POSTTRAUMATIC STRESS SYMPTOMS IN EMERGENCY SERVICE AMBULANCE PERSONNEL

A diversity of research has demonstrated that, although all people will present with a reaction after a traumatic incident, only a minority will develop posttraumatic stress disorder PTSD (Allan, La Grange, Niehaus, Scheurkogel & Stein, 1998). A complex interaction of multiple pre- and post-trauma factors determines the response. Numerous studies have attempted to assess variables that make an individual more susceptible to developing PTSD. A number of factors were investigated including genetic (Eisen, Goldberg, Heath, Lyons, Nowak & Rise, 1993), family history (Breslau, Davis, Andreski & Peterson, 1991), individual personality (Schurr, Friedman & Rosenberg, 1993), past history of trauma (Zaidi & Foy, 1994) and life events (McFarlane, 1989). A number of studies have identified posttraumatic stress disorder (PTSD) as an important issue in various South African groups (Kaminer, Seedat, Lockhat & Stein 2000; Marais, De Villiers, Möller & Stein, 1999)

The experience of admission to psychiatric hospital among Chinese adult patients in Hong Kong

<p>Abstract</p> <p>Background</p> <p>The paper reports on a study to evaluate the psychometric properties and cultural appropriateness of the Chinese translation of the Admission Experience Survey (AES).</p> <p>Methods</p> <p>The AES was translated into Chinese and back-translated. Content validity was established by focus groups and expert panel review. The Chinese version of the Admission Experience Survey (C-AES) was administered to 135 consecutively recruited adult psychiatric patients in the Castle Peak Hospital (Hong Kong SAR, China) within 48 hours of admission. Construct validity was assessed by comparing the scores from patients admitted voluntarily versus patients committed involuntarily, and those received physical or chemical restraint versus those who did not. The relationship between admission experience and psychopathology was examined by correlating C-AES scores with the Brief Psychiatric Rating Scale (BPRS) scores.</p> <p>Results</p> <p>Spearman's item-to-total correlations of the C-AES ranged from 0.50 to 0.74. Three factors from the C-AES were extracted using factor analysis. Item 12 was omitted because of poor internal consistency and factor loading. The factor structure of the Process Exclusion Scale (C-PES) corresponded to the English version, while some discrepancies were noted in the Perceived Coercion Scale (C-PCS) and the Negative Pressure Scale (C-NPS). All subscales had good internal consistencies. Scores were significantly higher for patients either committed involuntarily or subjected to chemical or physical restrain, independent on severity of psychotic symptoms.</p> <p>Conclusion</p> <p>The Chinese AES is a psychometrically sound instrument assessing the three different aspects of the experience of admission, namely "negative pressure, "process exclusion" and "perceived coercion". The potential of C-AES in exploring subjective experience of psychiatric admission and effects on treatment adherence should be further explored.</p

Posttraumatic stress symptoms in emergency service ambulance personnel

CITATION: Stewart, J. & Swartz, L. 2005. Posttraumatic stress symptoms in emergency service ambulance personnel. Social Work, 41(4):362-377, doi:10.15270/41-4-316.The original publication is available at http://socialwork.journals.ac.zaA diversity of research has demonstrated that, although all people will present with a reaction after a traumatic incident, only a minority will develop posttraumatic stress disorder PTSD (Allan, La Grange, Niehaus, Scheurkogel & Stein, 1998). A complex interaction of multiple pre- and post-trauma factors determines the response. Numerous studies have attempted to assess variables that make an individual more susceptible to developing PTSD. A number of factors were investigated including genetic (Eisen, Goldberg, Heath, Lyons, Nowak & Rise, 1993), family history (Breslau, Davis, Andreski & Peterson, 1991), individual personality (Schurr, Friedman & Rosenberg, 1993), past history of trauma (Zaidi & Foy, 1994) and life events (McFarlane, 1989). A number of studies have identified posttraumatic stress disorder (PTSD) as an important issue in various South African groups (Kaminer, Seedat, Lockhat & Stein 2000; Marais, De Villiers, Möller & Stein, 1999).http://socialwork.journals.ac.za/pub/article/view/316Publisher's versio

