and high coping scores were compared to mean distress levels. 
. Survey participants showed high levels of distress, with a mean NDT score of 8.06. Those with higher coping self-efficacy scores reported less distress. A moderate, negative correlation was shown, with a statistically significant Pearson coefficient of -0.371. Responses to the open-ended questions revealed common stressors and pointed to solutions that institutions might implement to support nurses.
. Because coping self-efficacy related to lower distress levels in inpatient oncology nurses, institutional-level support for oncology nurses should be provided. 
. Interventions aimed at coping self-efficacy may prepare oncology nurses to cope better with their professional demands. Future research should explore how nurse distress affects patients.

Characterizing psychosocial distress in melanoma patients using the expert rating instrument PO-Bado SF.

PubMed

Loquai, C; Scheurich, V; Syring, N; Schmidtmann, I; Müller-Brenne, T; Werner, A; Grabbe, S; Beutel, M E

2014-12-01

Although psychosocial distress has been evaluated well in cancer entities like breast or prostate cancer, its impact on melanoma patients still needs to be characterized. The objectives of this study were to (i) evaluate psychosocial distress in melanoma patients using an expert rating instrument [basic documentation for psycho-oncology short version (PO-Bado SF)]; (ii) determine associated demographic and clinical variables; and (iii) assess the acceptance of using PO-Bado SF as a routine procedure in a skin cancer unit. A cross-sectional group of 696 melanoma patients was recruited. During the routine contact, doctors assessed the patients subjective distress using PO-Bado SF. Sociodemographic data, tumour data, treatment and the course of the disease were extracted from the patients' charts. PO-Bado SF was completed in 688 of 696 (99%) participating patients, revealing a high acceptance. In 51 (7%) patients, the PO-Bado SF cut-off score indicated the potential need of psychosocial support. Patients with previous or ongoing radiotherapy, a history of major surgery due to organ metastases, younger age and shorter time since diagnosis were considered significantly more distressed than patients without these criteria. Patients were most distressed by suffering from anxiety/worries and/or tensions. In younger patients emotional variables and other problems like social or family problems were deemed more relevant while functional limitations in daily living were reasons for higher distress in older patients. PO-Bado SF is a useful, well-accepted, practical and economic screening tool to identify distressed melanoma patients. Although most melanoma patients seem to cope well with their disease, special attention should be given to young patients in the first years after initial diagnosis and to patients with advanced disease, radiotherapy and major surgery due to their disease. Combination of expert rating tools with self-report screening instruments could further

Mental distress predicts divorce over 16 years: the HUNT study.

PubMed

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

2015-04-01

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

Young Children Sympathize Less in Response to Unjustified Emotional Distress

ERIC Educational Resources Information Center

Hepach, Robert; Vaish, Amrisha; Tomasello, Michael

2013-01-01

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

Rank, job stress, psychological distress and physical activity among military personnel

PubMed Central

2013-01-01

Background Physical fitness is one of the most important qualities in armed forces personnel. However, little is known about the association between the military environment and the occupational and leisure-time dimensions of the physical activity practiced there. This study assessed the association of rank, job stress and psychological distress with physical activity levels (overall and by dimensions). Methods This a cross-sectional study among 506 military service personnel of the Brazilian Army examined the association of rank, job stress and psychological distress with physical activity through multiple linear regression using a generalized linear model. Results The adjusted models showed that the rank of lieutenant was associated with most occupational physical activity (β = 0.324; CI 95% 0.167; 0.481); “high effort and low reward” was associated with more occupational physical activity (β = 0.224; CI 95% 0.098; 0.351) and with less physical activity in sports/physical exercise in leisure (β = −0.198; CI 95% −0.384; −0.011); and psychological distress was associated with less physical activity in sports/exercise in leisure (β = −0.184; CI 95% −0.321; −0.046). Conclusions The results of this study show that job stress and rank were associated with higher levels of occupational physical activity. Moreover job stress and psychological distress were associated with lower levels of physical activity in sports/exercises. In the military context, given the importance of physical activity and the psychosocial environment, both of which are related to health, these findings may offer input to institutional policies directed to identifying psychological distress early and improving work relationships, and to creating an environment more favorable to increasing the practice of leisure-time physical activity. PMID:23914802

A Longitudinal Study of Service Use in Families of Children Adopted from Romanian Orphanages

ERIC Educational Resources Information Center

Le Mare, Lucy; Audet, Karyn; Kurytnik, Karen

2007-01-01

Post-adoption service use and unmet service needs were examined longitudinally in three matched groups of children: children adopted from Romanian orphanages following a minimum of eight months' institutional experience (RO: n = 36); children from Romania who were destined for orphanages but were adopted early in infancy (EA: n = 25); and Canadian…

It could have been me: vicarious victims and disaster-focused distress.

