The Traumatic Process: Conceptualization and Treatment

2004 ◽  
Vol 19 (1) ◽  
pp. 37-45 ◽  
Author(s):  
Shabtai Noy
Keyword(s):  
Primary Prevention ◽  
Secondary Prevention ◽  
Traumatic Stress ◽  
Tertiary Treatment ◽  
Proposed Model ◽  
Model Treatment ◽  
Three Stages ◽  
Planning Strategies ◽  
The Impact

AbstractTraumatic stress stems from a threat to an individual's or a group's very existence. The impact of the existential threat may be compounded by an inability to cope, which affects the perception of helplessness and loss of lawfulness. A model is proposed in which the traumatic process is conceptualized to develop through three stages: (1) alert; (2) impact; and (3) post-trauma. In this model, treatment of traumatic stress emphasizes the need to control and expand life, and to achieve lawfulness and meaningfulness. In the proposed model of treatment, there are essential differences at each of the stages of the traumatic process: (1) primary prevention at the stage of alert focuses on planning strategies for coping; (2) secondary prevention at the stage of impact is based on forward treatment and debriefing; and (3) tertiary treatment at the post-trauma stage attends to coping with internal chaos and arbitrariness.

Different arrhythmic prognosis in high-risk arrhythmogenic right ventricular cardiomyopathy according to the indication of the defibrillator

2019 ◽  
Author(s):  
Amalio Ruiz-Salas ◽  
Isabel Navarro-Arce ◽  
Carmen Medina-Palomo ◽  
Alberto Barrera-Cordero ◽  
Manuel Jiménez-Navarro ◽  
...  
Keyword(s):  
Heart Failure ◽  
Primary Prevention ◽  
High Risk ◽  
Secondary Prevention ◽  
Right Ventricular ◽  
Arrhythmogenic Right Ventricular Cardiomyopathy ◽  
Left Ventricular ◽  
Risk Category ◽  
Ventricular Cardiomyopathy ◽  
The Impact

Abstract Background: Arrhythmogenic right ventricular cardiomyopathy (ARVC/D) is an inherited cardiomyopathy characterized by ventricular arrhythmias and heart failure. The aim of our study was to analyze the impact of the ICD indication in the prognosis of patients with high-risk ARVC/D according to the consensus document. Methods The high-risk category includes patients who experienced cardiac arrest due to sustained ventricular tachycardia or ventricular fibrillation and patients with severe right or left ventricular dysfunction. We included 41 patients with high-risk ARVC/D: 33 in secondary prevention and 8 in primary prevention. Results We followed 41 patients during 6.37 ± 4.88 years. Twenty-six patients (63.4%) had at least one appropriate arrhythmic event: 24 p (72.7%) in secondary prevention and 2 p (25%) in primary prevention; p=0.02. Twenty-four patients (72.7%) in secondary prevention and five (62.5%) in primary prevention had a cardiovascular event such as arrhythmias, admission due to heart failure, heart transplantation or cardiovascular death. Conclusions High-risk ARVC/D patients had a high number of cardiovascular events, but their nature and treatment were different. Arrhythmic prognosis was worse in secondary prevention and most of the events found in primary prevention were related to heart failure and, therefore, without benefit of the ICD.

Lifestyle Modifications and Policy Implications for Primary and Secondary Cancer Prevention: Diet, Exercise, Sun Safety, and Alcohol Reduction

2018 ◽  
pp. 88-100 ◽  
Author(s):  
Noelle K. LoConte ◽  
Jeffrey E. Gershenwald ◽  
Cynthia A. Thomson ◽  
Tracy E. Crane ◽  
Gil E. Harmon ◽  
...  
Keyword(s):  
Public Health ◽  
Primary Prevention ◽  
Alcohol Use ◽  
Secondary Prevention ◽  
Indoor Tanning ◽  
Policy Implications ◽  
Healthy Weight ◽  
Care Providers ◽  
Cancer Support ◽  
The Impact

