Predictors of postevent distress and growth among firefighters after work-related emergencies — A cross-national study

Firefighters may experience posttraumatic stress symptomatology (i.e. post-event distress) as a consequence of exposure to work-related distressing incidents. However, positive psychological changes (i.e. post-event growth) should also be taken into account. The aim of this cross-national study was to investigate both post-event distress and growth in firefighters following distressing incidents. A sample of 1916 firefighters from eight predominantly European countries recalled a work-related distressing incident. Two hierarchical regression analyses were run to reveal predictors of post-event distress and growth, respectively. Predictors included person pre-event characteristics, objective (e.g. type of incident, time since incident, fatalities) and subjective (e.g. perceived life-threat, peri-event distress, most distressing aspect) incident features, and the participant’s country. Post-event distress was measured by the Impact of Event Scale-Revised (IES-R) and growth by the Posttraumatic Growth Inventory-Short Form (PTGI-SF). The final models explained 29% of the variation in post-event distress and 26% in growth. Post-event distress and growth were predicted by different variables. Country differences were found after controlling for all other variables. Further research is needed to explain these differences

Posttraumatic reactions among firefighters after critical incidents: cross-national data

The presence of posttraumatic stress disorder (PTSD) symptoms and posttraumatic growth (PTG) following a critical incident were examined among firefighters from eight predominantly European countries. A sample of 1916 firefighters completed the Impact of Event Scale–Revised (IES–R) and the Posttraumatic Growth Inventory–Short Form (PTGI–SF) with reference to a critical incident they had experienced. Analyses indicated both negative and positive posttraumatic outcomes could derive from experiencing critical incidents in the line of duty. The analyses also showed country differences exist regarding firefighters’ PTSD symptoms and PTG. It is recommended that future researchers examine factors that could evoke such national differences

Relationships between firefighters’ post-event distress and growth at different times after distressing incidents

As a consequence of exposure to distressing work-related incidents, firefighters may experience negative symptomatic responses, that is, postevent distress. As well as negative outcomes, empirical studies have documented the experience of growth, that is, positive psychological changes, among first responders after encountering distressing work-related incidents. Postevent distress and growth may evolve independently at different times following a distressing event yet are likely to influence each other. In the present study the impact of distressing work-related incidents on firefighters was investigated, examining the relationship (linear, quadratic, and cubic) between postevent distress and growth. To see what this relationship looked like in the immediate and in the more distant aftermath of distressing incidents, participants were split into 2 groups: those with more recent exposure (i.e., their distressing incident occurred within the past 12 months) and those with more distant exposure (i.e., their distressing incident occurred 13–24 months ago). A sample of 927 firefighters from 8 predominantly European countries completed the Impact of Event Scale–Revised and the Posttraumatic Growth Inventory–Short Form with reference to an incident they perceived to be most stressful. Time since this incident occurred was not significantly associated with growth, but was negatively associated with postevent distress. The relationship between postevent distress and growth at different times was first explored using the loess statistical method. Subsequent multivariate regression analyses produced evidence of both linear and curvilinear relationships between postevent distress and growth. Nevertheless, the cubic model appeared to be the best fit of the data for recent distressing incidents and the quadratic model for more distant distressing incidents. The regression results were consistent with the results of the loess smoothing. Implications for clinical practice are discussed

An Efficient Strategy to Induce and Maintain In Vitro Human T Cells Specific for Autologous Non-Small Cell Lung Carcinoma

BACKGROUND: The efficient expansion in vitro of cytolytic CD8+ T cells (CTLs) specific for autologous tumors is crucial both for basic and translational aspects of tumor immunology. We investigated strategies to generate CTLs specific for autologous Non-Small Cell Lung Carcinoma (NSCLC), the most frequent tumor in mankind, using circulating lymphocytes. PRINCIPAL FINDINGS: Classic Mixed Lymphocyte Tumor Cultures with NSCLC cells consistently failed to induce tumor-specific CTLs. Cross-presentation in vitro of irradiated NSCLC cells by autologous dendritic cells, by contrast, induced specific CTL lines from which we obtained a high number of tumor-specific T cell clones (TCCs). The TCCs displayed a limited TCR diversity, suggesting an origin from few tumor-specific T cell precursors, while their TCR molecular fingerprints were detected in the patient's tumor infiltrating lymphocytes, implying a role in the spontaneous anti-tumor response. Grafting NSCLC-specific TCR into primary allogeneic T cells by lentiviral vectors expressing human V-mouse C chimeric TCRalpha/beta chains overcame the growth limits of these TCCs. The resulting, rapidly expanding CD4+ and CD8+ T cell lines stably expressed the grafted chimeric TCR and specifically recognized the original NSCLC. CONCLUSIONS: This study defines a strategy to efficiently induce and propagate in vitro T cells specific for NSCLC starting from autologous peripheral blood lymphocytes

