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critical incident stress management

Stavroula Stavrou, Nicolas C Nicolaides, Elena Critselis, Christina Darviri, Evangelia Charmandari, George P Chrousos
BACKGROUND: Stress is defined as a state of threatened or perceived as threatened homeostasis. A broad spectrum of extrinsic or intrinsic, real or perceived stressful stimuli, called "stressors", activates a highly conserved system, the "stress system", which adjusts homeostasis through central and peripheral neuroendocrine responses. Inadequate, excessive or prolonged adaptive responses to stress may underlie the pathogenesis of several disease states prevalent in modern societies. The development and severity of these conditions primarily depend on the genetic vulnerability of the individual, the exposure to adverse environmental factors and the timing of the stressful event(s), given that prenatal life, infancy, childhood and adolescence are critical periods characterized by increased vulnerability to stressors...
January 11, 2017: European Journal of Clinical Investigation
Dawn Edge, Amy Degnan, Sarah Cotterill, Katherine Berry, Richard Drake, John Baker, Christine Barrowclough, Adwoa Hughes-Morley, Paul Grey, Dinesh Bhugra, Patrick Cahoon, Nicholas Tarrier, Shôn Lewis, Kathryn Abel
BACKGROUND: African-Caribbeans in the UK have the highest schizophrenia incidence and greatest inequity in access to mental health services of all ethnic groups. The National Institute for Health and Care Excellence (NICE) highlights this crisis in care and urgent need to improve evidence-based mental healthcare, experiences of services and outcomes for this group. Family intervention (FI) is clinically and cost-effective for the management of schizophrenia but it is rarely offered. Evidence for FI with minority ethnic groups generally, and African-Caribbeans in particular, is lacking...
2016: Pilot and Feasibility Studies
Laura Alonso Guardo, Carlos Cano Gala, Antonio Rodriguez Calvo, Adriana M Buritica Aguirre, Nadia A Dávila Arango, Elena García Fernández, Carmen Ruiz Chirosa, David Sánchez Poveda, Agustín Díaz Álvarez
: The manipulation of an airway is always a critical moment in the anesthetic management of patients with pheochromocytoma due to the high incidence of undesirable hemodynamic events in relation with the stimulus represented by the laryngoscopy. A known difficult airway in which it is necessary to carry out an orotracheal intubation while preserving spontaneous ventilation subjects the patient to a stressful situation. The objective is to obtain an acceptable level of comfort and sedation avoiding respiratory depression (Anesthesiol Clin 2015;33:233-40)...
December 2016: Journal of Clinical Anesthesia
Yuhei Kawano
The relationship between salt and hypertension is well established, and salt restriction is widely recommended in the management of hypertension. However, people living in northeast Asia have consumed large amount of salt, and the prevalence of hypertension and the incidence of stroke have been high in that area. Mechanisms of salt-induced hypertension may be complex, but volume expansion in the presence of impaired natriuretic capacity of the kidney and action on the central nervous system and neurohormoral pathways seem to be important...
September 2016: Journal of Hypertension
Shirish Dattatraya Yande, Omkar Vinay Joglekar, Maya Joshi
INTRODUCTION: Role of urodynamics prior to surgery of stress urinary incontinence (SUI) is under constant debate. Demonstration of the presence of detrusor overactivity is the only aspect that has been emphasized in the literature so far. We believe that there are number of other factors which may influence the evaluation and in turn the choice of surgical management and prediction of outcome of treatment. They are as follows: (1) Presence of voiding inefficiency, (2) asymptomatic detrusor overactivity, (3) and severity of SUI...
July 2016: Journal of Mid-life Health
Dan Bohström, Eric Carlström, Nils Sjöström
BACKGROUND: Ambulance nurses display stress symptoms, resulting from their work with patients in an emergency service. Certain individuals seem, however, to handle longstanding stress better than others and remain in exposed occupations such as ambulance services for many years. This paper examines stress inducing and stress defusing factors among ambulance nurses. METHODS: A qualitative descriptive design using critical incident technique was used. A total of 123 critical incidents were identified, and a total of 61 strategies dealing with stress were confirmed...