PubMed

Wayment, Heidi A

2004-04-01

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

Frequency and predictors of psychological distress after a diagnosis of epilepsy: A community-based study.

PubMed

Xu, Ying; Hackett, Maree L; Glozier, Nick; Nikpour, Armin; Bleasel, Andrew; Somerville, Ernest; Lawson, John; Jan, Stephen; Hyde, Lorne; Todd, Lisa; Martiniuk, Alexandra; Ireland, Carol; Anderson, Craig S

2017-10-01

The objective of the study was to determine the frequency and predictors of psychological distress after a diagnosis of epilepsy. The Sydney Epilepsy Incidence Study to Measure Illness Consequences (SEISMIC) was a prospective, multicenter, community-based study of people of all ages with newly diagnosed epilepsy in Sydney, Australia. Analyses involved multivariate logistic regression and multinomial logit regression to identify predictors of psychological distress, assessed using the Hospital Anxiety and Depression Scale (HADS) and the Strengths and Difficulties Questionnaire (SDQ), as part of structured interviews. Psychological distress occurred in 33% (95% confidence interval [CI] 26 to 40%) and 24% (95% CI 18 to 31%) of 180 adults at baseline and 12months, respectively, and 23% (95% CI 14 to 33%) of 77 children at both time points. Thirty adults and 7 children had distress at baseline who recovered at 12months, while 15 adults and 7 children had new onset of distress during this period. History of psychiatric or behavioral disorder (for adults, odds ratio [OR] 6.82, 95% CI 3.08 to 15.10; for children, OR 28.85, 95% CI 2.88 to 288.60) and higher psychosocial disability (adults, OR 1.17, 95% CI 1.07 to 1.27) or lower family functioning (children, OR 1.80, 95% CI 1.08 to 3.02) were associated with psychological distress (C statistics 0.80 and 0.78). Psychological distress is common and fluctuates in frequency after a diagnosis of epilepsy. Those with premorbid psychological, psychosocial, and family problems are at high risk of this adverse outcome. Copyright © 2017 Elsevier Inc. All rights reserved.

Quality of life in pediatric cancer survivors: contributions of parental distress and psychosocial family risk

PubMed Central

Racine, N.M.; Khu, M.; Reynolds, K.; Guilcher, G.M.T.; Schulte, F.S.M.

2018-01-01

Background Pediatric survivors of childhood cancer are at increased risk of poor quality of life and social-emotional outcomes following treatment. The relationship between parent psychological distress and child adjustment in pediatric cancer survivors has been well established. However, limited research has examined the factors that may buffer this association. The current study examined the associations between psychosocial family risk factors, parental psychological distress, and health-related quality of life (hrql) in pediatric cancer survivors. Methods Fifty-two pediatric cancer survivors (34 males, 18 females, mean age = 11.92) and their parents were recruited from a long-term cancer survivor clinic. Children and their parents who consented to participate completed the Pediatric Quality of Life Inventory 4.0. Parents completed a demographic information form, the Psychosocial Assessment Tool (pat 2.0) and the Brief Symptom Inventory (bsi). The Intensity of Treatment Rating (itr-3) was evaluated by the research team. Results Multiple regression analyses revealed that parental psychological distress negatively predicted parent-reported hrql, while treatment intensity, gender, and psychosocial risk negatively predicted parent and child-reported hrql. Psychosocial risk moderated the association between parent psychological distress and parent-reported child hrql (p = 0.03), whereby parents with high psychological distress but low levels of psychosocial risk reported their children to have higher hrql. Conclusion Low levels of family psychosocial risk buffer the impact of parent psychological distress on child hrql in pediatric cancer survivors. The findings highlight the importance of identifying parents and families with at-risk psychological distress and psychosocial risk in order to provide targeted support interventions to mitigate the impact on hrql. PMID:29507482

Mental distress and subsequent use of psychotropic drugs among adolescents-a prospective register linkage study.

