Posttraumatic Stress Symptomatology in Aging Combat Veterans: The Direct and Buffering Effects of Stress and Social Support

AbstractThe literature has reported that some older veterans are still distressed by memories of traumatic experiences decades after wartime military service. Recent research has suggested that posttraumatic stress symptoms may appear or reappear during late life in survivors of past trauma and that stress associated with age-related changes may intensify this phenomenon. This dissertation research examined the relationship between past combat exposure and posttraumatic stress symptomatology in community-dwelling veterans of World War II and the Korean War. The risk factor of perceived stress and the protective factor of perceived social support were examined for their potential to exacerbate or mitigate this relationship. The study also investigated the effect of past combat exposure and the role of the moderating variables on health-related quality of life. A secondary aim of the research was to assess the direct effect of perceived stress and perceived social support on the outcome variables.The results indicated that past combat exposure was positively associated with experiencing posttraumatic stress symptoms in World War II and Korean War veterans. Perceived stress was found to significantly exacerbate this relationship. Direct effect relationships were found between perceived stress and both posttraumatic stress symptomatology and health-related quality of life. The mean number of posttraumatic stress symptoms experienced by participants at the symptomatic level was five. The most frequent symptom experienced was sleep disturbance, the second was becoming upset at reminders of the traumatic experience. Increased levels of posttraumatic stress symptoms were found in veterans who were not married, living in an urban area, and diagnosed with depression

Increase in HIV sexual risk behaviour in homosexual men in Scotland, 1996–2002: prevention failure?

<b>Objective</b>: To investigate trends in homosexual men’s sexual risk behaviour for HIV infection in Scotland. <b>Methods</b>: Cross sectional surveys in 1996, 1999, and 2002 were carried out in "gay" bars in Glasgow and Edinburgh, Scotland. 6508 men—2276 (79% response rate) in 1996, 2498 (78%) in 1999, and 1734 (62%) in 2002. <b>Results</b>: In 1996, 10.7% of men surveyed and in 1999, 11.2% reported unprotected anal intercourse (UAI) with casual partners, compared with 18.6% in 2002 (p<0.001). There was also a significant increase in men reporting that they "knew" their casual partners’ HIV status, despite no increase in HIV testing among men who reported UAI with casual partners. In 2002, increases in UAI with more than one partner, in UAI with casual partners and in reporting seroconcordance remained significant after adjusting for confounding factors including HIV testing status and demographic characteristics. <b>Conclusions</b>: High risk sexual behaviour among homosexual men in Scotland increased between 1999 and 2002. Men showed increased confidence of shared antibody status, despite no increase in HIV testing, or evidence of discussion of HIV status. Explanations for this must include consideration of a cultural shift in the perception of HIV and "prevention failure" on the part of governments and health agencies

Integration of overseas-trained doctors into the Australian medical workforce

The document attached has been archived with permission from the editor of the Medical Journal of Australia. An external link to the publisher’s copy is included. See page 7 of PDF for this item.Linsey S Hart, Jane Vernon-Robert

The relation between cholesterol and haemorrhagic or ischaemic stroke in the Renfrew/Paisley study

Studies have found little association between cholesterol and overall stroke risk, but this could be attributable to different relations for haemorrhagic and ischaemic stroke. Stroke mortality data from prospective studies cannot usually be divided into stroke subtypes. We have therefore analysed stroke based on hospital admissions, obtained by computerised linkage with acute hospital discharges in Scotland for a large prospective cohort study

The Financial Position of Pennsylvania's Public Sector: Past, Present, and Future

This report is the third of three reports that address the fiscal conditions of other states, explores the factors that explain the conditions, and the likely future trends. FRC Report 15

