scholarly journals Fractured Pasts: The Structure of the Life Story in Sexual-Trauma Survivors With Posttraumatic Stress Disorder

2020 ◽  
Vol 8 (4) ◽  
pp. 723-738
Author(s):  
Georgina Clifford ◽  
Caitlin Hitchcock ◽  
Tim Dalgleish
Keyword(s):  
Sexual Trauma ◽  
Life Story ◽  
Secondary Analysis ◽  
Trauma Survivors ◽  
Self Identity ◽  
Depressed Group ◽  
Past Life ◽  
The Impact ◽  
Negative Attributes ◽  
Life Structure

We examined the organization of past and future affective autobiographical knowledge in sexual-trauma survivors compared with control participants. Participants ( N = 113) divided their past (and future) life into chapters (e.g., “college,” “marriage”), then characterized each chapter using positive or negative attributes. Sexual-trauma survivors ( n = 27) endorsed a greater proportion of negative attributes, demonstrated greater affective compartmentalization (separation of positive and negative attributes into different chapters), and showed reduced redundancy (consistent endorsement across chapters) of positive attributes relative to control participants ( n = 23). Groups did not differ on negative redundancy for past life structure or any metrics for future life structure. In a secondary analysis, we compared life structures for the sexual-trauma group and for individuals with chronic depression but no sexual-trauma history ( n = 30) and matched control participants ( n = 56), which revealed significantly greater negative redundancy in the depressed group. The distinct life structure presented by sexual-trauma survivors may reflect efforts to constrain the impact of trauma on an individual’s self-identity.

Fractured pasts: The structure of the life story in sexual trauma survivors with Posttraumatic Stress Disorder (PTSD)

2018 ◽  
Author(s):  
Georgina Clifford ◽  
Caitlin Hitchcock ◽  
Tim Dalgleish
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Sexual Trauma ◽  
Stress Disorder ◽  
Sorting Task ◽  
Trauma Survivors ◽  
The Past ◽  
Depressed Group ◽  
Past Life ◽  
Life Structure

This study primarily examined the organization of past and future autobiographical knowledge in a sample of sexual trauma survivors with posttraumatic stress disorder (PTSD) compared to a sample of healthy controls, using a self-descriptive card-sorting task. Participants were asked to imagine that they had to write their autobiography and in preparation that they should divide their past (and future) life into chapters (e.g. ‘school years’ and ‘marriage’). They then characterized each chapter using a list of positive or negative attributes. We explored whether individuals with PTSD possessed a more affectively-compartmentalized life-structure, whereby positive and negative self-attributes showed greater disaggregation into separate chapters. We also examined redundancy (i.e., consistent endorsement) of positive and negative self-attributes across the different life-chapters. Results revealed that the PTSD group overall utilized a greater proportion of negative descriptors, along with greater affective compartmentalization and reduced positive redundancy, across their past life-structure relative to the control participants. Groups did not differ on negative redundancy for the past life structure nor on any metrics for future life structure. Follow-up secondary analyses compared the past life-structure profile for those with PTSD to that of individuals with chronic depression, revealing significantly greater negative redundancy in the depressed group. Our findings are consistent with the prior theoretical and empirical literatures on mechanisms, such as avoidance and dissociation, that are implicated in PTSD as a means of inhibiting the negative impact of past traumatic experiences specifically, and negative information more generally.

scholarly journals OP0172 EFFECT OF WEIGHT LOSS AND LIRAGLUTIDE ON SERUM URATE LEVELS AMONG OBESE KNEE OSTEOARTHRITIS PATIENTS: SECONDARY ANALYSIS OF A RANDOMISED CONTROLLED TRIAL

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 107.1-108
Author(s):  
K. Zobbe ◽  
S. M. Nielsen ◽  
R. Christensen ◽  
A. Overgaard ◽  
H. Gudbergsen ◽  
...  
Keyword(s):  
Weight Loss ◽  
Knee Osteoarthritis ◽  
Secondary Analysis ◽  
Serum Urate ◽  
Advisory Board ◽  
Research Support ◽  
Blood Samples ◽  
Diet Intervention ◽  
Lowering Drug ◽  
The Impact