PubMed

Steffenak, Anne Kjersti Myhrene; Nordström, Gun; Wilde-Larsson, Bodil; Skurtveit, Svetlana; Furu, Kari; Hartz, Ingeborg

2012-06-01

To investigate the association between mental distress, other factors, and subsequent use of psychotropic drugs in adolescents aged 15-16 years. This study is based on information retrieved from the Norwegian Youth Health Surveys (2000-2003) and linked to prescription data from the Norwegian Prescription Database (2004-2009). The study population included 11,620 adolescents aged 15-16 (87% response rate) years. Self-reported mental distress (Hopkins Symptom Checklist-10 score 1.85) was recorded along with health and lifestyle habits, education plans, and family economics. Incident psychotropic drug use (outcome measure) was defined ≥1 prescriptions of one of the following psychotropic drugs: anxiolytics, hypnotics, antidepressants, or phenothiazines registered in the Norwegian Prescription Database. Overall, 15.5% of the adolescents reported mental distress, 75% of them were girls. For both genders, incident psychotropic use was significantly higher among those reporting mental distresses at baseline, compared with the rest of the participants. The highest psychotropic drug use was observed among mentally distressed girls (27.7%). Mental distress was significantly associated with incident use of psychotropic drugs (odds ratio: 2.25, 95% confidence interval: 1.97-2.55). After adjustment for confounding factors and inclusion of potential mediating factors, the odds ratio attenuated to 1.59 (95% confidence interval: 1.35-1.86). The prevalence of mental distress among adolescents may have consequences for health promotion. Public health nurses in Norway, working in health centers and schools, have a responsibility to promote health and prevent health problems. They have the opportunity and a responsibility to identify vulnerable young people. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Mental Disorder, Psychological Distress, and Functional Status in Canadian Military Personnel.

PubMed

Sampasa-Kanyinga, Hugues; Zamorski, Mark A; Colman, Ian

2018-01-01

We examined the overlap between mood and anxiety disorders and psychological distress and their associations with functional status in Canadian Armed Forces (CAF) personnel. Data on Regular Forces personnel ( N = 6700) were derived from the 2013 Canadian Forces Mental Health Survey, a nationally representative survey of the CAF personnel. Current psychological distress was assessed using the Kessler K10 scale. Past-month mood and anxiety disorders were assessed using the World Health Organization World Mental Health Composite Diagnostic Interview. The prevalence of psychological distress was the same as that of any past-month mood or anxiety disorder (7.1% for each). A total of 3.8% had both distress and past-month mood or anxiety disorder, 3.3% had past-month disorder without psychological distress, while another 3.3% had psychological distress in the absence of a past-month mood or anxiety disorder. After adjusting for age, sex, marital, education, income, language, element, rank, and alcohol use disorder, individuals with both psychological distress and past-month mood and anxiety disorders exhibited the highest levels of disability, days out of role, and work absenteeism relative to those with neither mental disorders nor psychological distress. Relative to individuals with both disorder and distress, those who endured distress in the absence of mental disorder exhibited lower, but meaningful, levels of disability compared with those with neither disorder nor distress. Disability is most severe among CAF personnel with both distress and past-month mood and anxiety disorders. Nevertheless, distress in the absence of disorder is prevalent and is associated with meaningful levels of disability.

Distress Intolerance during Smoking Cessation Treatment

PubMed Central

Farris, Samantha G.; Leyro, Teresa M.; Allan, Nicholas P.; Øverup, Camilla S.; Schmidt, Norman B.; Zvolensky, Michael J.

2016-01-01

Distress intolerance is a key vulnerability factor implicated in the maintenance and relapse of cigarette smoking. Yet, past work has not examined changes in these processes during smoking cessation treatment or their relation to smoking cessation outcomes. The aim of the present study was to examine the effect of two smoking cessation interventions on changes in self-report and behavioral distress intolerance indices during treatment, and whether these changes are associated with smoking cessation outcomes. Treatment-seeking smokers (N = 384) were randomly assigned to one of two 4-session smoking cessation treatment programs: Standard Cessation Program (SCP) or Smoking Treatment and Anxiety Management Program (STAMP). Quit dates were scheduled to coincide with the final treatment session. Physical domains of distress intolerance were assessed at baseline and at each weekly session, via the Discomfort Intolerance Scale (DIS; higher scores indicate more intolerance for discomfort) and Breath Holding Duration Task (shorter durations indicate more intolerance for respiratory distress). The STAMP condition produced a greater rate of reduction in DIS scores than did the SCP condition. Changes in DIS scores during treatment mediated the effect of STAMP treatment on 7-day point prevalence abstinence at Month 3 post-quit attempt. There were no treatment conditions differences in changes in Breath-Holding duration. Data suggest self-reported distress intolerance is malleable in the context of stress sensitivity reduction treatment, but not standard smoking cessation treatment, and such reductions may result in promotion of smoking abstinence. PMID:27565398

Setting the stage for universal financial distress screening in routine cancer care.