Expression of MAGE-C1/CT7 and MAGE-C2/CT10 Predicts Lymph Node Metastasis in Melanoma Patients

MAGE-C1/CT7 and MAGE-C2/CT10 are members of the large MAGE family of cancer-testis (CT) antigens. CT antigens are promising targets for immunotherapy in cancer because their expression is restricted to cancer and germ line cells and a proportion of cancer patients presents with immune responses against CT antigens, which clearly demonstrates their immunogenicity. This study investigates the expression of MAGE-C1/CT7 and MAGE-C2/CT10 in primary and metastatic melanoma. Immunohistochemical staining of tissue microarrays that consisted of 59 primary malignant melanomas of the skin, 163 lymph node and distant melanoma metastases and 68 melanoma cell lines was performed. We found MAGE-C1/CT7 expression in 15 out of 50 (24%) primary melanomas and 15 out of 50 (24%) cell lines, whereas MAGE-C2/CT10 was detected in 17 out of 51 (33%) primary melanomas and 14 out of 68 (17%) cell lines. MAGE-C1/CT7 and MAGE-C2/CT10 were both detected in 40% of melanoma metastases. Patients with MAGE-C1/CT7 or MAGE-C2/CT10 positive primary melanoma had significantly more lymph node metastases (p = 0.005 and p<0.001, resp.). Prediction of lymph node metastasis by MAGE-C1/CT7 and MAGE-C2/CT10 was independent of tumor cell proliferation rate (Ki67 labeling index) in a multivariate analysis (p = 0.01). Our results suggest that the expression of MAGE-C1/CT7 and MAGE-C2/CT10 in primary melanoma is a potent predictor of sentinel lymph node metastasis

Regulation of the Actin Cytoskeleton by an Interaction of IQGAP Related Protein GAPA with Filamin and Cortexillin I

Filamin and Cortexillin are F-actin crosslinking proteins in Dictyostelium discoideum allowing actin filaments to form three-dimensional networks. GAPA, an IQGAP related protein, is required for cytokinesis and localizes to the cleavage furrow during cytokinesis. Here we describe a novel interaction with Filamin which is required for cytokinesis and regulation of the F-actin content. The interaction occurs through the actin binding domain of Filamin and the GRD domain of GAPA. A similar interaction takes place with Cortexillin I. We further report that Filamin associates with Rac1a implying that filamin might act as a scaffold for small GTPases. Filamin and activated Rac associate with GAPA to regulate actin remodelling. Overexpression of filamin and GAPA in the various strains suggests that GAPA regulates the actin cytoskeleton through interaction with Filamin and that it controls cytokinesis through association with Filamin and Cortexillin

Notfallerfahrung und Notfallwissen – die Zusammenhänge mit Risikowahrnehmung und Disstress bei Notfällen und Katastrophen.