Background:There is a strong association between gout and obesity. Lowering urate is the cornerstone of gout management [1] and urate levels correlate strongly with central obesity. Previous studies suggest that weight loss has a positive effect on serum urate, however, the studies are sparse and small [2].Objectives:To assess the impact of an initial low-calorie diet-induced weight loss and subsequent randomisation to the body weight-lowering drug liraglutide (a glucagon-like peptide 1 receptor agonist) or placebo on serum urate levels.Methods:In the LOSE-IT trial (NCT02905864), a randomised, double-blinded, placebo-controlled, parallel group, single-centre trial [3], 156 obese individuals with knee osteoarthritis, but without gout, were offered an initial 8-week intensive diet intervention (week -8 to 0) on Cambridge Weight Plan (800-1000 kcal/day) followed by a weight loss maintenance period in which participants were randomised to either liraglutide 3 mg/day or placebo for 52 weeks. We conducted a secondary analysis of blood samples collected at week -8, 0 and 52. The primary outcome measure was change in serum urate. We used paired t-test for the change from week -8 to 0, and for change from week 0 to 52 we used an ANCOVA model adjusted for stratification factors (sex, age category and obesity class), and the level of the outcome at baseline. Data were analysed as observed (i.e. no imputation of missing data).Results:156 individuals were randomised and 155 had blood samples taken at baseline. In the initial intensive diet intervention period (week -8 to 0) they lost a mean of 12.5 kg (95% CI -13.1 to -11.9, n 156). In the following 52 weeks, the liraglutide group lost an additional 4.1 kg (SE 1.2, n 71) whereas the control group was almost unchanged with a weight loss of 0.2 kg (SE 1.2, n 66). Looking at the main outcome of serum urate levels change, the initial intensive diet resulted in a mean decrease of 0.21 mg/dL (95% CI 0.35 to 0.07, n 155) for the entire cohort. In the following year (week 0 to 52) the liraglutide group exhibited a further mean decrease in serum urate of 0.48 mg/dL (SE 0.11, n 69), whereas the placebo group exhibited a slight decrease in mean serum urate of 0.07 mg/dL (SE 0.12, n 65) resulting in a significant between-group difference of -0.40 mg/dL (95% CI -0.69 to -0.12, n 134) – see Figure 1. Four participants in each group experienced serious adverse events; no deaths were observed.Conclusion:This secondary analysis of the LOSE-IT trial suggests that liraglutide provides a potential novel serum urate lowering drug mechanism in obese patient populations, with potential implication for gout treatment.References:[1]Richette P et al. 2016.Ann Rheum Dis2017;76:29–42.[2]Nielsen SM et al.Ann Rheum Dis2017 76(11):1870-1882.[3]Gudbergsen H et al.BMJ2019. 71–2.Disclosure of Interests:Kristian Zobbe: None declared, Sabrina Mai Nielsen: None declared, Robin Christensen: None declared, Anders Overgaard: None declared, henrik gudbergsen Speakers bureau: Pfizer 2016, Marius Henriksen: None declared, Henning Bliddal Grant/research support from: received research grant fra NOVO Nordic, Consultant of: consultant fee fra NOVO Nordic, Lene Dreyer: None declared, Lisa Stamp: None declared, Filip Krag Knop Shareholder of: Minority shareholder in Antag Therapeutics Aps, Grant/research support from: AstraZeneca, Gubra, Novo Nordisk, Sanofi and Zealand Pharma, Consultant of: Amgen, AstraZeneca, Boehringer Ingelheim, Carmot Therapeutics, Eli Lilly, MSD/Merck, Mundipharma, Novo Nordisk, Sanofi and Zealand Pharma., Speakers bureau: AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, MedImmune, MSD/Merck, Mundipharma, Norgine, Novo Nordisk, Sanofi and Zealand Pharma., Lars Erik Kristensen Consultant of: UCB Pharma (Advisory Board), Sannofi (Advisory Board), Abbvie (Advisory Board), Biogen (Advisory Board), Speakers bureau: AbbVie, Amgen, Biogen, Bristol-Myers Squibb, Celgene, Eli Lilly, Gilead, Forward Pharma, Janssen Pharmaceuticals, MSD, Novartis, Pfizer, and UCB Pharma

scholarly journals Impact of Roommates on MDRO Spread in Nursing Homes

2020 ◽  
Vol 41 (S1) ◽  
pp. s66-s67
Author(s):  
Gabrielle M. Gussin ◽  
Ken Kleinman ◽  
Raveena D. Singh ◽  
Raheeb Saavedra ◽  
Lauren Heim ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Secondary Analysis ◽  
Nursing Home Residents ◽  
Multidrug Resistant ◽  
Healthcare Intervention ◽  
Odds Ratios ◽  
Care Needs ◽  
Environmental Cleaning ◽  
The Impact