September 21, 2016: International Emergency Nursing
Yuhei Kawano
The relationship between salt and hypertension is well established, and salt restriction is widely recommended in the management of hypertension. However, people living in northeast Asia have consumed large amount of salt, and the prevalence of hypertension and the incidence of stroke have been high in that area. Mechanisms of salt-induced hypertension may be complex, but volume expansion in the presence of impaired natriuretic capacity of the kidney and action on the central nervous system and neurohormoral pathways seem to be important...
September 2016: Journal of Hypertension
Julia Wuthnow, Sean Elwell, Joann McDaniels Quillen, Nicole Ciancaglione
No abstract text is available yet for this article.
November 2016: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
Katerina Placha, Dominika Luptakova, Ladislav Baciak, Eduard Ujhazy, Ivo Juranek
Neonatal brain hypoxic-ischemic injury represents a serious health care and socio-economical problem since it is one of the most common causes of mortality and morbidity of newborns. Neonatal hypoxic-ischemic encephalopathy is often associated with signs of perinatal asphyxia, with an incidence of about 2-4 per 1,000 live births and mortality rate up to 20%. In about one half of survivors, cerebral hypoxic-ischemic insult may result in more or less pronounced neuro-psychological sequelae of immediate or delayed nature, such as seizures, cerebral palsy or behavioural and learning disabilities, including attention-deficit hyperactivity disorder...
2016: Neuro Endocrinology Letters
Gunnel Östlund, Ingrid Thyberg, Eva Valtersson, Mathilda Björk, Sverker Annette
OBJECTIVES: Living with a chronic disease means learning to live under new circumstances and involves a continuous adaptation to new ways of living. There is increasing knowledge about how people cope with stressful life events and adapt to new life situations. Approximately a third of patients diagnosed with rheumatoid arthritis (RA) are men; however, few studies have described the needs and experiences of men living with RA. The aim of the present study was to explore men's strategies for handling challenges related to participation in everyday life...
December 2016: Musculoskeletal Care
Gary S Solomon, Andrew W Kuhn, Scott L Zuckerman
Since its third iteration in 2008, the international Concussion in Sport Group (CISG) has delineated several 'modifying factors' that have the potential to influence the management of sport-related concussions (SRC). One of these factors is co- and pre-morbidities, which includes migraines, mental health disorders, attention-deficit hyperactive disorder (ADHD), learning disability, and sleep disorders. Mental health disorders, and in particular, depression, have received some attention in the management of SRC and in this review we summarize the empirical evidence for its inclusion as a modifying factor...
2016: Physician and Sportsmedicine
Yuping Zhang, J Brett Sallach, Laurie Hodges, Daniel D Snow, Shannon L Bartelt-Hunt, Kent M Eskridge, Xu Li
Treated wastewater is expected to be increasingly used as an alternative source of irrigation water in areas facing fresh water scarcity. Understanding the behaviors of contaminants from wastewater in soil and plants following irrigation is critical to assess and manage the risks associated with wastewater irrigation. The objective of this study was to evaluate the effects of soil texture and drought stress on the uptake of antibiotics and the internalization of human pathogens into lettuce through root uptake following wastewater irrigation...
January 2016: Environmental Pollution
Adriano Zamperini, Cristina Paoloni, Ines Testoni
INTRODUCTION: Despite the suggestion to adopt a balanced approach between detachment and involvement, the nurse-patient relationship is always embedded with emotional conflicts. AIMS: To collect data on how nurses manage the emotional support to patients. METHOD: The study adopted the theoretical perspective of the emotional work. Fifty-three nurses completed a questionnaire investigating everyday "emotional accidents." The data were analyzed considering the strategies employed to address and resolve them...
July 2015: Assistenza Infermieristica e Ricerca: AIR
Elizabeth A Donnelly, Paul Bradford, Matthew Davis, Cathie Hedges, Michelle Klingel
OBJECTIVE: Emergency medical service (EMS) providers are exposed to a variety of stressors endemic to the profession. These exposures may contribute to stress reactions, including posttraumatic stress. The objective of this study was to evaluate the relationship between work-related stressors and posttraumatic stress. The secondary objective was to determine paramedics' preferred sources of support for managing work-related stress. METHODS: 269 paramedics in a county-based EMS service were invited to complete an online survey...
