Trauma-Related Dissociative States and Long-Term Psychopathology in Posttraumatic Stress Disorder

Dissociative responses to trauma have been hypothesized to be associated with long-term increases in psychopathology. The purpose of this study was to examine dissociative responses to premilitary, combat-related and postmilitary traumatic events and long-term psychopathology in Vietnam combat veterans with (n = 34) and without (n = 28) posttraumatic stress disorder (PTSD). PTSD patients reported higher levels of dissociative states at the time of combat-related traumatic events than non-PTSD patients. Higher levels of dissociative states persisted in PTSD patients in the form of higher levels of dissociative states in response to postmilitary traumatic events. In addition, dissociative responses to combat trauma were associated with higher long-term general dissociative symptomatology as measured by scores on the Dissociative Experience Scale, as well as increases in the number of flashbacks since the time of the war. These findings are consistent with previous formulations that dissociation in the face of trauma is a marker of long-term psychopathology.     

Epidural anaesthesia in the management of the painful bladder.

Bladder pain is a difficult symptom to manage. Epidural anaesthesia, which was used in 10 patients with sensory disorders, carries a low morbidity and helps to define those patients with severe bladder pain who might benefit from denervation procedures.     

Clonal analysis and virulence of Australian isolates of Streptococcus suis type 2.

Multilocus enzyme electrophoresis was used to divide 124 Australian isolates of Streptococcus suis type 2 into 17 electrophoretic types (ETs). Isolates in ET 1 were the most frequent cause of disease amongst Western Australian pigs, but isolates of ET 8 were more commonly associated with disease in other Australian states. Multiple isolates from 10 of 19 farms all belonged to the same ET, whilst isolates from the other farms belonged to between 2 and 4 different ETs. Some isolates could be differentiated further by DNA restriction endonuclease analysis, whilst others with the same restriction pattern were located in different, but closely-related ETs. Fourteen isolates were tested for their virulence in mice. Most caused disease if given in high numbers, but isolates in ET 1 were virulent at lower dose rates. This virulent clone also was distinguished by the fact that 80% of isolates produced extracellular factor (EF).     

Linking perceptions of the community to behavior: are protective social factors associated with physical activity?

Although the relationship of psychosocial factors to physical activity has been explored, there is increased interest in how perceptions of the community environment influence behavior. However, few methodological studies have incorporated perceptions of the social and community environment (protective social factors) or addressed key measurement issues. Computer-assisted telephone interviews were administered to a national sample of 1,818 U.S. adults. Unadjusted and multivariate-adjusted odds ratios were calculated to compare active and inactive participants by Protective Social Factors (PSF) scores and selected sociodemographics. Confirmatory factor analysis and reliability analysis suggested strong PSF scale psychometric properties (alpha = .92). After adjustment for potential confounders, a 10-point rise in the PSF score resulted in a 12% increased likelihood of meeting Centers for Disease Control and Prevention/American College of Sports Medicine recommendations. Additional analyses indicated that greater perceived PSFs were associated with meeting these recommendations among Whites but not among African Americans.     

Personal history,training, and worksite as predictors of back pain of nurses

Back pain among nurses is a common problem. Prior studies of this problem have been based on cross-sectional or retrospective data. This 18-month prospective study involving nurses newly graduated from nursing school investigated personal, worksite, and training factors associated with future risk of back pain. Each nurse underwent a preliminary interview and periodic follow-ups to identify those with back injuries. Contingency tables and logistic regression analyses demonstrated that prior significant back pain episodes (evidenced by previous job changes because of back pain, frequent medication use, etc.) were associated with increased future risk. Training at nursing school or on the job did not have a protective effect. This pilot study therefore suggests factors useful in placement and counseling of new nurses and indicates the need for further implementation of mechanical lift assist device use. © 1994 Wiley-Liss, Inc.     

The Canadian Psychiatric Association practice profile survey: I. Methods and general sample characteristics.

OBJECTIVE: To describe the rationale, methodology, and general sample characteristics of the Canadian Psychiatric Association (CPA) practice profile survey, a national survey of psychiatrists and psychiatric practice. METHOD: Mail-in interviews were sent to all Canadian psychiatrists listed in their provincial registers and to all active CPA members (total = 3628). Respondents provided general information about their professional activities for one 24-hour day and detailed information for 1 randomly selected hour. Patient information--including sociodemographics, diagnostic profiles, functioning levels, risk of harm to self or others, and disposition--was elicited for 1 patient seen during the random hour as well as for the most seriously ill patient receiving clinical services that day. RESULTS: There was a 45.5% response rate. Questionnaires completed by nonpsychiatrists or with a large percentage of missing or incorrect data were eliminated (107 surveys), resulting in a final sample size of 1570. CPA members and those from Western Canada responded at a higher rate to the survey. The results suggest some cause for concern about future manpower shortages. Most psychiatrists practise eclectically, seeing patients across the life-span, and working in both community and institutional settings. The old and the young appear to be underserviced, compared with adults. CONCLUSIONS: This study represents an important step forward in evaluating the profile and activities of the profession.     

Collateral vessel regression in a child with primary congenital glaucoma.

The presence of collateral vessels in a young child with glaucoma is rare. The authors describe a case of collateral vessel regression with intraocular pressure reduction in a child with primary congenital glaucoma. Six months following 180 degrees goniotomies in each eye, the intraocular pressure was reduced, dilation of the retinal arteries and veins resolved, and collateral vessels in both eyes regressed. Intraocular pressure reduction may lead to the regression of collateral vessels in children with primary congenital glaucoma.     

Application of moist wound healing to the gerontologic population

During a five year period, approximately 150 elderly patients were treated with a water vapor and oxygen permeable membrane (VPM) in an open fashion. The following is important when treating elderly patients with VPM: xerosis or irritant dermatitis must be thoroughly treated before use of VPM as it will not adhere to abnormal skin; alcohol or acetone should not be used to prepare the treatment site as they cause irritation; VPM must not be stretched prior to placement as friction blisters occur in fragile, elderly skin; prior to removal, VPM should be soaked in soapy water or its surface rubbed lightly with alconol to break the adhesive bond to prevent stripping off epidermis; in patients with protein-calorie malnutrition, serum albumin should be monitored as large amounts of protein-rich fluid collect under VPM. VPM is a useful non-surgical approach to treating many ulcers in the elderly. Certain precautions must be taken to achieve optimum success in this population.