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Knowledge of sex differences in risk factors for posttraumatic stress disorder (PTSD) can contribute to the development of refined preventive interventions. Therefore, the aim of this study was to examine if women and men differ in their vulnerability to risk factors for PTSD.
Methods
As part of the longitudinal AURORA study, 2924 patients seeking emergency department (ED) treatment in the acute aftermath of trauma provided self-report assessments of pre- peri- and post-traumatic risk factors, as well as 3-month PTSD severity. We systematically examined sex-dependent effects of 16 risk factors that have previously been hypothesized to show different associations with PTSD severity in women and men.
Results
Women reported higher PTSD severity at 3-months post-trauma. Z-score comparisons indicated that for five of the 16 examined risk factors the association with 3-month PTSD severity was stronger in men than in women. In multivariable models, interaction effects with sex were observed for pre-traumatic anxiety symptoms, and acute dissociative symptoms; both showed stronger associations with PTSD in men than in women. Subgroup analyses suggested trauma type-conditional effects.
Conclusions
Our findings indicate mechanisms to which men might be particularly vulnerable, demonstrating that known PTSD risk factors might behave differently in women and men. Analyses did not identify any risk factors to which women were more vulnerable than men, pointing toward further mechanisms to explain women's higher PTSD risk. Our study illustrates the need for a more systematic examination of sex differences in contributors to PTSD severity after trauma, which may inform refined preventive interventions.
Several hypotheses may explain the association between substance use, posttraumatic stress disorder (PTSD), and depression. However, few studies have utilized a large multisite dataset to understand this complex relationship. Our study assessed the relationship between alcohol and cannabis use trajectories and PTSD and depression symptoms across 3 months in recently trauma-exposed civilians.
Methods
In total, 1618 (1037 female) participants provided self-report data on past 30-day alcohol and cannabis use and PTSD and depression symptoms during their emergency department (baseline) visit. We reassessed participant's substance use and clinical symptoms 2, 8, and 12 weeks posttrauma. Latent class mixture modeling determined alcohol and cannabis use trajectories in the sample. Changes in PTSD and depression symptoms were assessed across alcohol and cannabis use trajectories via a mixed-model repeated-measures analysis of variance.
Results
Three trajectory classes (low, high, increasing use) provided the best model fit for alcohol and cannabis use. The low alcohol use class exhibited lower PTSD symptoms at baseline than the high use class; the low cannabis use class exhibited lower PTSD and depression symptoms at baseline than the high and increasing use classes; these symptoms greatly increased at week 8 and declined at week 12. Participants who already use alcohol and cannabis exhibited greater PTSD and depression symptoms at baseline that increased at week 8 with a decrease in symptoms at week 12.
Conclusions
Our findings suggest that alcohol and cannabis use trajectories are associated with the intensity of posttrauma psychopathology. These findings could potentially inform the timing of therapeutic strategies.
In the Brits area of the Bushveld Complex, the stratigraphically lowermost magnetitite layer of the Upper Zone is underlain by an anorthosite containing discrete, euhedral magnetite crystals, measuring 0.1–0.3 mm in diameter, which form thin layers (1 mm-1 cm thick) and laminae (commonly one grain in thickness). Discordant relationships between laminae and layers indicate a consistent younging direction upwards towards the contact with the overlying magnetitite. Our interpretation is that these crystals are cumulus and have escaped modification by postcumulus overgrowth. They also record, in places, the morphology of the floor onto which they accumulated. Their preservation is largely attributed to adcumulus growth of plagioclase before, during and after, accumulation, but may also indicate that there was only a limited supply of magnetite to the floor, thus precluding grain contact and prohibiting grain enlargement. The results of a study of compositional variations across individual plagioclase grains suggest that the presence of magnetite within the crystallising mush hindered the development of an ideal plagioclase adcumulate.
In 1990, 13 regionally based Behaviour Intervention Support Teams (BISTs) were established in Victoria to assist agencies providing support to persons with an intellectual disability who exhibited challenging behaviour. A primary function of the BISTs was to conduct intensive interventions for clients with severe challenging behaviours. The outcomes of the interventions conducted by eight of these teams were monitored over the period from 1991 to 1993. During this time, a total of 134 such interventions were completed by the teams. Many outcome measures were used for each intervention. These included direct observational measures of the challenging behaviours, measures of skill acquisition by the clients, and satisfaction with the results by caregivers. It was concluded that the interventions resulted in a high rate of success (approximately 75%). Additionally, it was concluded that the use of regionally based specialist teams was an effective way of treating severe challenging behaviours that had previously proven difficult to manage.
In 1990 a number of regionally based Behaviour Intervention Support Teams (BISTs) were established in Victoria to assist agencies providing support to persons with an intellectual disability who exhibited challenging behaviour. A primary function of the BISTs was to conduct intensive interventions for clients with severe challenging behaviours. A cost-benefit analysis of these interventions was carried out. It was found that the existence of a severe challenging behaviour resulted in an additional cost to the service system of an average $40,510 per annum. In contrast, the cost of a single intensive intervention conducted by a BIST was $5,725. Allowing for the fact that not all intensive interventions were successful, it was still concluded that the interventions conducted by the BISTs were cost efficient. Methodological difficulties associated with the cost-benefit analysis are discussed.
The model of addiction proposed by Redish et al. shows a lack of fit with recent data and models in psychological studies of addiction. In these dual process models, relatively automatic appetitive processes are distinguished from explicit goal-directed expectancies and motives, whereas these are all grouped together in the planning system in the Redish et al. model. Implications are discussed.