Allergy, Stress and Sense of Coherence in Families with Children living in accordance with an Anthroposophic Lifestyle

Background: Previous studies on anthroposophic lifestyle and allergy show that the children have less risk of developing allergies. All studies so far have been retrospective and have included children in school age. In view of the facts that this lifestyle seems to protect children from allergies and that different symptoms of atopy have increased dramatically during the last decades it is of general interest to study this group of children more in detail. The earlier findings have now been followed up in a prospective research program ALADDIN (Assessment of Life style and Allergic Disease During Infancy), applying different approaches. One of these is to focus on stress (as measured by cortisol) as a factor that may underlie the decreased risk of allergy in children from anthroposophic families.   Aim: This thesis is based on data from the ALADDIN study focusing on influence of family lifestyle on allergy sensitization early in children’s life in relation to psychosocial factors and salivary cortisol as an indicator of stress. Methods: A total of 552 families were recruited during pregnancy or during the first month of the child´s life in two recruitment waves, 330 families between September 2004 and November 2007 and another 222 families between March 2008 and January 2011. They were recruited at anthroposophic maternal and child health care centers (MCHC) and from conventional MCHCs.  Data on demographics and exposures were obtained by questionnaires and interviews. Parental capacity to adapt to stressors was evaluated by means of the questionnaire “Sense of Coherence” (SOC; Antonovsky). Salivary samples were collected at home from the infants and both parents for analyzes of cortisol. Blood samples were obtained from the parents and from the children for analyzes of IgE. Results: Many family related characteristics differed markedly between the groups before and during pregnancy, during delivery and the first 12 months of age. Children from anthroposophic families had lower levels of salivary cortisol compared to peers from families with a more conventional lifestyle on all sampling occasions at 6 months of age and on some of the occasions at 12 and 24 months of age. There were no differences concerning cortisol between parents with different lifestyle and no significant differences concerning SOC-scores between the three lifestyle groups. An anthroposophic lifestyle was associated with a lower risk of allergic sensitization up to five years of age. This risk was partially explained by lower cortisol levels during infancy. Children in families with a partly anthroposophic lifestyle also had substantially lower risk of sensitization. Conclusion: An anthroposophic lifestyle protects from development of allergy during childhood, at least up to five years of age. This protective capacity is partly mediated by low cortisol levels during infancy but is also dependent on unknown characteristics of this lifestyle.  These results call for further studies on health related effects of an anthroposophic lifestyle

Reduced risk of pre-eclampsia with organic vegetable consumption: results from the prospective Norwegian Mother and Child Cohort Study

Objective: Little is known about the potential health effects of eating organic food either in the general population or during pregnancy. The aim of this study was to examine associations between organic food consumption during pregnancy and the risk of pre-eclampsia among nulliparous Norwegian women. Design: Prospective cohort study. Setting: Norway, years 2002-2008. Participants: 28 192 pregnant women (nulliparous, answered food frequency questionnaire and general health questionnaire in mid-pregnancy and no missing information on height, body weight or gestational weight gain). Main outcome measure: Relative risk was estimated as ORs by performing binary logistic regression with pre-eclampsia as the outcome and organic food consumption as the exposure. Results: The prevalence of pre-eclampsia in the study sample was 5.3% (n=1491). Women who reported to have eaten organic vegetables 'often' or 'mostly' (n=2493, 8.8%) had lower risk of pre-eclampsia than those who reported 'never/rarely' or 'sometimes' (crude OR=0.76, 95% CI 0.61 to 0.96; adjusted OR=0.79, 95% CI 0.62 to 0.99). The lower risk associated with high organic vegetable consumption was evident also when adjusting for overall dietary quality, assessed as scores on a healthy food pattern derived by principal component analysis. No associations with pre-eclampsia were found for high intake of organic fruit, cereals, eggs or milk, or a combined index reflecting organic consumption. Conclusions: These results show that choosing organically grown vegetables during pregnancy was associated with reduced risk of pre-eclampsia. Possible explanations for an association between pre-eclampsia and use of organic vegetables could be that organic vegetables may change the exposure to pesticides, secondary plant metabolites and/or influence the composition of the gut microbiota

