Law enforcement is inherently stressful, and police officers are particularly vulnerable to mental and physical disorders. As such, researchers are currently assessing intervention strategies that ...may combat or manage these psychological, physical and mental issues. To review most recent information regarding anxiety, PTSD, and sleepiness and fatigue and identify the interventions and treatments proposed to overcome work related stressors and associated mental illnesses inflicting law enforcement officers. The EMBASE, OVID MEDLINE and PsycINFO databases were canvassed for articles investigating anxiety, post-traumatic stress disorder, sleepiness, and fatigue. Initial article selections were made based on title, whilst final inclusion was informed by a full critical appraisal with respect to the primary and secondary effects. The systematic search returned 363 records, of which 183 were unique. Following screening, 43 records were included in the final review. The included literature assessed the efficacy of several interventions, and provided a number of recommendations regarding interventions, and policy. Moreover, literature indicates that police officers benefit from interventions targeting work-related stress and potential psychological disorders, if these interventions are continuous. Furthermore, larger controlled studies are required to further elucidate the benefits of psychosocial intervention in law enforcement.
Peer support programs have been utilized for a variety of mental-health-related needs, including suicidality and depression. In this pilot program, we developed a peer support network to address ...multimorbidity involving intimate partner violence (IPV), suicidal ideation, and depression. Over one year, our Suicide Obviation Support (SOS) navigators enrolled and provided at-elbow support to 108 patients (67.6% women) who screened positive for IPV, many of whom also screened at moderate or high risk for suicidality (64.8%) and/or exhibited depression symptoms. At a 6-month follow-up, 63 participants (58.3%) were retained. Those who stayed enrolled in the program for six months were less likely to report IPV and depression symptoms and were at a lower risk for suicide than the original sample, and analyses showed that IPV, depression, and suicide risk scores declined significantly in this group. The SOS navigators provided direct support and continuity of care for these high-risk patients, which included referrals to mental health treatment and other types of support services, such as transportation and emergency housing. This program provides a model for healthcare systems that desire to implement peer support programs servicing individuals who face multiple, acute mental health care needs.
ABSTRACTThis exploratory study was designed to investigate the link between a client’s heart rate variability (HRV) and the forming of a therapeutic alliance (TA) during psychotherapy. Change in HRV ...is associated with many psychological and physiological situations, including cardiac mortality. Cardiac effects were evaluated during therapy in 30 symptomatically anxious clients using HRV during six weekly 1-hour therapy sessions (S1–S6). Therapeutic index (TI), a measure of TA, was evaluated using skin conductance resonance between client and therapist. The Working Alliance Inventory provides a subjective measure of TA. State and trait anxiety and mood states were also assessed. Most HRV parameters were highest during S4. The sympathovagal balance was highest in S1 but stabilized after S2. In S4, TI was linked to high HRV parameters. Overall higher anxiety levels seem to be associated to lower HRV parameters. Conversely, in S4, high HRV parameters were linked to higher mood scores. This study found that a subjective measure of TA contradicted the physiological outcome. Results suggest that physiological data collected during therapy are a more accurate barometer of TA forming. These research findings suggest a need for further research identifying physiological markers in clients with a variety of mental health disorders over long-term therapy.
The purpose of the current study was to investigate the differences and correlations between fatigue levels and blood glucose in individuals with and without diabetes, using psychometric and ...metabolic assessment of participants. The findings of the present study were that individuals with diabetes are susceptible to fatigue as measured by the Fatigue Severity Scale and the Checklist Individual Scale. Additionally, individuals with fatigue were found to be more susceptible to sleepiness and had overall lower poor sleep quality than those without diabetes as measured by the Karolinska Sleepiness Scale, the Epworth Sleepiness Scale and the Pittsburgh Sleep Quality index (<0.05).