May 2016: CJEM
R M Waeschle, M Bauer, C E Schmidt
The guarantee of quality of care and patient safety is of major importance in hospitals even though increased economic pressure and work intensification are ubiquitously present. Nevertheless, adverse events still occur in 3-4 % of hospital stays and of these 25-50 % are estimated to be avoidable. The identification of possible causes of error and the development of measures for the prevention of medical errors are essential for patient safety. The implementation and continuous development of a constructive culture of error tolerance are fundamental...
September 2015: Der Anaesthesist
Amina Godinjak, Amer Iglica, Azra Burekovic, Selma Jusufovic, Anes Ajanovic, Ira Tancica, Adis Kukuljac
INTRODUCTION: Hyperglycemia is a common complication of critical illness. Patients in intensive care unit with stress hyperglycemia have significantly higher mortality (31%) compared to patients with previously confirmed diabetes (10%) or normoglycemia (11.3%). Stress hyperglycemia is associated with increased risk of critical illness polyneuropathy (CIP) and prolonged mechanical ventilation. Intensive monitoring and insulin therapy according to the protocol are an important part of the treatment of critically ill patients...
June 2015: Medical Archives
J S Rutherford, R Flin, A Irwin
The outcome of critical incidents in the operating theatre has been shown to be influenced by the behaviour of anaesthetic technicians (ATs) assisting anaesthetists, but the specific non-technical skills involved have not been described. We performed a review of critical incidents (n=1433) reported to the Australian Incident Monitoring System between 2002 and 2008 to identify which non-technical skills were used by ATs. The reports were assessed if they mentioned anaesthetic assistance or had the boxes ticked to identify "inadequate assistance" or "absent supervision or assistance"...
July 2015: Anaesthesia and Intensive Care
Patricia Davidson, Cynthia Ann Kwiatkowski, Michelle Wien
There has been increased attention on the importance of identifying and distinguishing the differences between stress-induced hyperglycemia (SH), newly diagnosed hyperglycemia (NDH), and hyperglycemia in persons with established diabetes mellitus (DM). Inpatient blood glucose control is now being recognized as not only a cost issue for hospitals but also a concern for patient safety and care. The reasons for the increased incidence of hyperglycemia in hospitalized patients include preexisting DM, undiagnosed DM or prediabetes, SH, and medication-induced hyperglycemia with resulting transient blood glucose variability...
October 2015: Nutrition in Clinical Practice
Li-Chun Lee, Chich-Hsiu Hung
AIM: The post-partum period is a stressful time of change, particularly for immigrant women, but, to the best of the present authors' knowledge, the subject has not been explored. This study aimed to examine immigrant women's post-partum stress, depression, and levels of social support, and to determine the predictors of post-partum stress for Vietnamese immigrant women in Taiwan. METHODS: A cross-sectional design was used. In this descriptive survey, 208 Vietnamese immigrant women were telephone interviewed by a trained Vietnamese research assistant during one of their 6 weeks post-partum...
January 2016: Japan Journal of Nursing Science: JJNS
Jean-Charles Preiser, Arthur R H van Zanten, Mette M Berger, Gianni Biolo, Michael P Casaer, Gordon S Doig, Richard D Griffiths, Daren K Heyland, Michael Hiesmayr, Gaetano Iapichino, Alessandro Laviano, Claude Pichard, Pierre Singer, Greet Van den Berghe, Jan Wernerman, Paul Wischmeyer, Jean-Louis Vincent
The results of recent large-scale clinical trials have led us to review our understanding of the metabolic response to stress and the most appropriate means of managing nutrition in critically ill patients. This review presents an update in this field, identifying and discussing a number of areas for which consensus has been reached and others where controversy remains and presenting areas for future research. We discuss optimal calorie and protein intake, the incidence and management of re-feeding syndrome, the role of gastric residual volume monitoring, the place of supplemental parenteral nutrition when enteral feeding is deemed insufficient, the role of indirect calorimetry, and potential indications for several pharmaconutrients...
2015: Critical Care: the Official Journal of the Critical Care Forum
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