Vaccination and Allergic Sensitization in Early Childhood – The ALADDIN Birth Cohort

Background: The increasing incidence of allergic diseases highlights the importance of finding underlying mechanisms. Early vaccination has been suggested as one influential factor. However, it is difficult to find a study group with a large variation between subjects concerning compliance to the official vaccination program. The anthroposophic lifestyle is of interest in this context. Moreover, cohort studies show that children of families with this lifestyle run a lower risk of allergic sensitization and allergy-related disease. Methods: From the prospective birth cohort ALADDIN we included one group from the anthroposophic community, with restrictive attitudes concerning vaccinations, and two other groups of age-matched children with more conventional parental lifestyles. In all, 466 children were followed from birth to five years of age. Detailed vaccination data and blood samples were collected at six months, one, two, and five years. Information was also obtained on risk factors for allergy. The outcome variable, allergic sensitization was defined as allergen-specific serum IgE levels ≥ 0.35 kUA/L. Findings: In a logistic regression model adjusted for socio-demographics and established allergy risk factors, vaccination at later age or having a lower number of injections or vaccines were associated with low OR for allergic sensitization during the first year of life. However, after adjustment for anthroposophic lifestyle, no statistically significant associations remained. The adjusted OR for sensitization at five years of age in children not receiving any vaccinations (n = 54) was 0.98 [95% CI 0.38–2.57]. Interpretation: We found no support for an association between early childhood vaccination and subsequent allergic sensitization. Our findings do not support scepticism towards early childhood vaccination motivated by allergy risk. Keywords: ALADDIN, Allergic sensitization, Anthroposophic lifestyle, Early childhood, Vaccinatio

Organic Food Consumption during Pregnancy and Hypospadias and Cryptorchidism at Birth: The Norwegian Mother and Child Cohort Study (MoBa)

BACKGROUND: The etiologies of the male urogenital anomalies hypospadias and cryptorchidism remain unclear. It has been suggested that maternal diet and environmental contaminants may affect the risk of these anomalies via placental or hormonal disturbances. OBJECTIVES: We examined associations between organic food consumption during pregnancy and prevalence of hypospadias and cryptorchidism at birth. METHODS: Our study includes 35,107 women participating in the Norwegian Mother and Child Cohort Study (MoBa) who delivered a singleton male infant. Information about use of six groups of organically produced food (vegetables, fruit, bread/cereal, milk/dairy products, eggs, and meat) during pregnancy was collected by a food frequency questionnaire. Women who indicated that they sometimes, often, or mostly consumed organic foods in at least one of the six food groups were classified as organic food consumers in analyses. Hypospadias and cryptorchidism diagnoses were retrieved from the Medical Birth Registry of Norway. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) using multiple logistic regression. RESULTS: Seventy-four male newborns were diagnosed with hypospadias (0.2%), and 151 with cryptorchidism (0.4%). Women who consumed any organic food during pregnancy were less likely to give birth to a boy with hypospadias (OR = 0.42; 95% CI: 0.25, 0.70, based on 21 exposed cases) than women who reported they never or seldom consumed organic food. Associations with specific organic foods were strongest for vegetable (OR = 0.36; 95% CI: 0.15, 0.85; 10 exposed cases) and milk/dairy (OR = 0.43; 95% CI: 0.17, 1.07; 7 exposed cases) consumption. No substantial association was observed for consumption of organic food and cryptorchidism. CONCLUSIONS: Consumption of organically produced foods during pregnancy was associated with a lower prevalence of hypospadias in our study population. These findings were based on small numbers of cases and require replication in other study populations. CITATION: Brantsæter AL, Torjusen H, Meltzer HM, Papadopoulou E, Hoppin JA, Alexander J, Lieblein G, Roos G, Holten JM, Swartz J, Haugen M. 2016. Organic food consumption during pregnancy and hypospadias and cryptorchidism at birth: the Norwegian Mother and Child Cohort Study (MoBa). Environ Health Perspect 124:357–364; http://dx.doi.org/10.1289/ehp.140951