民航飞行学员飞行训练应激源研究

目的确定我国民航飞行学员飞行训练的应激源。方法采用德尔菲法形成量表初步维度并在此基础上编制初测量表,从不同训练分院及国外训练归校的学员中采取分层随机取样;选取524名飞行学员进行测试,对所得数据进行分析形成正式问卷。对所获数据进行探索性因素分析和验证性因素分析,并分别检验量表的内部一致性系数、重测信度、内容效度与结构效度。结果训练环境、职业前景、飞行教员、座舱环境4个维度共解释了总变异的57.154%。量表总体的Cronbach’sα系数为0.830,各因子的Cronbach’sα系数为0.751~0.782,重测的相关系数均在0.806(P<0.01)以上。维度间的相关系数为0.134~0.438(P<0.05),各维度与总体的相关系数在0.617~0.748(P<0.01)。一阶4因素模型(GFI=0.929、IFI=0.989、TLI=0.986、CFI=0.989、RMSEA=0.013)拟合效果较好。结论民航飞行学员飞行训练应激源量表符合心理测量学标准,具有良好信效度,民航飞行学员飞行训练应激源主要来源于训练环境、职业前景、飞行教员、座舱环境。     

Isolation rearing-induced deficits in prepulse inhibition and locomotor habituation are not potentiated by water deprivation

Prepulse inhibition (PPI) of the acoustic startle reflex is an operational measure of sensorimotor gating and is reduced in neuropsychiatric disorders such as schizophrenia. Isolation rearing of rats is a developmentally specific, nonpharmacological manipulation that leads to deficits in sensorimotor gating that mimic those observed in schizophrenia patients. This study examined the effects of an added stressor (water deprivation) on the magnitude of the isolation rearing effect on PPI and locomotor activity. At the time of weaning, male (n = 80) and female (n = 80) rats were assigned to either social housing or isolation housing and were subsequently assigned to the water-deprived or non-water-deprived groups. Rats were tested for acoustic startle and PPI at 3, 5 and 7 weeks postweaning. Isolated rats showed a significant decrease in PPI that was apparent at all 3 weeks. Water deprivation did not significantly affect PPI, nor was there a significant interaction between housing and water treatment or between sex and housing. When tested in the Behavior Pattern Monitor to assess locomotor activity, isolated rats displayed decreased habituation across the 1-h test session. Water deprivation did not affect locomotor activity in any significant, independent manner, nor did it potentiate the effects of isolation rearing on locomotor habituation. In these studies, both male and female Long-Evans rats were sensitive to the PPI-disruptive and locomotor-activating effects of social isolation. Isolation rearing significantly disrupts PPI and locomotor habituation independent of any effects of water deprivation.     

Psychological Resilience in Older Residents of Long-Term Care Facilities: Occurrence and Associated Factors

ObjectivesThe researchers aimed to (1) explore the occurrence of psychological resilience in the face of a major life stressor and conflict in older residents of long-term care facilities (LTCFs), and (2) identify factors associated with resilience in this population.DesignLongitudinal cohort study using the Dutch InterRAI-LTCF cohort.Setting and participantsOlder residents (≥60 years old) of 21 LTCFs in the Netherlands.MethodsThe researchers selected 2 samples of residents who had at least 2 assessments surrounding (1) an incident major life stressor, or (2) incident conflict with other resident or staff. A resilient outcome was operationalized as not having clinically meaningful mood symptoms at the post-stressor assessment and equal or fewer mood symptoms at the post-stressor relative to the pre-stressor assessment. The researchers used 2 resilience outcomes per stressor: 1 based on observer-reported mood symptoms and 1 based on self-reported mood symptoms. The most important factors from among 21 potential resilience factors for each of the 4 operationalizations of resilience were identified using a backward selection procedure with 2-level generalized estimating equations analyses.ResultsForty-eight percent and 50% of residents were resilient in the face of a major life stressor, based on observer-reported (n = 248) and self-reported (n = 211) mood, respectively. In the face of conflict, 26% and 51% of the residents demonstrated resilience, based on the observer-reported (n = 246) and self-reported (n = 183) mood, respectively. Better cognitive functioning, a strong and supportive relationship with family, participation in social activities, and better self-reported health were most strongly associated with resilience in the face of a major life stressor. Better communicative functioning, absence of psychiatric diagnoses, a strong and supportive relationship with family, not being lonely, social engagement, and not reminiscing about life were most strongly associated with resilience in the face of conflict.Conclusions and ImplicationsFactors with a social aspect appear to be particularly important to psychological resilience in older LTCF residents, and provide a potential target for intervention in the LTCF setting.     

压力源和快乐源对医务人员绩效的影响

目的 明确医务人员工作压力源和快乐源并分析其对工作绩效的影响,为制定合理有效的干预策略提供参考.方法 以医院70名在职医务人员为研究对象,运用自行设计的量表进行问卷调查收集资料,并做方差和相关性统计分析.结果 调查量表具有较高的信度;医务人员总体工作绩效为4.18分,处于良好的绩效水平;医务人员工作压力源排在前3位的分别是服务关系、生活影响和工作要求,工作快乐源排在前3位的分别为服务关系、关系氛围和工作成效;工作压力源与工作绩效呈负相关关系,工作快乐源与工作绩效呈正相关关系.结论 医务人员工作绩效受到工作压力源和快乐源的影响,缓解职业压力,提升快乐元素,对改善工作绩效推动医院发展具有很好促进作用.     

