Walk the line: a systemic perspective on stress experienced by emergency medical personnel by comparing military and civilian prehospital settings

IntroductionEmergency Medicine (EM) personnel in both military and civilian prehospital settings are often exposed to stressful and extreme events. Therefore, a cross-pollination between both contexts in terms of coping strategies may generate new information for purposes of training, prevention, and support programs. In the current study, we aimed at comparing both contexts to understand the type of stress events personnel experience; whether experience differs between civilian and military personnel; and how they cope with it.MethodsWe used a mixed method approach, combining the results of a quantitative questionnaire and a thematic analysis of 23 in-depth semi-structured interviews to gain additional qualitative information.ResultsWhereas the questionnaire pointed to a significant preference for task-oriented coping over avoidant and emotion-oriented coping, the interviews offered a more nuanced insight, showing a constant aim to position themselves on a continuum between emotional disconnection from the patient to preserve operationality on the one hand; and remaining enough empathic to preserve humanity on the other hand. We further identified an ambivalent awareness regarding emotions and stress, a vulnerable disbalance between an excessive passion for the job with the sacrifice of own's personal life (for a growing volatile and dangerous working environment) and a lack of recognition from both the patient and organizational environment. The combination of these factors may carry the risk for moral injury and compassion fatigue. Therefore, mutual trust between the organizational level and EM personnel as well as among team members is crucial.DiscussionThe results are discussed from a systemic SHELL perspective, indicating how the specific profile of EM personnel relates to the software, hardware, environmental and liveware components of their professional and private life. Trainings on stress- and risk awareness should be approached both on an individual and systemic level, knowing that there is clearly no “one-size-fits-all” manner

Living on the edge: How to prepare for it?

IntroductionIsolated, confined, and extreme (ICE) environments such as found at Antarctic, Arctic, and other remote research stations are considered space-analogs to study the long duration isolation aspects of operational space mission conditions.MethodsWe interviewed 24 sojourners that participated in different short/long duration missions in an Antarctic (Concordia, Halley VI, Rothera, Neumayer II) or non-Antarctic (e.g., MDRS, HI-SEAS) station or in polar treks, offering a unique insight based on first-hand information on the nature of demands by ICE-personnel at multiple levels of functioning. We conducted a qualitative thematic analysis to explore how sojourners were trained, prepared, how they experienced the ICE-impact in function of varieties in environment, provided trainings, station-culture, and type of mission.ResultsThe ICE-environment shapes the impact of organizational, interpersonal, and individual working- and living systems, thus influencing the ICE-sojourners' functioning. Moreover, more specific training for operating in these settings would be beneficial. The identified pillars such as sensory deprivation, sleep, fatigue, group dynamics, displacement of negative emotions, gender-issues along with coping strategies such as positivity, salutogenic effects, job dedication and collectivistic thinking confirm previous literature. However, in this work, we applied a systemic perspective, assembling the multiple levels of functioning in ICE-environments.DiscussionA systemic approach could serve as a guide to develop future preparatory ICE-training programs, including all the involved parties of the crew system (e.g., family, on-ground crew) with attention for the impact of organization- and station-related subcultures and the risk of unawareness about the impact of poor sleep, fatigue, and isolation on operational safety that may occur on location

From the midnight sun to the longest night: sleep in Antarctica

Sleep disturbances are the main health complaints from personnel deployed in Antarctica. The current paper presents a systematic review of research findings on sleep disturbances in Antarctica. The available sources were divided in three categories: results based on questionnaire surveys or sleep logs, studies using actigraphy, and data from polysomnography results. Other areas relevant to the issue were also examined. These included chronobiology, since the changes in photoperiod have been known to affect circadian rhythms; mood disturbances; exercise, sleep and hypoxia; countermeasure investigations in Antarctica; and other locations lacking a normal photoperiod

Building a Community with Mothers and Babies in a Context of Postnatal Depression: A Story of Cooperation and Relatedness in Human Kinship

UID/EAT/00693/2013publishersversionpublishe

Le toucher maternel « gentle touch » : une invitation à une danse tactile ?

ULBabyLabinfo:eu-repo/semantics/publishe

Cognitive Performance Enhancement: Do Biofeedback and Neurofeedback Work?

Biofeedback (BFB) and neurofeedback (NFB) training are two promising approaches for the non-invasive modulation of human physiological activity paired with cognitive, emotional, and behavioral functioning. In this article, we summarize the state of the art with regard to the efficiency of BFB and NFB studies for the optimization of cognitive performance within a non-clinical context. We review the different training protocols with their underlying theoretical perspectives and the different outcomes regarding cognitive performance. This review showed that BFB and NFB are promising training techniques. However, the use of varying terminology to refer to similar concepts, diverse methodological designs, and cognitive assessments along with apparent differences in NFB frequency ranges makes it difficult to compare the outcomes over different studies and to draw general conclusions. Furthermore, a question largely ignored until now remains about the long-term effects of both training and thus the sustainability of the achieved cognitive enhancement. Despite promising results of both techniques, this overview summarizes the encountered issues and formulates suggestions to solve them in order to be able to provide a definitive answer to the title question: “do biofeedback and neurofeedback work as a cognitive performance enhancement method?”SCOPUS: re.jinfo:eu-repo/semantics/publishe