Das Ziel dieser Arbeit war die Untersuchung der Zusammenhänge von Notfallwissen und Notfallerfahrung mit der Risikowahrnehmung für verschiedene Ereignisse (d.h. Brände, Hochwasser, Erdbeben und terroristische Anschläge). Die möglichen Übertragungseffekte von Notfallerfahrung auf die Risikowahrnehmung für andere Ereignisse sowie die Einflüsse von multinationalen objektiven Risikodaten auf Risikowahrnehmung wurden untersucht. Darüber hinaus wurde der Zusammenhang von Notfallwissen und Notfallerfahrung auch in Bezug auf den empfunden Disstress während eines Brandes analysiert. Sowohl das wahrgenommene Risiko als auch das ereignisbezogene Wissen gelten als wichtige initiale Komponenten des Prozesses zur Initiierung von präventiven Verhaltensweisen bzw. vorbereitenden Handlungen. Notfallwissen kann sowohl theoretisch, zum Beispiel durch eine gedankliche Auseinandersetzung mit dem Thema, als auch praktisch, in Form von direkter Erfahrung mit einer solchen Situation, erlangt werden. Internationale Vergleiche bzw. Vergleiche zwischen verschiedenen Ereignissen sind auf Grund fehlender standardisierter Instrumente kaum möglich, und beziehen sich meist auf ein einzelnes spezifisches Ereignis. Notsituationen wie Brände, Erdbeben oder Hochwasser erfordern Reaktionen zumeist in kurzer Zeit und unter möglicherweise großem Stress. Notfallerfahrung sowie Notfallwissen könnten Faktoren sein, die die wahrgenommene Fähigkeit zum Handeln bzw. Bewältigen einer Situation erhöhen und somit möglicherweise den Disstress während der Ereignisse reduzieren. Zur Beantwortung der Fragestellungen wurden eine multinationale Stichprobe von Notfallbetroffenen sowie eine repräsentative Stichprobe der Bevölkerung Deutschlands herangezogen. Der positive Zusammenhang von Notfallerfahrungen und dem wahrgenommenen Risiko für dasselbe Ereignis konnte in den Studien für alle untersuchten Ereignisse bestätigt werden. Darüber hinaus zeigte sich eine erhebliche Reduzierung der Varianz zwischen den Ländern für die Risikowahrnehmung bezüglich Erdbeben und auch Terrorismus, wenn objektive länderspezifische Risikodaten in die Analyse einbezogen wurden. Der Einfluss von vorheriger Erfahrung auf die Risikowahrnehmung war für das Ereignis Hochwasser besonders groß, während er in Bezug auf Brände geringer war. Darüber hinaus zeigten die Ergebnisse, dass Männer, insbesondere ohne vorherige Notfallerfahrung, eher zur Unterschätzung des eigenen Risikos neigen, während Frauen das eigene Risiko seltener unterschätzen und es eher überschätzen. Neben den direkten Effekten von Notfallerfahrung auf die Risikowahrnehmung konnten auch Übertragungseffekte identifiziert werden, wie z.B. der positive Zusammenhang zwischen der Erfahrung eines Brandes in einem öffentlichen Gebäude und der Risikowahrnehmung für einen Terroranschlag. Ein möglicher Erklärungsfaktor für die gefundenen Übertragungseffekte ist der gemeinsame Kontext dieser Ereignisse (öffentliches vs. privates Setting). Die Erfahrung mit einem Ereignis kann also möglicherweise nicht nur die Vorstellbarkeit des gleichen Ereignisses erhöhen und somit auch die Risikowahrnehmung für dieses Ereignis, sondern, bei ähnlichem Kontext, auch die Leichtigkeit des Abrufs für ähnliche Ereignisse. In Bezug auf das Notfallwissen konnte ein positiver Zusammenhang mit der Risikowahrnehmung für alle untersuchten Ereignisse gefunden werden, während der Zusammenhang zwischen Notfallwissen und der Ausprägung von Disstress während eines Brandes negativ war. Bei der Evaluation von Trainings erfolgt zumeist eine Bewertung des objektiven Wissensstandes, während eine subjektive Einschätzung des Wissens nicht erhoben wird. Die gefundenen Ergebnisse deuten darauf hin, dass eine zusätzliche Erhebung dieser subjektiven Einschätzung des Notfallwissens sinnvoll sein kann, da diese den induzierten Disstress reduzieren kann. Zusammenfassend konnten die Untersuchungen zeigen, dass die Effekte von Notfallerfahrung auf Risikowahrnehmung nicht für alle Ereignisse gleich stark sind. Darüber hinaus konnten sowohl Übertragungseffekte von Notfallerfahrung als auch spezifische Effekte auf die Risikowahrnehmung von Männern und Frauen identifiziert werden. Um die Effektivität von Risikokommunikation zu steigern, könnte diese für spezifische Subgruppen angepasst werden. Zukünftige Studien sollten hier auch die möglichen Einflüsse weiterer Faktoren wie z.B. der altersspezifischen Risikodaten einbeziehen. Darüber hinaus könnten die identifizierten Übertragungseffekte darauf hindeuten, dass der Kontext von Ereignissen eine wichtige Rolle spielt. Eine Einführung von Präventionsmaßnahmen und die gleichzeitige Thematisierung der Relevanz für Ereignisse mit vergleichbarem Kontext könnten effektiv sein und so möglicherweise die Bereitschaft erhöhen. Im Hinblick auf die Effekte von wahrgenommenem Notfallwissen wären experimentelle Studien wertvoll, welche den Einfluss von Wissen prospektiv untersuchen.The aim of this study was to examine the relationships of emergency knowledge and emergency experience with risk perception for different events (i.e. fires, floods, earthquakes and terrorist attacks). In particular, the possible cross-over effects of emergency experience on risk perception for other events as well as the impact of multinational objective risk data on risk perception were