Multidimensional sexual perfectionism and female sexual function: A longitudinal investigation

Research on multidimensional sexual perfectionism differentiates four forms of sexual perfectionism: self-oriented, partner-oriented, partner-prescribed, and socially prescribed. Self-oriented sexual perfectionism reflects perfectionistic standards people apply to themselves as sexual partners; partner-oriented sexual perfectionism reflects perfectionistic standards people apply to their sexual partner; partner-prescribed sexual perfectionism reflects people’s beliefs that their sexual partner imposes perfectionistic standards on them; and socially prescribed sexual perfectionism reflects people’s beliefs that society imposes such standards on them. Previous studies found partner-prescribed and socially prescribed sexual perfectionism to be maladaptive forms of sexual perfectionism associated with a negative sexual self-concept and problematic sexual behaviors, but only examined cross-sectional relationships. The present article presents the first longitudinal study examining whether multidimensional sexual perfectionism predicts changes in sexual self-concept and sexual function over time. A total of 366 women aged 17-69 years completed measures of multidimensional sexual perfectionism, sexual esteem, sexual anxiety, sexual problem self-blame, and female sexual function (cross-sectional data). Three to six months later, 164 of the women completed the same measures again (longitudinal data). Across analyses, partner-prescribed sexual perfectionism emerged as the most maladaptive form of sexual perfectionism. In the cross-sectional data, partner-prescribed sexual perfectionism showed positive relationships with sexual anxiety, sexual problem self-blame, and intercourse pain and negative relationships with sexual esteem, desire, arousal, lubrication, and orgasmic function. In the longitudinal data, partner-prescribed sexual perfectionism predicted increases in sexual anxiety and decreases in sexual esteem, arousal, and lubrication over time. The findings suggest that partner-prescribed sexual perfectionism contributes to women’s negative sexual self-concept and female sexual dysfunction

Assessment of cognitive self-statements during marital problem solving: A comparison of two methods

Twenty maritally distressed couples (DC) and 20 nondistressed couples (NDC) were recruited and asked to undertake 10 minutes of problem-solving discussions, which were videotaped. Each individual partner’s cognitive self-statements during the interaction were assessed using two methods: video-assisted recall (VR) and thought listing (TL). Reported cognitions from each method were content- analysed and classified into five categories: partner- referent positive, partner- referent negative, self-referent positive, self- referent negative, and other. Proportions of reported cognitions falling into each category were analysed in two separate two-way MANOVAs (marital distress/ nondistress x sex) for the VR and TL measures. Results of each MANOVA indicated a highly significant effect of marital distress on cognitions, and a significant effect of sex on the VR but not the TL measure. Discriminant analyses showed that the VR and TL methods both discriminated between DC and NDC groups. Post hoc univariate ANOVAs indicated that DC had significantly higher proportions of negative partner- referent cognitions, and lower proportions of positive partner- referent cognitions, than NDC while problem solving. The relative merits of each cognitive assessment method, and their potential use in increasing marital therapy effectiveness, are discussed

The Primary Prevention of PTSD in Firefighters: Preliminary Results of an RCT with 12-Month Follow-Up

AIM: To develop and evaluate an evidence-based and theory driven program for the primary prevention of Post-traumatic Stress Disorder (PTSD). DESIGN: A pre-intervention / post-intervention / follow up control group design with clustered random allocation of participants to groups was used. The "control" group received "Training as Usual" (TAU). METHOD: Participants were 45 career recruits within the recruit school at the Department of Fire and Emergency Services (DFES) in Western Australia. The intervention group received a four-hour resilience training intervention (Mental Agility and Psychological Strength training) as part of their recruit training school curriculum. Data was collected at baseline and at 6- and 12-months post intervention. RESULTS: We found no evidence that the intervention was effective in the primary prevention of mental health issues, nor did we find any significant impact of MAPS training on social support or coping strategies. A significant difference across conditions in trauma knowledge is indicative of some impact of the MAPS program. CONCLUSION: While the key hypotheses were not supported, this study is the first randomised control trial investigating the primary prevention of PTSD. Practical barriers around the implementation of this program, including constraints within the recruit school, may inform the design and implementation of similar programs in the future. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12615001362583

Social and occupational factors associated with psychological distress and disorder among disaster responders: a systematic review