PubMed

Khera, Nandita; Holland, Jimmie C; Griffin, Joan M

2017-11-01

Financial burden from cancer treatment is increasingly being recognized as a threat to optimal access, quality, and outcomes of cancer care for patients. Although research in the area is moving at a fast pace, multiple questions remain unanswered, such as how to practically integrate the assessment and management of financial burden into routine health care delivery for patients with cancer. Although psychological distress screening for patients undergoing cancer treatment now is commonplace, the authors raise the provocative idea of universal screening for financial distress to identify and assist vulnerable groups of patients. Herein, the authors outline the arguments to support screening for financial burden in addition to psychological distress, examining it as an independent patient-reported outcome for all patients with cancer at various time points during their treatment. The authors describe the proximal and downstream impact of such a strategy and reflect on some challenges and potential solutions to help integrate this concept into routine cancer care delivery. Cancer 2017;123:4092-4096. © 2017 American Cancer Society. © 2017 American Cancer Society.

Women's experiences of postnatal distress: a qualitative study.

PubMed

Coates, Rose; Ayers, Susan; de Visser, Richard

2014-10-14

Women can experience a range of psychological problems after birth, including anxiety, depression and adjustment disorders. However, research has predominantly focused on depression. Qualitative work on women's experiences of postnatal mental health problems has sampled women within particular diagnostic categories so not looked at the range of potential psychological problems. The aims of this study were to explore how women experienced and made sense of the range of emotional distress states in the first postnatal year. A qualitative study of 17 women who experienced psychological problems in the first year after having a baby. Semi-structured interviews took place in person (n =15) or on the telephone (n =2). Topics included women's experiences of becoming distressed and their recovery. Data were analysed using Interpretative Phenomenological Analysis (IPA). Themes were developed within each interview before identifying similar themes for multiple participants across interviews, in order to retain an idiographic approach. Psychological processes such as guilt, avoidance and adjustment difficulties were experienced across different types of distress. Women placed these in the context of defining moments of becoming a mother; giving birth and breastfeeding. Four superordinate themes were identified. Two concerned women's unwanted negative emotions and difficulties adjusting to their new role. "Living with an unwelcome beginning" describes the way mothers' new lives with their babies started out with unwelcome emotions, often in the context of birth and breastfeeding difficulties. All women spoke about the importance of their postnatal healthcare experiences in "Relationships in the healthcare system". "The shock of the new" describes women's difficulties adjusting to the demands of motherhood and women emphasised the importance of social support in "Meeting new support needs". These findings emphasise the need for exploration of psychological processes such as

Resilience and Psychological Distress in Psychology and Medical Students.

PubMed

Bacchi, Stephen; Licinio, Julio

2017-04-01

The authors investigated levels of resilience and psychological distress in medical and psychology students, factors that may affect these levels, the relationship between resilience and psychological distress, and student opinion on causes of stress and possible interventions. A voluntary anonymous online survey was distributed to University of Adelaide medical and psychology students. Medical and psychology students (n = 560; response rate = 24.7%) had similar mean resilience and psychological distress scores, and 47.9% of medical students and 55.1% of psychology students were psychologically distressed. Higher levels of resilience were associated with lower levels of distress (p < 0.001). Students supported resilience-based interventions, greater financial support, clearer learning objectives and more continuous assessment as potential means to reduce the effects of stress. Higher levels of resilience were associated with lower levels of psychological distress. Further studies are required to determine the efficacy of resilience-based interventions in these groups.

A 3-stage model of patient-centered communication for addressing cancer patients' emotional distress.