Luminescence quenching experiments on oriented and drop-cast poly(phenylene vinylene), (PPV), films identify the excitons in these polymer films as Wannier-Mott excitons. The data are interpreted in terms of a distribution of exciton binding energies (Eb). We find that the width of this distribution is well correlated with the degree of structural disorder. The relatively small mean EbEb, approximately 60 meV, results in field-induced exciton disociation that limits the quantum efficiency obtained from polymer-based light emitting diodes (PLEDs) which typically are operated at applied fields of 106 V/cm or greater where the field-induced exciton disociation is significant. We present data and analysis that support these conclusions, as well as a discussion on the implications of our findings on polymer-based display technology.
Direct structural characterization of single junction p-i-n type μc-Si:H solar cells prepared in a single chamber, batch process type RF-PECVD system has been carried out using Raman scattering, XRD, and AFM. The overall degree of microcrystallinity of μc-Si:H i-layers is presented in terms of the ratio of peak intensities (Ic/Ia) of Raman shift at around 520 cm-1 and 480 cm-1, respectively. Strong correlations among device performance, i-layer structural properties, and uniformity have been established using information provided by such direct characterization. Our data support the notion that stable, high quality μc-Si i-layers are grown near the ‘edge’ of microcrystalline-to-amorphous phase transition. Solar cells made from such optimal areas exhibit moderate microcrystallinity (moderate Ic/Ia values). Preferential orientation corresponding to Si (220) planes was observed on those optimal solar cells, which also exhibit less-regular surface morphologies and lower surface roughness compared to that observed on solar cells with mixed-phase or highly crystalline Si:H i-layers.
Purine-rich exonic splicing enhancers (ESEs) have
been identified in many alternatively spliced exons. Alternative
splicing of several ESE-containing exons has been shown
to depend on subsets of the SR protein family of pre-mRNA
splicing factors. In this report, we show that purified
SR protein family member SRp55 by itself binds a 30-nt
ESE-containing exon, the alternatively spliced exon 5 of
avian cardiac troponin T. We show that purified SRp55 binds
specifically to this RNA sequence with an apparent
Kd of 60 nM as assayed
by gel mobility retardation experiments. Mutations in
the exon 5 sequence that increase or decrease exon 5
inclusion in vivo and in vitro have correspondingly
different affinities for SRp55 in our assays. The exon
5 sequence contains two purine-rich motifs, common to many
ESEs, and both are required for SRp55 binding. Hill plot
analysis of binding titration reactions indicates that
there is a cooperative binding of at least two SRp55 proteins
to the exon sequence. Chemical modification interference
studies using kethoxal show that SRp55 binding to exon
5 requires the N1 and/or the N2 of almost every G residue
in the exon. Dimethylsulfate modification interference
studies indicate that none of the N1 positions of A residues
in the exon are important for binding. We postulate that
SRp55 may recognize both primary sequence and RNA secondary
structural elements within pre-mRNA.
The use of a rotation pedicled flap, entitled the ‘Singapore Swing’, comprising temporalis fascia and mastoid periosteum, is presented as a new method of promoting healing in ‘open’ mastoid surgery for chronic ear discharge. Cadaver studies show that the main blood supply of the flap is derived from a branch of the postauricular artery which enters the pedicle near the mastoid tip. A review of the first 14 operations showed complete healing with dry ears and intact tympanic membranes in all instances, three cases requiring secondary grafting of residual perforations. We consider the results sufficiently encouraging to merit an extended trial ofthe technique.
Educational and Developmental Psychologists are frequently required to assess a person for the presence or absence of an intellectual disability. The assessment is important as the availability of particular services is usually tied to a formal determination that an intellectual disability is present. A key element to deciding on the existence of an intellectual disability is the presence of a level of intelligence below a predetermined level. Although definitions of intellectual disability usually refer only to significant sub-average intellectual functioning, the actual cut-off score used to indicate this level of intellectual functioning has varied over time. Whatever that cut-off level is determined to be, there are technical difficulties that make assessment of intellectual functioning less than straightforward. These difficulties result from (a) standardized tests having different standard deviations, resulting in differing scores for cut-off levels based on standard deviation calculations, (b) different standardized tests giving different scores when administered to the same person, (c) less than perfect test reliability creating uncertainty about whether the measured intelligence corresponds with the actual intelligence of the individual being assessed, and (d) many people having impairments in sight, hearing, or motor function that make the standardized administration of tests impossible. It is recommended that educational psychologists be familiar with these issues so that they can make decisions that satisfy social justice objectives. Furthermore, it is argued that familiarity with these issues will help psychologists to defend their decisions when it is necessary.
To test the hypothesis that a prehospital time threshold (PhTT) exists that when exceeded, significantly increases the mortality of trauma patients transported directly from the scene of injury to a trauma center rather than to the closest hospital.
Design:
Review of data contained within the Illinois Trauma Registry encompassing the period from fall 1989 through spring 1991.
Participants:
A total of 5,215 injured persons with an Injury Severity Score (ISS) >10, cared for in an Illinois level-I or -II trauma center outside of the city of Chicago.
Measurements:
Injury severity expressed as ISS, scene time (ST), transport time (TrT), total emergency medical services time (TEMST), and outcome were determined for each patient. Patients were stratified into groups on the basis of ISS.
Results:
Patient outcomes were significantly different statistically between ISS groups (p <0.001, X2). Mean ST and TEMST, but not TrT, were significantly different statistically between ISS groups (p <0.001, analysis of variance). Lower ISS was associated with longer times. Mean ST, TrT, and TEMST were significantly different statistically between survivors and nonsurvivors (p <0.001, two-sample t-tests). Survival was associated with longer times. Each of the mean times remained significantly different between survivors and nonsurvivors after controlling for severity of injury (p <0.001, two-way analysis of variance).
Conclusion:
No PhTT beyond which time patient transport to the closest hospital would have decreased mortality was identifiable, because no prehospital time <90 minutes exerted a significant adverse effect upon survival.