A New Approach to Fibrous Composite Laminate Strength Prediction

A method of predicting the strength of cross-plied fibrous composite laminates is based on expressing the classical maximum-shear-stress failure criterion for ductile metals in terms of strains. Starting with such a formulation for classical isotropic materials, the derivation is extended to orthotropic materials having a longitudinal axis of symmetry, to represent the fibers in a unidirectional composite lamina. The only modification needed to represent those same fibers with properties normalized to the lamina rather than fiber is a change in axial modulus. A mirror image is added to the strain-based lamina failure criterion for fiber-dominated failures to reflect the cutoffs due to the presence of orthogonal fibers. It is found that the combined failure envelope is now identical with the well-known maximum-strain failure model in the tension-tension and compression-compression quadrants but is truncated in the shear quadrants. The successive application of this simple failure model for fibers in the 0/90 degree and +/- 45 degree orientations, in turn, is shown to be the necessary and sufficient characterization of the fiber-dominated failures of laminates made from fibers having the same tensile and compressive strengths. When one such strength is greater than the other, the failure envelope is appropriately truncated for the lesser direct strain. The shear-failure cutoffs are now based on the higher axial strain to failure since they occur at lower strains than and are usually not affected by such mechanisms as microbuckling. Premature matrix failures can also be covered by appropriately truncating the fiber failure envelope. Matrix failures are excluded from consideration for conventional fiber/polymer composites but the additional features needed for a more rigorous analysis of exotic materials are covered. The new failure envelope is compared with published biaxial test data. The theory is developed for unnotched laminates but is easily shrunk to incorporate reductions to allow for bolt holes, cutouts, reduced compressive strength after impact, and the like

The Distribution of Revenues From State-Collected Consumer Taxes

Värdegrundsarbetet i förskolan där genus och likabehandling står i fokus är ett ämne som skall arbetas aktivt med och det var detta som var grunden i underökning. Undersökningen utgick ifrån två frågor som handlade om pedagogernas kompetens i genusvetenskap samt vilka genuspedagogiska strategier som de använde i arbetet med barnen. För att undersöka detta så valde jag att använda mig av en halvstrukturerad enkät där de flesta frågorna var av öppen karaktär för att kunna fånga vad pedagogernas kunskap om de olika genusvetenskapliga begreppen. De slutna frågorna fångade vilka genuspedagogiska strategier som pedagogerna använde i sitt arbete med barnen. 40 enkäter delades ut till pedagogerna i ett rektorsområde. Från resultatdelen kunde det utläsas att det var många olika definitioner på de genusvetenskapliga begreppen och att flertalet av pedagogerna inte hade samma syn som forskningen kring om det beror på det sociala eller det biologiska när barnen positionerar sig som pojkar eller flickor. Resultatet visade också att endast ett fåtal pedagogerna använder sig av det komplicerande och normkritiska arbetssättet med barnen och att lite fler än hälften tycker att de har tillräckligt med kunskap för att arbeta med genus. Slutsatser som kunde dras från resultaten från enkäten är att pedagogernas kompetenser i de genusvetenskapliga begreppen är på olika nivå och att de varierar väldigt mycket. Därför drog jag den slutsatsen att det är därför som det komplicerande och normkritiska arbetet inte används i arbetet med genus i förskolan. Ändå så ansåg flertalet av de pedagoger som inte arbetade med det komplicerande och normkritiska arbetet att de ändå hade tillräckligt med kunskap i genus. Kompetens i ett ämne gör att det är möjligt att ta ut svängarna, att verkligen se hur barnen gör genus i barngruppen och att ifrågasätta normer i samhället tillsammans med barnen

After 50 years and 200 papers, what can the Midspan cohort studies tell us about our mortality?

Objective: To distil the main findings from published papers on mortality in three cohorts involving over 27,000 adults, recruited in Scotland between 1965 and 1976 and followed up ever since. Method: We read and summarized 48 peer-reviewed papers about all-cause and cause-specific mortality in these cohorts, published between 1978 and 2013. Results: Mortality rates were substantially higher among cigarette smokers in all social classes and both genders. Exposure to second-hand smoke was also damaging. Exposure to higher levels of black smoke pollution was associated with higher mortality. After smoking, diminished lung function was the risk factor most strongly related to higher mortality, even among never-smokers. On average, female mortality rates were much lower than male but the same risk factors were predictors of mortality. Mortality rates were highest among men whose paternal, own first and most recent jobs were manual. Specific causes of death were associated with different life stages. Upward and downward social mobility conferred intermediate mortality rates. Low childhood cognitive ability was strongly associated with low social class in adulthood and higher mortality before age 65 years. There was no evidence that daily stress contributed to higher mortality among people in lower social positions. Men in manual occupations with fathers in manual occupations, who smoked and drank >14 units of alcohol a week had cardiovascular disease mortality rates 4.5 times higher than non-manual men with non-manual fathers, who neither smoked nor drank >14 units. Men who were obese and drank >14 units of alcohol per day had a mortality rate due to liver disease 19 times that of normal or underweight non-drinkers. Among women who never smoked, mortality rates were highest in severely obese women in the lowest occupational classes. Conclusion: These studies highlight the cumulative effect of adverse exposures throughout life, the complex interplay between social circumstances, culture and individual capabilities, and the damaging effects of smoking, air pollution, alcohol and obesity