Improved cancer treatments and cancer detection methods are not likely to completely eradicate the burden of cancer. Primary prevention of cancer is a logical strategy to use to control cancer while also seeking novel treatments and earlier detection. Lifestyle modification strategies to improve primary prevention and risk reduction for the development of cancer include choosing a healthy diet with an emphasis on plant sources, maintaining a healthy weight throughout life, being physically active, regularly using sunscreen and wearing protective clothing, limiting sun exposure during the hours of 10 AM to 2 PM, avoiding indoor tanning, and reducing or eliminating alcohol use. In addition to continued use of ongoing education of the public, health care providers, and cancer support communities, other policy and public health efforts should be pursued as well. Examples of supported and successful policy approaches are included in this article, including efforts to limit indoor tanning and improve community-wide interventions to reduce ultraviolet radiation exposure as well as to formally support various alcohol policy strategies including increasing alcohol taxes, reducing alcohol outlet density, improving clinical screening for alcohol use disorders, and limiting youth exposure to alcohol marketing and advertising. These prevention strategies are expected to have the largest impact on the development of melanoma as well as breast, colorectal, head and neck, liver, and esophageal cancers. The impact of these strategies as secondary prevention is less well understood. Areas of additional needed research and implementation are also highlighted. Future areas of needed research are the effects of these modifications after the diagnosis of cancer (as secondary prevention).

scholarly journals Comparing Strategies to Prevent Stroke and Ischemic Heart Disease in the Tunisian Population: Markov Modeling Approach Using a Comprehensive Sensitivity Analysis Algorithm

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Olfa Saidi ◽  
Martin O’Flaherty ◽  
Nada Zoghlami ◽  
Dhafer Malouche ◽  
Simon Capewell ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Primary Prevention ◽  
Secondary Prevention ◽  
Markov Model ◽  
Ischemic Heart ◽  
Tunisian Population ◽  
Minor Stroke ◽  
Dietary Salt ◽  
Salt Consumption ◽  
The Impact

Background. Mathematical models offer the potential to analyze and compare the effectiveness of very different interventions to prevent future cardiovascular disease. We developed a comprehensive Markov model to assess the impact of three interventions to reduce ischemic heart diseases (IHD) and stroke deaths: (i) improved medical treatments in acute phase, (ii) secondary prevention by increasing the uptake of statins, (iii) primary prevention using health promotion to reduce dietary salt consumption. Methods. We developed and validated a Markov model for the Tunisian population aged 35–94 years old over a 20-year time horizon. We compared the impact of specific treatments for stroke, lifestyle, and primary prevention on both IHD and stroke deaths. We then undertook extensive sensitivity analyses using both a probabilistic multivariate approach and simple linear regression (metamodeling). Results. The model forecast a dramatic mortality rise, with 111,134 IHD and stroke deaths (95% CI 106567 to 115048) predicted in 2025 in Tunisia. The salt reduction offered the potentially most powerful preventive intervention that might reduce IHD and stroke deaths by 27% (−30240 [−30580 to −29900]) compared with 1% for medical strategies and 3% for secondary prevention. The metamodeling highlighted that the initial development of a minor stroke substantially increased the subsequent probability of a fatal stroke or IHD death. Conclusions. The primary prevention of cardiovascular disease via a reduction in dietary salt consumption appeared much more effective than secondary or tertiary prevention approaches. Our simple but comprehensive model offers a potentially attractive methodological approach that might now be extended and replicated in other contexts and populations.

scholarly journals A Stairs Evacuation Model Considering the Pedestrian Merging Flows

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Xia Zhong Zheng ◽  
Dan Tian ◽  
Ming Zhang ◽  
Chaoran Hu ◽  
Liyang Tong
Keyword(s):  
Pedestrian Flow ◽  
Output Rate ◽  
Evacuation Time ◽  
Building Evacuation ◽  
Complex Interactions ◽  
Proposed Model ◽  
Three Stages ◽  
Evacuation Model ◽  
The Impact