PubMed

Dean, Marleah; Street, Richard L

2014-02-01

To describe pathways through which clinicians can more effectively respond to patients' emotions in ways that contribute to betterment of the patient's health and well-being. A representative review of literature on managing emotions in clinical consultations was conducted. A three-stage, conceptual model for assisting clinicians to more effectively address the challenges of recognizing, exploring, and managing cancer patients' emotional distress in the clinical encounter was developed. To enhance and enact recognition of patients' emotions, clinicians can engage in mindfulness, self-situational awareness, active listening, and facilitative communication. To enact exploration, clinicians can acknowledge and validate emotions and provide empathy. Finally, clinicians can provide information empathetically, identify therapeutic resources, and give referrals and interventions as needed to help lessen patients' emotional distress. This model serves as a framework for future research examining pathways that link clinicians' emotional cue recognition to patient-centered responses exploring a patient's emotional distress to therapeutic actions that contribute to improved psychological and emotional health. Specific communicative and cognitive strategies are presented that can help clinicians better recognize a patient's emotional distress and respond in ways that have therapeutic value. Published by Elsevier Ireland Ltd.

Romanian Educational Seismic Network Project

NASA Astrophysics Data System (ADS)

Tataru, Dragos; Ionescu, Constantin; Zaharia, Bogdan; Grecu, Bogdan; Tibu, Speranta; Popa, Mihaela; Borleanu, Felix; Toma, Dragos; Brisan, Nicoleta; Georgescu, Emil-Sever; Dobre, Daniela; Dragomir, Claudiu-Sorin

2013-04-01

Romania is one of the most active seismic countries in Europe, with more than 500 earthquakes occurring every year. The seismic hazard of Romania is relatively high and thus understanding the earthquake phenomena and their effects at the earth surface represents an important step toward the education of population in earthquake affected regions of the country and aims to raise the awareness about the earthquake risk and possible mitigation actions. In this direction, the first national educational project in the field of seismology has recently started in Romania: the ROmanian EDUcational SEISmic NETwork (ROEDUSEIS-NET) project. It involves four partners: the National Institute for Earth Physics as coordinator, the National Institute for Research and Development in Construction, Urban Planning and Sustainable Spatial Development " URBAN - INCERC" Bucharest, the Babeş-Bolyai University (Faculty of Environmental Sciences and Engineering) and the software firm "BETA Software". The project has many educational, scientific and social goals. The main educational objectives are: training students and teachers in the analysis and interpretation of seismological data, preparing of several comprehensive educational materials, designing and testing didactic activities using informatics and web-oriented tools. The scientific objective is to introduce into schools the use of advanced instruments and experimental methods that are usually restricted to research laboratories, with the main product being the creation of an earthquake waveform archive. Thus a large amount of such data will be used by students and teachers for educational purposes. For the social objectives, the project represents an effective instrument for informing and creating an awareness of the seismic risk, for experimentation into the efficacy of scientific communication, and for an increase in the direct involvement of schools and the general public. A network of nine seismic stations with SEP seismometers

The mediating effects of social support and self-efficacy on the relationship between social distress and emotional distress in head and neck cancer outpatients with facial disfigurement.

PubMed

Deno, Minako; Tashiro, Mie; Miyashita, Mitsunori; Asakage, Takahiro; Takahashi, Koji; Saito, Kenich; Busujima, Yasunobu; Mori, Yoshiyuki; Saito, Hiroto; Ichikawa, Yuji

2012-02-01

Although social support has been recognized as an important factor in the quality of life of head and neck cancer patients, there has been little investigation of the buffering effect of social support on these patients' social distress or of the coping skill of self-efficacy. The aim of this study was to examine how social support and self-efficacy mediate the relationship between social distress and emotional distress in head and neck cancer patients. Two hundred twenty-five head and neck cancer patients completed our questionnaire (effective response rate, 92.2%). Of these, 129 (57.3%) had facial disfigurement. These participants responded to questions about perception of social distress, social support, self-efficacy, and emotional distress (depression and anxiety). We used structural equation modeling for statistical analysis. The fit indices of this model were excellent (χ2 (7) = 9.147, p = 0.242, goodness of fit index (GFI) = 0.981, adjusted goodness of fit index (AGFI) = 0.922, comparative fit index (CFI) = 0.993, root mean square error of approximation (RMSEA) = 0.049). Self-efficacy strongly buffered the negative influence of social distress on emotional distress. Social support from family members did not have a direct or indirect influence on emotional distress. Social support from friends was related to lower social distress and higher emotional distress. Our findings suggest that self-efficacy might confound the relationship between social support and emotional distress, and that different sources of social support might play different roles in the mediation of social distress on emotional distress. Copyright © 2010 John Wiley & Sons, Ltd.