Background: Addressing the high burden of multidrug-resistant organisms (MDROs) in nursing homes is a public health priority. High interfacility transmission may be attributed to inadequate infection prevention practices, shared living spaces, and frequent care needs. We assessed the contribution of roommates to the likelihood of MDRO carriage in nursing homes. Methods: We performed a secondary analysis of the SHIELD OC (Shared Healthcare Intervention to Eliminate Life-threatening Dissemination of MDROs in Orange County, CA) Project, a CDC-funded regional decolonization intervention to reduce MDROs among 38 regional facilities (18 nursing homes, 3 long-term acute-care hospitals, and 17 hospitals). Decolonization in participating nursing homes involved routine chlorhexidine bathing plus nasal iodophor (Monday through Friday, twice daily every other week) from April 2017 through July 2019. MDRO point-prevalence assessments involving all residents at 16 nursing homes conducted at the end of the intervention period were used to determine whether having a roommate was associated with MDRO carriage. Nares, bilateral axilla/groin, and perirectal swabs were processed for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococcus (VRE), extended-spectrum β-lactamase (ESBL)–producing Enterobacteriaceae, and carbapenem-resistant Enterobacteriaceae (CRE). Generalized linear mixed models assessed the impact of maximum room occupancy on MDRO prevalence when clustering by room and hallway, and adjusting for the following factors: nursing home facility, age, gender, length-of-stay at time of swabbing, bedbound status, known MDRO history, and presence of urinary or gastrointestinal devices. CRE models were not run due to low counts. Results: During the intervention phase, 1,451 residents were sampled across 16 nursing homes. Overall MDRO prevalence was 49%. In multivariable models, we detected a significant increasing association of maximum room occupants and MDRO carriage for MRSA but not other MDROs. For MRSA, the adjusted odds ratios for quadruple-, triple-, and double-occupancy rooms were 3.5, 3.6, and 2.8, respectively, compared to residents in single rooms (P = .013). For VRE, these adjusted odds ratios were 0.3, 0.3, and 0.4, respectively, compared to residents in single rooms (P = NS). For ESBL, the adjusted odds ratios were 0.9, 1.1, and 1.5, respectively, compared to residents in single rooms (P = nonsignificant). Conclusions: Nursing home residents in shared rooms were more likely to harbor MRSA, suggesting MRSA transmission between roommates. Although decolonization was previously shown to reduce MDRO prevalence by 22% in SHIELD nursing homes, this strategy did not appear to prevent all MRSA transmission between roommates. Additional efforts involving high adherence hand hygiene, environmental cleaning, and judicious use of contact precautions are likely needed to reduce transmission between roommates in nursing homes.Funding: NoneDisclosures: Gabrielle M. Gussin, Stryker (Sage Products): Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Clorox: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Medline: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Xttrium: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes.

scholarly journals Parental incarceration affects children’s emotional and behavioral outcomes: A longitudinal cohort study of children aged 9 to 13 years

2021 ◽  
pp. 016502542199591
Author(s):  
Daragh Bradshaw ◽  
Ann-Marie Creaven ◽  
Orla T. Muldoon
Keyword(s):  
Cohort Study ◽  
Relationship Quality ◽  
Child Outcomes ◽  
Behavioral Outcomes ◽  
Secondary Analysis ◽  
Parental Incarceration ◽  
Child Relationship ◽  
Children And Parents ◽  
The Impact

