Walking on Eggshells: The Lived Experience of Partners of Veterans with PTSD

This phenomenological study examined the descriptions of lived experience among female partners of veteran men with combat-related posttraumatic stress disorder (PTSD) via internet discussion forums. Personal, self-initiated written accounts of 30 partners were analyzed with respect to meaning, challenges, coping responses, and role in veterans’ healing and rehabilitation. Following data analysis, five descriptive themes emerged: all-consuming effect of the illness, walking on eggshells, ambiguous loss, alone, and facing PTSD as a unit. The central meaning of these themes describes the widespread priority of the veterans’ illness, and the resulting isolation, grief, and apprehension experienced by intimate partners as they assume primary caregiving roles. The findings indicate that the nature of combat-related PTSD places significant burden and responsibility on partners. I argue that mental health supports and services should be implemented in order to meet the needs of partners of veteran with PTSD. Furthermore, the needs and preferences of partners should be considered in the design and delivery of mental health services targeted toward veterans. This study has implications for practitioners and for future planning and implementation of services and interventions for military families affected by combat trauma

Examining adherence to activity monitoring devices to improve physical activity in adults with cardiovascular disease: A systematic review

Background Activity monitoring devices are currently being used to facilitate and monitor physical activity. No prior review has examined adherence to the use of activity monitoring devices amongst adults with cardiovascular disease. Methods Literature from June 2012 to October 2017 was evaluated to examine the extent of adherence to any activity monitoring device used to collect objective physical activity data. Randomized control trials comparing usual care against the use of an activity monitoring device, in a community intervention for adults from any cardiovascular diagnostic group, were included. A systematic search of databases and clinical trials registers was conducted using Joanna Briggs Institute methodology. Results Of 10 eligible studies, two studies reported pedometer use and eight accelerometer use. Six studies addressed the primary outcome. Mean adherence was 59.1% (range 39.6% to 85.7%) at last follow-up. Studies lacked equal representation by gender (28.6% female) and age (range 42 to 82 years). Conclusion This review indicates that current research on activity monitoring devices may be overstated due to the variability in adherence. Results showed that physical activity tracking in women and in young adults have been understudied

Hyperhomocysteinemia is associated with an increased risk of cardiovascular disease, especially in non-insulin-dependent diabetes mellitus - A population-based

A high serum total homocysteine (tHcy) level is an independent risk factor for cardiovascular disease. Because it is not known whether the strength of the association between hyperhomocysteinemia and cardiovascular disease is similar for peripheral arterial, coronary artery, and cerebrovascular disease, we compared the three separate risk estimates in an age-, sex-, and glucose tolerance-stratified random sample (n=631) from a 50- to 75-year-old general white population. Furthermore, we investigated the combined effect of hyperhomocysteinemia and diabetes mellitus with regard to cardiovascular disease. The prevalence of fasting hyperhomocysteinemia (>14.0 micromol/L) was 25.8%. After adjustment for age, sex, hypertension, hypercholesterolemia, diabetes, and smoking, the odds ratios (ORs; 95% confidence intervals) per 5-micromol/L increment in tHcy were 1.44 (1.10 to 1.87) for peripheral arterial, 1.25 (1.03 to 1.51) for coronary artery, 1.24 (0.97 to 1.58) for cerebrovascular, and 1.39 (1.15 to 1.68) for any cardiovascular disease. After stratification by glucose tolerance category and adjustment for the classic risk factors and serum creatinine, the ORs per 5-micromol/L increment in tHcy for any cardiovascular disease were 1.38 (1.03 to 1.85) in normal glucose tolerance, 1.55 (1.01 to 2.38) in impaired glucose tolerance, and 2.33 (1.11 to 4.90) in non-insulin-dependent diabetes mellitus (P=.07 for interaction). We conclude that the magnitude of the association between hyperhomocysteinemia and cardiovascular disease is similar for peripheral arterial, coronary artery, and cerebrovascular disease in a 50- to 75-year-old general population. High serum tHcy may be a stronger (1.6-fold) risk factor for cardiovascular disease in subjects with non-insulin-dependent diabetes mellitus than in nondiabetic subjects