examined. Furthermore, the relationship of emergency knowledge and emergency experience with distress during a fire was investigated. Both the perceived risk and the event-related knowledge are seen as important initial components in order to adopt preventive behaviors or preparedness measures. Emergency knowledge can be obtained by direct experience with the particular hazard or by receiving information or training. International comparisons within and between different events are rare due to a lack of standardized instruments, and usually refer to one single event therefore, a generalization of results might be difficult since they might be due to the specific characteristics of this one event. Emergency situations such as fires, earthquakes and floods require reactions usually in a short period of time which possibly induces distress during the event. Emergency information and emergency knowledge might be factors that increase the perceived ability to handle the situation and thus may reduce the amount of distress during the events. In order to investigate the impact of emergency experience and emergency knowledge on risk perception and distress a multinational sample of emergency survivors as well as a representative sample of the population of Germany was drawn. A positive relationship between emergency experience and the perceived risk of the same event could be confirmed for all investigated events. Furthermore, country-level variances in risk perception for earthquakes and terrorism were significantly reduced when objective country-specific risk data were incorporated in the analysis. The impact of previous experience on perception of risk was especially large for floods, while it was rather small with respect to fires. In addition, the results showed that men, especially without prior emergency experience, rather underestimate their own risk, whereas women were less likely to underestimate their own risk and rather overestimated it. In addition to the direct effects of emergency experience on risk perception, some cross-over effects could be identified, such as a positive relationship between the experience of a fire in a public building and the perception of risk for a terrorist attack. A possible explanatory factor for this effect might be the shared context of these events (public vs. private setting). The experience of an event can therefore not only increase the ease of recalling the same event and thus the perception of risk for this event, but, in a similar context, the ease of recalling similar events. With respect to emergency knowledge a positive relationship with risk perception was found for all investigated events, while the link between emergency knowledge and the distress during a fire was negative. In the evaluation of emergency trainings usually only objective knowledge is investigated while the subjective assessment of knowledge is not examined. The present results suggest that an additional assessment of perceived and therefore subjective emergency knowledge can be useful, since it can reduce the induced distress during a fire. In summary, the studies showed that the effects of emergency experience on risk perception are not equally strong for all events. In addition, not only cross-ever effects of emergency experience but also gender-specific effects of emergency experience on risk perception could be identified. In order to improve the effectiveness of risk communication, an adaption of risk of risk information for these specific subgroups might be necessary. Future studies should not only try to include gender specific objective risk but also include even more specific sub-group risks such as the risks for different age-groups. In addition, the identified cross-over effects could indicate that the context of events plays an important role. An introduction of preventive measures by simultaneously addressing the relevance for different events with a similar context could be more effective and therefore increase the willingness to participate. With regard to the effects of perceived emergency knowledge on risk perception, experimental studies would be of value examining the impact of knowledge prospectively

Perievent distress during fires - The impact of perceived emergency

Emotional distress during fire situations and other emergencies has been found to be an important factor in predicting posttraumatic stress symptoms. Little research has been done concerning the predictors of peri-event emotional distress itself and its related factors. The present study investigated the predictive power of pre- and peri-event factors on peri-event emotional distress in a European convenience sample of 574 domestic fire survivors. In addition to peri-event emotional distress, the increase in distress due to the fire (i.e. fire-induced emotional distress) was investigated. It was found that fire-induced emotional distress could be predicted by the amount of prior perceived emergency knowledge, perceived time pressure, perceived threat, panic attack symptoms and education. Results of a path analysis revealed perceived emergency knowledge as the most important factor in reducing stress caused by the fire. Possible differences between perceived and actual emergency knowledge and their implications for training are discussed