Parental incarceration (PI) is negatively associated with emotional, educational, and psychological child outcomes. However, few studies explore potential mechanisms through which these outcomes are transmitted or the means by which prosocial outcomes might develop. This study used data from two waves of a population cohort study of children aged 9 years and followed up aged 13 years living in Ireland. Children and parents ( N = 8,568) completed measures of PI, primary caregiver (PCG) depression, PCG-child relationship quality, and child behavioral adjustment. We then conducted a secondary analysis on this national longitudinal study of children in Ireland. Using sequential mediation models, we observed a mediated indirect effect of PI on prosocial outcomes via PCG depression and PCG-child relationship quality. PI at age 9 was associated with increased difficulties and reduced prosocial behavior at age 13. Additionally, PI at age 9 affected PCG depression and the PCG-child relationship quality. Additionally, child prosocial outcomes, and emotional and behavioral difficulties were less apparent where PI had a weaker effect on PCG depression and the quality of PCG-child relationship. Supports that can mitigate the impact of PI for vulnerable caregivers and children are discussed.

scholarly journals Social-Emotional Difficulties in Irish Children Aged Five and Nine Years: A National, Longitudinal Study

Children ◽  
2021 ◽  
Vol 8 (8) ◽  
pp. 656
Author(s):  
Ann Swift ◽  
Roy McConkey ◽  
Philip Curry ◽  
Edurne Garcia Iriarte
Keyword(s):  
Social Services ◽  
Family Relations ◽  
Secondary Analysis ◽  
Primary Caregivers ◽  
Emotional Difficulties ◽  
Children And Families ◽  
Social Emotional ◽  
Early Intervention Services ◽  
Nationally Representative ◽  
The Impact

A small proportion of children experience social-emotional difficulties from early childhood onwards. Longitudinal studies with nationally representative samples are needed to identify the prevalence and the characteristics of children and families persistently experiencing these difficulties. Secondary analysis of data collected on over 7500 Irish children and with the Strengths and Difficulties Questionnaire as the primary indicator, found that 6% of children when they were five year olds and 8% when they were nine-years, had above threshold scores that warranted further investigation. A smaller proportion—2.9% had elevated scores at both ages. Logistic regression analyses found that children with one or more developmental disabilities were up to six times more likely to have sustained difficulties. There were also significant associations with the lower education attainment of primary caregivers and the socio-economic deprivation of families. Primary caregivers and teachers reported higher conflict in their relationships with these children. Although the number of Irish children presenting with continuing social-emotional difficulties is small, they can present an ongoing and future societal cost in terms of the impact on family relations and demands placed on educational, health and social services. This study identified the children and families who are at greatest risk and for whom targeted early intervention services could be provided.

scholarly journals The impact of arthritis on the educational and early work experiences of young people: a qualitative secondary analysis

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Albert Farre ◽  
Sara Ryan ◽  
Abigail McNiven ◽  
Janet E. McDonagh
Keyword(s):  
Young People ◽  
Secondary Analysis ◽  
Young Person ◽  
Full Potential ◽  
Work Experiences ◽  
Health Providers ◽  
Structured Interviews ◽  
Self Advocacy ◽  
School Work ◽  
The Impact

Abstract Introduction Young people’s transition into adulthood is intertwined with the worlds of education and work. Poor health in adolescence has been associated with poorer education and employment outcomes in adulthood. This paper explores the impact of arthritis on the educational and early work experiences of young people with arthritis. Methods We undertook a supplementary secondary analysis of a qualitative dataset comprising narrative and semi-structured interviews of 39 young people who had been diagnosed with arthritis in childhood, adolescence or young adulthood. Results Our findings illustrate how young people living with arthritis are faced with a range of added disruptions and challenges in their educational/vocational lives. There is an important element of resilience associated with the process of making a career choice and acting upon personal aspirations. Appropriate support and flexibility in the workplace/educational setting can enable successful outcomes, but disclosure is not a straightforward process for young people living with arthritis. Conclusions It is paramount that health providers consistently and effectively address self-advocacy skills with the young person, particularly during educational and vocational transitions. Alongside this, there is the need to further strengthen the health-school/work interface to ensure that young people living with chronic illness can meet their full potential in adulthood.