Modelling additive transport in metal halide lamps

In 1912 Charles Steinmetz was granted a patent for a new light source. By adding small amounts of sodium, lithium, rubidium and potassium to a mercury lamp he was able to modify the light output from "an extremely disagreeable colour" to "a soft, brilliant, white light". Much later, at the New York world trade fair in 1964 General Electric was the first to introduced a commercial lamp based on the same principle. The light emitting metallic elements are introduced as components of halide salts. Hence, they are called metal halide lamps. The physics behind discharge lamps of this type, however, is still a matter of active investigation. One well-known phenomenon is that, when operated vertically, the metal halides in the lamp tend to demix; the concentration of metal halides in the gas phase is much greater at the bottom of the lamp. Demixing, or segregation as it is also called, has a negative impact on the lamp’s efficacy. It is currently avoided by using lamp designs with very small or very large aspect ratios. Gaining more insight into the process of demixing would allow a broader range of lamp designs with still better luminous efficacies. The demixing is caused by a competition between convection and diffusion. The centre of the lamp must be hot to produce as much light as possible. The walls must stay relatively cool to avoid them weakening and releasing the mercury vapour. Thus, large temperature gradients are present in the lamp, driving convective flows. In the hot centre the molecules are dissociated into atoms. The atoms are smaller and more mobile than the molecules. The atoms are dragged up by the convective currents while diffusing outward. Because of their larger mobility, however, the atoms do not reach the top of the lamp. The result is a larger concentration of metal additives at the walls and at the bottom of the lamp than at the centre and the top of the lamp. This thesis describes the process of demixing in a self consistent and quantitative manner using state-of-the-art computational methods. The competition between convection and diffusion is studied using a variety of models built with the plasma modelling toolkit Plasimo. Using Plasimo allows for the construction of models in a modular fashion. Partial models are used to study the conveci vtive flow as a result of the temperature gradients, the chemical composition as a function of temperature and pressure, and the radiation transport on the lamp. A grand model is formed by combining modules for ray tracing, elemental diffusion, convective flow and the temperature equation. The model result is validated against experiments done by colleagues: Experiments which have been carried out in Eindhoven, at the Argonne National Laboratories in the USA, and in the International Space Station. Cross validation with theoretical work has also been performed. Axial demixing is shown to be the result of the competition between axial convection and radial diffusion. This competition is best expressed by the dimensionless Peclet number. When the Peclet number is approximately equal to unity, axial segregation is strongest. The degree of axial segregation is best expressed by the dimensionless segregation depth t . The largest value of t depends on the element under study and on the position in the discharge where the molecules dissociate to form ions

Obesity - a risk factor for postoperative complications in general surgery?

Background: Obesity is generally believed to be a risk factor for the development of postoperative complications. Although being obese is associated with medical hazards, recent literature shows no convincing data to support this assumption. Moreover a paradox between body mass index and survival is described. This study was designed to determine influence of body mass index on postoperative complications and long-term survival after surgery. Methods: A single-centre prospective analysis of postoperative complications in 4293 patients undergoing general surgery was conducted, with a median follow-up time of 6.3 years. We analyzed the impact of bodyweight on postoperative morbidity and mortality, using univariate and multiv

Becoming the Vulnerable Neighbour: From Trauma Research to Practice

This article explores the relevancy and application of Gadamerian hermeneutics and Levinisian philosophy as adapted by Orange (2011) to the field of counselling psychology, with a focus on working with individuals who have experienced trauma. I begin by exploring an encounter that ignited my search for better understanding the suffering associated with traumatic betrayal in the context of military service, a journey which led me to an application of hermeneutics as a theoretical orientation in trauma counselling. I then examine Gadamerian hermeneutics and Levinisian constructs with respect to how my practice was altered by this encounter and how my approach to working with survivors of trauma continually evolves. The review of Gadamer’s constructs of dialogue and prejudice and Orange’s hermeneutic sensibility brings me to new insights as to the application of hermeneutics in the context of counselling psychology and its associated work in trauma care

Hyperhomocysteinemia is associated with the presence of retinopathy in type 2 diabetes mellitus. The Hoorn Study..