BACKGROUND: When disasters occur, there are many different occupational groups involved in rescue, recovery and support efforts. This study aimed to conduct a systematic literature review to identify social and occupational factors affecting the psychological impact of disasters on responders. METHODS: Four electronic literature databases (MEDLINE®, Embase, PsycINFO® and Web of Science) were searched and hand searches of reference lists were carried out. Papers were screened against specific inclusion criteria (e.g. published in peer-reviewed journal in English; included a quantitative measure of wellbeing; participants were disaster responders). Data was extracted from relevant papers and thematic analysis was used to develop a list of key factors affecting the wellbeing of disaster responders. RESULTS: Eighteen thousand five papers were found and 111 included in the review. The psychological impact of disasters on responders appeared associated with pre-disaster factors (occupational factors; specialised training and preparedness; life events and health), during-disaster factors (exposure; duration on site and arrival time; emotional involvement; peri-traumatic distress/dissociation; role-related stressors; perceptions of safety, threat and risk; harm to self or close others; social support; professional support) and post-disaster factors (professional support; impact on life; life events; media; coping strategies). CONCLUSIONS: There are steps that can be taken at all stages of a disaster (before, during and after) which may minimise risks to responders and enhance resilience. Preparedness (for the demands of the role and the potential psychological impact) and support (particularly from the organisation) are essential. The findings of this review could potentially be used to develop training workshops for professionals involved in disaster response. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40359-016-0120-9) contains supplementary material, which is available to authorized users

215 Artificial Intelligence Predicts Sepsis After Burn Injury

Abstract Introduction Artificial intelligence has proven to be useful in a wide range of medical applications. The purpose of this study was to use artificial intelligence, through supervised machine learning, to predict sepsis in patients with burn injuries. Methods Burn-injured patients were identified from the 2010–2014 Nationwide Readmissions Database. Three machine learning classifiers --logistic regression, gradient boosted trees, and neural network-- were trained with different algorithms to predict the primary outcome of sepsis. The classifiers used categorical variables corresponding to: age, gender, TBSA percentage, burn degree, burn site, and burn mechanism. Classifier cross-validation was performed with ten groups including equal proportions of septic patients. Nine groups were used for training and one for validation. This process was repeated using each group for validation once. The receiver operating characteristic curves (ROC) were plotted for each validation and the mean areas under the curve (AUC) were calculated. Results There were 65,029 patients admitted for burns and the rate of sepsis was 2.8%. Logistic regression performed with an AUC of 0.876 ± 0.012 and an accuracy of 97.15%±0.04%. Neural network had an AUC of 0.860 ± 0.011 and an accuracy of 97.14%±0.10%. Gradient boosted trees performed with an AUC of 0.881 ± 0.010 and an accuracy of 97.19%±0.08%. The most important variables were TBSA ≥20% (57.32%), second degree (20.08%), third degree (4.99%), flame mechanism (2.89%), and age ≥65 (2.89%). Conclusions This study demonstrates the utility of artificial intelligence for the development of highly-accurate prediction models for sepsis in burn patients. Applicability of Research to Practice These models could be easily incorporated into future systems designed to identify and prevent septicemia in burn patients

T4 Variation in National Readmission Patterns After Burn Injury

Abstract Introduction The purpose of this study was to identify risk factors and costs associated with readmission after burn injury across the United States. Methods The 2010–2014 Nationwide Readmissions Database was queried for patients admitted for burn. Multivariate logistic regression identified risk factors for 30-day readmission at index and different hospitals. Readmission cost was calculated using cost-to-charge ratios. Results Of the 94,759 patients admitted with a burn, 7.4% (n=7000) were readmitted within 30 days and of those, 29.2% (n=2047) occurred at a different hospital. Infection (29.4% [n=1990]), graft loss, wound healing, late effects, or aftercare issues (15.3% [n=1074]), and pain control and/or hydration (19.2% [n=1346]) were the most common reasons for readmission. Risk factors unique to readmission to a different hospital include: second degree burns (OR 1.23, p 7 days (OR 2.07, p<0.01), and admission to a metropolitan teaching hospital (OR 1.50, p<0.01) compared to a metropolitan non-teaching hospital. Other risk factors for readmission to a different hospital included: burn of face, head and neck (OR 1.53, p<0.01) and admission to non-metropolitan hospital (OR 1.93, p<0.01). Compared to private insurance, Medicare and Medicaid patients were more likely to get readmitted to a different hospital (OR 1.29, p<0.01 and OR 1.21, p<0.049, respectively). Overall risk factors for readmission at 30 days included: depression (OR 1.30, p<0.01), psychoses (OR 1.53, p<0.01), burn of lower limbs (OR 1.29, p<0.01), third degree burns (OR 1.31, p<0.01), leaving against medical advice (OR 3.39, p<0.01), admission to for-profit hospital (OR 1.30, p<0.01), and Charlson Comorbidity Index ≥2 (OR 1.48, p<0.01). Further risk factors are presented in Table 1. The median readmission cost was higher for patients readmitted to a different hospital $9,005 [$4,792–18,615] vs $8,697 [$5,118-$18,030], p<0.041). The median cost of readmission within 1 year was$10,959 [$5,369-$23,940]. Conclusions Previously unreported, 1 in 3 burn readmissions nationally occur at a different hospital, have unique risk factors, are costlier, and are missed by current quality metrics. For-profit hospitals have higher rates of readmissions overall. Applicability of Research to Practice A significant proportion of burn readmissions are missed by benchmarking and have unique risk factors, suggesting prevention programs, quality monitoring, and policy need to be changed