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1.
Objective The objective of the present study was to explore causal pathways to understand how second traumatic experiences could affect the development of emotional exhaustion and psychiatric problems. Methods A total of 582 workers who had jobs vulnerable to secondary traumatic experiences were enrolled for this study. Emotional exhaustion, secondary trauma, resilience, perceived stress, depression, anxiety, and sleep problems were evaluated. A model with pathways from secondary traumatic experience score to depression and anxiety was proposed. The participants were divided into three groups according to the resilience: the low, middle and high resilience group. Results Resilience was a meaningful moderator between secondary traumatic experiences and psychiatric problems. In the path model, the secondary trauma and perceived stress directly and indirectly predicted perceived stress, emotional exhaustion, depression, anxiety, and sleep problems in all three groups. Direct effects of perceived stress on depression and anxiety were the largest in the low resilience group. However, direct effects of secondary trauma on perceived stress and emotional exhaustion were the largest in the high resilience group. Conclusion Understanding the needs of focusing for distinct psychological factors offers a valuable direction for the development of intervention programs to prevent emotional exhaustion among workers with secondary traumatic experiences.  相似文献   
2.

Background

Asthma is an expensive chronic lung disease that affects 7% of U.S. adults and results in as many as 1.8 million emergency department (ED) visits each year. Pharmacists play an important role in managing asthma, including assessing control and monitoring disease progression, educating the patient about the disease and associated treatments, and ensuring safe and cost-effective medication use. However, comprehensive studies that account for the complex relationships between factors impacting asthma-related ED visits are lacking in the adult asthma population.

Objective

To explore the complex relationships between asthma control, medication use, co-morbid conditions, minority status, environment and asthma-related ED visits using a path analysis approach.

Methods and materials

Data for this study were obtained from the 2012 Behavioral Risk Factor Surveillance System's Asthma Call Back Survey. Current asthmatics 18 and older were included in the sample. Path analysis was used to evaluate the direct effects of the independent variables on asthma-related ED visits, as well as the indirect effects mediated through asthma control, health status, and daily use of inhaled corticosteroids.

Results

Having controlled asthma (β = ?0.153, p < 0.01) and good health status (β = ?0.133, p < 0.01) were associated with significantly fewer ED visits. Good health status was associated with daily use of inhaled corticosteroids, which in turn was associated with better asthma control. Hispanic ED use was mediated by asthma control (β = ?0.067, p < 0.05), while African American ED use was mediated by health status (β = 0.050, p < 0.05).