BACKGROUND: Retinopathy is the leading cause of blindness among patients with type 2 diabetes mellitus (DM). Hyperhomocysteinemia is a recently recognized risk factor for cardiovascular disease, independent of established risk factors. OBJECTIVE: To study the association between the homocysteine level and retinopathy among subjects with and without DM. METHODS: We studied an age-, sex-, and glucose tolerance-stratified random sample of a 50- to 75-year-old general white population in the Hoorn Study (N = 625). Retinal vascular changes (retinopathy) were assessed using ophthalmoscopy and/or fundus photography. Hyperhomocysteinemia was defined as a serum total homocysteine level greater than 16 micromol/L. RESULTS: The prevalence of retinopathy was 9.8% (28/285) in subjects with normal glucose tolerance, 11.8% (20/169) in those with impaired glucose tolerance, 9.4% (10/106) in those with newly diagnosed type 2 DM, and 32.3% (21/65) in those with known type 2 DM. The prevalence of retinopathy was 10.3% (39/380) in subjects without hypertension and 16.3% (40/245) in subjects with hypertension; it was 12.0% (64/534) in subjects with a serum total homocysteine level of 16 micromol/L or less and 16.5% (15/91) in those with a serum total homocysteine level of more than 16 micromol/L. After stratification for DM and adjustment for age, sex, glycosylated hemoglobin, and hypertension, the odds ratio (95% confidence interval) for the relation between retinopathy and hyperhomocysteinemia was 0.97 (95% confidence interval, 0.42-2.82) in patients without DM and 3.44 (95% confidence interval, 1.13-10.42) in patients with DM (P =.08 for interaction). CONCLUSION: The findings suggest that hyperhomocysteinemia may be a risk factor for retinopathy in patients with type 2 DM, but probably not in patients without DM. Arch Intern Med. 2000;160:2984-299

The Role of Clinical Supervision in Supervisee Burnout: A Call to Action

Professional burnout is a well-documented issue in professional psychology and has been associated with multiple negative personal, professional, and institutional consequences. Interestingly, burnout in the context of psychologists-in-training has received very little attention. This article defines burnout in the context of professional psychology, outlines the factors leading to burnout, discusses burnout in the context of psychologists-in-training, and examines how clinical supervisors can play a preventative and/or remedial role in supervisee burnout. The article concludes by highlighting the need to integrate education and wellness plans into supervisory relationships and settings

Breda University of Applied Science Introduction Course “Basic AI for Teaching Staff”

BUAS has launched a mandatory introductory course on Artificial Intelligence (AI) for all staff, aimed at establishing a consistent foundational knowledge in AI. This course, starting in Feb. 2024, comprises two components: a 1.5-hour e-learning segment and a workshop which takes 2 hours. The e-learning utilizes publicly accessible YouTube videos, integrated within the interactive platform FeedBack Fruits. Acknowledging the rapid development of AI, we are committed to continuously updating the course content to reflect the latest trends and innovations. This approach ensures that our teaching staff remains at the forefront of AI knowledge, aligning with BUAS\u27s dedication to a progressive and informed educational environment

Blood pressure, lipids, and obesity are associated with reteinopathy - The Hoorn study

OBJECTIVE - To study potential risk factors for retinopathy in diabetic and nondiabetic individuals. RESEARCH DESIGN AND METHODS - The Hoorn Study is a population-based study including 2,484 50- to 74-year-old Caucasians. A subsample of 626 individuals stratified by age, sex, and glucose tolerance underwent extensive measurements during 1989-1992, including ophthalmologic examination and two-field 45-degree fundus photography. The prevalence of (diabetic) retinopathy was assessed among individuals with normal glucose metabolism (NGM) and impaired glucose metabolism (IGM) and individuals with newly diagnosed diabetes mellitus (NDM) and known diabetes mellitus (KDM) (new World Health Organization 1999 criteria). RESULTS - The prevalence of retinopathy was 9% in NGM, 11% in IGM, 13% in NDM, and 34% in KDM. Retinopathy worse than minimal nonproliferative diabetic retinopathy was present in 8% in KDM and 0-2% in other glucose categories. The prevalence of retinopathy was positively associated with elevated blood pressure, BMI, cholesterol, and triglyceride serum levels in all glucose categories. The age-, sex-, and glucose metabolism category-adjusted odds ratios were 1.5 (95% CI 1.2-1.9), 1.3 (1.0-1.7), and 1.3 (1.0-1.6) per SD increase of systolic blood pressure, BMI, and total cholesterol concentration, respectively, and 1.2 (1.0-1.5) per 50% increase of triglyceride level. Elevated blood pressure and plasma total and LDL cholesterol levels showed associations with retinal hard exudates. CONCLUSIONS - Retinopathy is a multifactorial microvascular complication, which, apart from hyperglycemia, is associated with blood pressure, lipid concentrations, and BMI