The Psychological and Financial Impact of Cybercrime Victimization: A Novel Application of the Shattered Assumptions Theory

2021 ◽  
pp. 089443932098382
Author(s):  
Jildau Borwell ◽  
Jurjen Jansen ◽  
Wouter Stol
Keyword(s):  
Negative Impact ◽  
Secondary Analysis ◽  
Well Being ◽  
Policy Implications ◽  
Financial Impact ◽  
Financial Loss ◽  
Data Set ◽  
Loss Compensation ◽  
Shattered Assumptions ◽  
The Impact

While criminality is digitizing, a theory-based understanding of the impact of cybercrime on victims is lacking. Therefore, this study addresses the psychological and financial impact of cybercrime on victims, applying the shattered assumptions theory (SAT) to predict that impact. A secondary analysis was performed on a representative data set of Dutch citizens ( N = 33,702), exploring the psychological and financial impact for different groups of cybercrime victims. The results showed a higher negative impact on emotional well-being for victims of person-centered cybercrime, victims for whom the offender was an acquaintance, and victims whose financial loss was not compensated and a lower negative impact on emotional well-being for victims with a higher income. The study led to novel scientific insights and showed the applicability of the SAT for developing hypotheses about cybercrime victimization impact. In this study, most hypotheses had to be rejected, leading to the conclusion that more work has to be done to test the applicability of the SAT in the field of cybercrime. Furthermore, policy implications were identified considering the prioritization of and approach to specific cybercrimes, treatment of victims, and financial loss compensation.

scholarly journals Adoption of Enhanced Surgical Recovery (ESR) Protocol for Lumbar Fusion Decreases In-Hospital Postoperative Opioid Consumption

2021 ◽  
pp. 219256822110156
Author(s):  
Ehsan Jazini ◽  
Alexandra E. Thomson ◽  
Andre D. Sabet ◽  
Leah Y. Carreon ◽  
Rita Roy ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Length Of Stay ◽  
Transition Period ◽  
Urinary Catheter ◽  
Lumbar Fusion ◽  
Secondary Analysis ◽  
Opioid Consumption ◽  
Catheter Removal ◽  
Pain Scores ◽  
The Impact

Study Design: Retrospective observational cohort. Objectives: We sought to evaluate the impact of ESR on in-hospital and 90-day postoperative opioid consumption, length of stay, urinary catheter removal and postoperative ambulation after lumbar fusion for degenerative conditions. Methods: We evaluated patients undergoing lumbar fusion surgery at a single, multi-surgeon center in the transition period prior to (N = 174) and after (N = 116) adoption of ESR, comparing in-hospital and 90-day postoperative opioid consumption. Regression analysis was used to control for confounders. Secondary analysis was preformed to evaluate the association between ESR and length of stay, urinary catheter removal and ambulation after surgery. Results: Mean age study participants was 52.6 years with 62 (47%) females. Demographic characteristics were similar between the Pre-ESR and ESR groups. ESR patients had better 3-month pain scores, ambulated earlier, had urinary catheters removed earlier and decreased in-hospital opioid consumption compared to Pre-ESR patients. There was no difference in 90-day opioid consumption between the 2 groups. Regression analysis showed that ESR was strongly associated with in-hospital opioid consumption, accounting for 30% of the variability in Morphine Milligram Equivalents (MME). In-hospital opioid consumption was also associated with preoperative pain scores, number of surgical levels, and insurance type (private vs government). Pre-op pain sores were associated with 90-day opioid consumption. Secondary analysis showed that ESR was associated with a shorter length of stay and earlier ambulation. Conclusions: This study showed ESR has the potential to improve recovery after lumbar fusion for degenerative conditions with reduced in-hospital opioid consumption and improved postoperative pain scores.

scholarly journals The Impact of Cultural Immersion Experience on Identity Transformation Process

2021 ◽  
Vol 18 (5) ◽  
pp. 2680
Author(s):  
Gloria Onosu
Keyword(s):  
Service Learning ◽  
Cultural Awareness ◽  
Local Community ◽  
Transformation Process ◽  
Identity Transformation ◽  
Cultural Immersion ◽  
Structured Interviews ◽  
Self Identity ◽  
Immersion Experience ◽  
The Impact

This study focused on understanding the cultural immersion experience of students who participated in Study Abroad Programs (SAP) and Global Service Learning Programs (GSL). The study looked at how the immersion experience impacted the participants’ view of self and others upon re-entry into their local community. Specifically, we applied the perspective transformation theoretical framework to analyze the extent to which participation in cultural immersion programs transforms students’ perceptions of self and others. The analysis of the semi-structured interviews suggested that by engaging in intentional immersion and guided reflections, participants became aware of the need to reevaluate their perspectives, expectations, and assumptions about self and others. We also found that there were differences in the way participants experienced the cultural immersion process and the impact it had on cultural awareness and self-identity.

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