Does retching matter? Reviewing the evidence—Physiology and forces

Failure of antireflux surgery is common in children with neurodisability, with a high incidence of persistent or recurrent symptoms, including retching. Anatomical disruption of the wrap is a frequent finding, but what forces underlie this disruption? This article reviews the forces generated during potential wrap-stressing episodes, putting them into the clinical context of wrap failure.Historically, wrap failure has been attributed to pressures arising from a reduction in gastric capacity or compliance, with advocates for an additional, gastric emptying procedure, at the time of fundoplication. However, any postoperative pressure changes are small and insufficient to cause disruption, and evidence of benefit from gastric emptying procedures is lacking.Diaphragmatic stressor events are common in the presence of neurodisability, and there is now increasing recognition of an association between diaphragmatic stressors and wrap breakdown. The analysis in this review demonstrates that the greatest forces on the fundoplication wrap are those associated with retching and vomiting. The direction and magnitude of these forces are sufficient to cause wrap herniation into the thorax, and wrap separation. Clinical series confirm that retching is consistently and strongly associated with wrap breakdown.Retching needs to be addressed if we are to reduce the incidence of wrap failure.Level of Evidence V.     

Stress‐related cortisol responsivity modulates prospective memory

It is known that there is inter‐individual variation in behavioural and physiological stress reactions to the same stressor. The present study aimed to examine the impact of cortisol responsivity on performance in a complex real life‐like prospective memory (PM) paradigm by a re‐analysis of data published previously, with a focus on the taxonomy of cognitive dimensions of PM. Twenty‐one male subjects were stressed with the Socially Evaluated Cold Pressor Test (SECPT) before the planning of intentions. Another group of 20 males underwent a control procedure. Salivary cortisol was measured to assess the intensity of the biological stress response. Additionally, participants rated the subjective experience of stress on a 5‐point rating scale. Stressed participants were post‐hoc differentiated in high (n = 11) and low cortisol responders (n = 10). Cortisol niveau differed significantly between the two groups, whereas subjective stress ratings did not. PM performance of low cortisol responders was stable across time and the PM performance of controls declined. High cortisol responders showed a nominally weaker PM retrieval across the early trails and significantly improved only on the last trial. The data demonstrate for the first time that participants with a low cortisol responsivity may benefit from stress exposure before the planning phase of PM. PM performance of high cortisol responders shows a more inconsistent pattern, which may be interpreted in the sense of a recency effect in PM retrieval. Alternatively, high cortisol responses may have a deteriorating effect on PM retrieval, which disappeared on the last trials of the task as a result of the decrease of cortisol levels across time. Importantly, the data also demonstrate that the intensity of cortisol responses does not necessarily correspond to the intensity of the mental experience of stress.     

Behavioral control over shock blocks behavioral and neurochemical effects of later social defeat

Experience with behavioral control over tailshock (escapable shock, ES) has been shown to block the behavioral and neurochemical changes produced by later uncontrollable tail shock (inescapable shock, IS). The present experiments tested, in rats, whether the protective effect of control over tailshock extends beyond reducing the behavioral and neurochemical impact of a subsequent tailshock experience to stressors that are quite different. Social defeat (SD) was chosen as the second stress experience because it has few if any cues in common with tailshock. SD produced shuttlebox escape learning deficits (“learned helplessness”) and reduced juvenile social investigation 24 h later, as does IS. IS is notable for inducing a large increase in dorsal raphe nucleus (DRN) serotonergic (5-HT) activity as measured by extracellular levels of 5-HT within the DRN, and SD did so as well. ES occurring 7 days before SD blocked this SD-induced DRN activation, as well as the SD-induced interference with shuttlebox escape and reduction in social investigation. Prior exposure to yoked IS did not reduce the DRN 5-HT activation or later behavioral effects produced by SD, and thus the proactive stress-blunting effects of ES can be attributed to it's controllability. Thus, ES confers a very general protection to the impact of a subsequent stress experience.     

The effects of treated effluents on the intensity of papillomatosis and HSP70 expression in roach

Epidermal papillomatosis in fish has been proposed as an indicator of environmental stress but experimental evidence of connection between contaminants and papillomatosis in fish is scarce. We studied changes in the intensity of epidermal papillomatosis and the expression of heat shock protein 70 (HSP70) in roach, Rutilus rutilus, exposed to treated pulp mill and municipal effluents. In male roach, the increase in papillomatosis intensity was higher in fish exposed to 15% than in fish exposed to 1.5% concentration of municipal effluent. No differences were observed in papillomatosis development in females, or in HSP70 expression. In all the experiments conducted, the increasing effect of effluents seemed to be more pronounced in male fish suggesting that sex-related factors affected the intensity of papillomatosis after exposure to effluents. The present results indicate that environmentally relevant concentrations of municipal effluents may be contributing to the development of papillomatosis in fish.     

护士职业认同及影响因素调查分析

目的研究护士职业认同水平及影响因素,为管理者制订干预措施提高护士职业认同水平提供依据。方法采取护士职业认同量表、中国护士压力源量表、社会支持评定量表,调查216名护士的职业认同情况及其相关因素。结果护士职业认同程度总分为(3.41±0.04)分;影响护士职业认同程度的主要因素是护龄、社会支持、工资满意度以及压力源。结论管理者应注重减轻临床护士的工作压力,营造有利于调动护士积极性、发挥主观能动性的工作氛围,满足护理人员所期待的物质需求和经济稳定。     

北京市部分三级甲等医院护士亚健康状况及工作压力源的相关性研究

目的探讨三级甲等医院护士亚健康状况与工作压力源之间的关系,旨在为护理管理工作提供依据。方法采用亚健康诊断问卷及护士工作压力源量表对北京市3所三级甲等医院578名护士进行调查。结果亚健康发生率为83.39%;存在亚健康状态护士的工作压力高于无亚健康的护士;亚健康症状数量与工作压力呈正相关。结论工作压力是护士发生亚健康的主要危险因素。应当重视临床护士的亚健康问题,减轻护士职业压力,以减少亚健康的发生。