Pedestrian merging flows are common in a stairs evacuation process, which involves complex interactions among pedestrians that substantially restrict the efficiency of the stairs evacuation process. Analyzing the pedestrian merging flows process and improving the efficiency of stairs evacuation are urgent and essential tasks. A novel simplified stairs evacuation model for simulating and analyzing the stairs evacuation process, which considers the impact of merging flows, is proposed in this process. The dynamic pedestrian output rate of a floor platform is calculated by the number of pedestrians on the floor platform. The merging ratio determined by the design size of stairs is adopted to determine the ratio between the stairs pedestrian flow and the floor pedestrian flow in the pedestrian output rate of the floor platform. To evaluate the stairs evacuation process is divided into three stages based on the pedestrian merging flows process, and the evacuation time at each stage is computed by the dynamic pedestrian output rate of the floor platform. The stairs evacuation capacity is calculated by the evacuation time and the number of pedestrians. A case study of a six-floor building evacuation is investigated, and the reliability and feasibility of the proposed model is verified. By establishing different merging ratios, the optimal merging ratio is obtained by comparing the evacuation capacities of different merging ratios, which provides a reference of stairs design for designers.

scholarly journals Building the tourist experience of visitors to sustainable smart tourist destinations

2021 ◽  
Vol 94 ◽  
pp. 04007
Author(s):  
Alexey Platov ◽  
Munir Kalemulloev ◽  
Shakhlo Zikirova ◽  
Elena Lysoivanenko
Keyword(s):  
Consumer Behavior ◽  
Quantitative Methods ◽  
Management Systems ◽  
Positive Experience ◽  
Customer Journey ◽  
Tourist Destinations ◽  
Proposed Model ◽  
Three Stages ◽  
Smart Technologies ◽  
The Impact

The aim of the study is to determine the impact of smart technologies on the formation of a positive experience of visitors to sustainable smart destinations. The aspects of consumer behavior in the context of the "Customer Journey Map" model are considered. A research framework was developed combining three research hypotheses. The proposed model was empirically tested on the basis of quantitative methods. Zaryadye Park in Moscow was chosen as a smart destination for the study. The results obtained demonstrated that smart technologies influence consumer behavior at all three stages of the “Customer Journey”. The strongest influence is manifested in the preliminary and active stages; at the reflexive stage it weakens. This study opens up a new understanding of the impact of smart technologies, its results have theoretical and marketing significance of sustainable smart destinations management systems.

Test of Mediation and Moderation between Employee Empathy and Customers’ Advocacy

2020 ◽  
Author(s):  
Sajjad Ahmad Afridi ◽  
Asad Shahjehan ◽  
Maqsood Haider ◽  
Dr Uzma Munawar
Keyword(s):  
Factor Analysis ◽  
Customer Loyalty ◽  
Service Sector ◽  
Mediating Effect ◽  
First Line ◽  
Private Hospitals ◽  
Proposed Model ◽  
Confirmatory Factor ◽  
The Impact ◽  
Significant Moderator

This study examined the impact of employee empathy on customers’ advocacy directly and indirectly through customers’ loyalty. Moreover, the interacting effect of customers’ trust was verified between the association of customers’ loyalty and advocacy. The attributes of the proposed model were examined in the context of first line employee and patients’ interactions. A total of 220 responses were collected for analysis from the private hospitals of Peshawar. The model fitness was confirmed through confirmatory factor analysis and hypotheses were examined. Findings confirmed the positive and significant impact of employee empathy on customers’ advocacy. Further, the mediating effect was examined and found that loyalty partially mediates employee empathy and customers’ advocacy. Additionally, trust was found a significant moderator between the association of customer loyalty and advocacy. Furthermore, findings revealed that trust based loyalty significantly and positively mediates employee empathy and customers’ advocacy. Findings of the present study provide understanding for the service sector, particularly in healthcare, to enhance customers’ loyalty, advocacy, and trust through service employee’s empathic aptitude. Keywords: Employee empathy, Service Eco-system, Customers’ Loyalty, Customers’ Advocacy, Trust-Based Loyalty, Healthcare, S-D Logic

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