Conclusion

These findings suggest that there may be race/ethnicity specific factors that may be targeted to reduce asthma-related ED visits in minority populations.  相似文献   
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We have shown that bipolar individuals have reduced quality diets, including lower intake of polyunsaturated fatty acids (PUFA). We have also reported reduced plasma levels of the n-6 PUFA, linoleic acid (LA), and the n-3 PUFA, eicosapentaenoic acid (EPA) in bipolar subjects. In the current analysis we hypothesized that LA and EPA plasma levels would mediate lower self-reported mental health and life functioning scores in bipolar subjects. In a cross-sectional study, we collected a 7-day diet record in bipolar (n = 56) and control subjects (n = 46) followed by a fasted blood draw. We used structured equation modeling path analysis to test for mediating effects of dietary intake and plasma levels of LA and EPA on self-reported mental health questionnaire scores, including the Life Functioning Questionnaire (LFQ), the Patient Health Questionnaire (PHQ9), and the Short Form Health Survey (SF12), extracting the mental health component summary score (SF12-MH). We adjusted for age, gender, psychiatric medication use, body mass index (BMI), and total caloric intake as covariates with bipolar disorder as the primary predictor. We found a significant path association from bipolar disorder to lower plasma LA levels (p = 0.03) and significant paths from plasma LA to PHQ9 (p = 0.05), LFQ (p = 0.01) and SF12-MH (p = 0.05) scores, such that lower plasma LA predicted worse outcomes. We found no significant paths from plasma EPA levels to any of the outcome measures. These findings suggest that plasma LA levels partially mediate the effect of bipolar disorder on self-reported measures of mental health and life functioning.  相似文献   
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目的探讨双相障碍抑郁患者应对方式、自我和谐和病耻感之间的关系。方法采用便利抽样法,选择2017年6月—2018年12月太原市某三甲医院精神卫生科住院治疗的双相障碍抑郁患者217例,采用一般资料调查表、贬低-歧视感知量表、自我和谐量表、简易应对方式问卷进行调查。采用AMOS 22.0软件进行路径分析。结果217例患者贬低-歧视感知量表得分(30.92±6.41)分,自我和谐量表得分(101.54±16.99)分,积极应对方式得分(21.63±6.46)分,消极应对方式得分(13.36±5.03)分。Pearson相关分析显示,患者积极应对方式与自我和谐和病耻感呈负相关(r值分别为-0.748、-0.655;P<0.01);消极应对方式与自我和谐和病耻感呈正相关(r值分别为0.553、0.742;P<0.01);自我和谐与病耻感呈正相关(r=0.763,P<0.01)。中介效应检验显示,自我和谐仅在消极应对方式和病耻感之间起部分中介作用,中介效应占总效应的40.54%。结论消极应对方式不仅直接影响双相障碍抑郁患者的病耻感,还通过自我和谐间接影响其病耻感。医护人员可以开展以路径为依托的干预措施,降低双相障碍抑郁患者的病耻感。  相似文献   
7.
This study evaluated the effect of new motions of the motor TriAuto ZX2 on the cyclic fatigue of endodontic instruments. Vortex Blue 35.06 instruments were divided into four groups (n = 10) and tested for fatigue in a curved artificial canal (90° and 2 mm radius) using the following motions: continuous rotation (CR), Optimum Torque Reverse (OTR) set at 180° and the Optimum Glide Path (OGP), which was tested at 90° and 240°. The time to fracture (TTF) and the lengths of the fractured fragments were recorded. The mean TTF was significantly different among the groups (anova , P < 0.05): OGP 90° (213.39 ± 27.45), OTR 180° (121.24 ± 17.03), OGP 240° (45.24 ± 5.61) and CR (8.43 ± 1.27). Weibull analysis confirmed the shortest life expectancy for CR and the longest survival for OGP at 90°. The resistance to fatigue was affected by motions and pre‐set angles. The proprietary movements that are currently available for endodontic instruments were classified according to their kinematics.  相似文献   
8.
《Neurobiology of aging》2014,35(12):2761-2769
Entorhinal grid cells and hippocampal place cells are key systems for mammalian navigation. By combining information from different sensory modalities, they provide abstract representations of space. Given that both structures are among the earliest to undergo age-related neurodegenerative changes, we asked whether age-related navigational impairments are related to deficient integration of navigational cues. Younger and older adults performed a homing task that required using visual landmarks, self-motion information, or a combination of both. Further, a conflict between cues assessed the influence of each sensory domain. Our findings revealed performance impairments in the older adults, suggestive of a higher noise in the underlying spatial representations. In addition, even though both groups integrated visual and self-motion information to become more accurate and precise, older adults did not place as much influence on visual information as would have been optimal. As these findings were unrelated to potential changes in balance or spatial working memory, this study provides the first evidence that increasing noise and a suboptimal weighting of navigational cues might contribute to the common problems with spatial representations experienced by many older adults. These findings are discussed in the context of the known age-related changes in the entorhinal-hippocampal network.  相似文献   
9.
It is difficult to create spoken forms that can be understood on the spot. But the manual modality, in large part because of its iconic potential, allows us to construct forms that are immediately understood, thus requiring essentially no time to develop. This paper contrasts manual forms for actions produced over three time spans—by silent gesturers who are asked to invent gestures on the spot; by homesigners who have created gesture systems over their life spans; and by signers who have learned a conventional sign language from other signers—and finds that properties of the predicate differ across these time spans. Silent gesturers use location to establish co-reference in the way established sign languages do, but they show little evidence of the segmentation sign languages display in motion forms for manner and path, and little evidence of the finger complexity sign languages display in handshapes in predicates representing events. Homesigners, in contrast, not only use location to establish co-reference but also display segmentation in their motion forms for manner and path and finger complexity in their object handshapes, although they have not yet decreased finger complexity to the levels found in sign languages in their handling handshapes. The manual modality thus allows us to watch language as it grows, offering insight into factors that may have shaped and may continue to shape human language.  相似文献   
10.
目的调查输氧湿化瓶的污染途径,了解其微生物污染情况及所检出致病菌的抗生素敏感度。方法对正在使用的输氧设施345套次的不同部位及痰和病房空气等处分别取样做细菌培养;针对致病菌铜绿假单胞菌进行药敏试验。结果湿化液严重污染占37.1%;湿化瓶和湿化液连续使用时间越长细菌检出率越高,且严重污染者亦随之升高,使用时间〉3d与〈1d对比差异显著(P〈0.05);湿化瓶盖、鼻导管、咽拭子、痰及病房空气培养检出的细菌种类与湿化液检出的细菌种类相似。结论湿化液的常见污染菌多为条件致病菌。本研究提示湿化液的污染途径为经鼻导管的逆行污染。  相似文献   
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