This study was an attempt to establish neurophysiological correlates, particularly brain activity, during high therapeutic alliance (TA) between client and therapist. The aim was to assess ...electroencephalography (EEG) activity in clients with symptomatic anxiety during high TA using
skin conductance resonance measurements from both client and therapist. Thirty clients, aged 43.8 11.5 years (males: n 15 females: n 15), underwent six, weekly, 1-hour sessions (180 hours of repeated measures). The EEG activity was measured from the prefrontal, temporal, parietal and occipital
sites during the sessions. State and trait anxiety, Working Alliance Inventory (WAI) and heart rate measures were obtained before and after each session. Prefrontal, parietal and occipital sites were associated with TA. Anxiety and heart rate were found to decrease after therapy, and for both
the client and the therapist, the WAI score increased significantly in later sessions. The results are discussed from the perspective of further understanding the neurophysiological associations to TA.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Nurses represent the largest sector of the healthcare workforce, and it is established that they are faced with ongoing physical and mental demands that leave many continuously stressed. In turn, ...this chronic stress may affect cardiac autonomic activity, which can be non‐invasively evaluated using heart rate variability (HRV). The association between neurocognitive parameters during acute stress situations and HRV has not been previously explored in nurses compared to non‐nurses and such, our study aimed to assess these differences. Neurocognitive data were obtained using the Mini‐Mental State Examination and Cognistat psychometric questionnaires. ECG‐derived HRV parameters were acquired during the Trier Social Stress Test. Between‐group differences were found in domain‐specific cognitive performance for the similarities (p = .03), and judgment (p = .002) domains and in the following HRV parameters: SDNNbaseline, (p = .004), LFpreparation (p = .002), SDNNpreparation (p = .002), HFpreparation (p = .02), and TPpreparation (p = .003). Negative correlations were found between HF power and domain‐specific cognitive performance in nurses. In contrast, both negative and positive correlations were found between HRV and domain‐specific cognitive performance in the non‐nurse group. The current findings highlight the prospective use of autonomic HRV markers in relation to cognitive performance while building a relationship between autonomic dysfunction and cognition.
The association between neurocognitive parameters during acute stress situations and HRV has not been previously explored in nurses compared to non‐nurses and such, our study aimed to assess these differences. The current findings highlight the prospective use of autonomic HRV markers in relation to cognitive performance while building a relationship between autonomic dysfunction and cognition.
Thirst in chronic heart failure: a review Allida, Sabine M; Inglis, Sally C; Davidson, Patricia M ...
Journal of clinical nursing,
04/2015, Letnik:
24, Številka:
7-8
Journal Article
Recenzirano
Aims and objectives
This review will (1) explore factors related to thirst in chronic heart failure and (2) describe interventions to alleviate thirst in chronic heart failure patients.
Background
...Thirst is a common and troublesome symptom of chronic heart failure. Despite the burden and prevalence of this symptom, there are limited strategies to assist in its management.
Design
This is a review of literature on the burden of thirst, contributors to thirst and potential management strategies of thirst in patients with chronic heart failure.
Methods
Medline, Cumulative Index for Nursing and Allied Health, PubMed and Scopus were searched using the key words thirst, chronic heart failure, angiotensin II, fluid restriction and intervention. Of the 165 citations yielded, nine studies (n = 9) were included. The eligibility criteria included participants with confirmed diagnosis of chronic heart failure, randomised controlled studies or any studies with thirst as primary or secondary outcome, in humans and in English. There was no limit to the years searched.
Results
Factors related to thirst in chronic heart failure were condition; prolonged neurohormonal activation, treatment; pharmacological interventions and fluid restriction and emotion. No intervention studies were found in chronic heart failure patients. Interventions such as artificial saliva and chewing gum have been investigated for their effectiveness as a thirst reliever in haemodialysis patients.
Conclusion
Thirst is a frequent and troublesome symptom for individuals with chronic heart failure. It is highly likely that this contributes to poor adherence with fluid restrictions. Chewing gum can help alleviate thirst, but investigation in people with heart failure is needed.
Relevance to clinical practice
Increasing awareness of thirst and interventions to relieve it in clinical practice is likely to improve the quality of care for people with chronic heart failure.
Background
Use of complementary and alternative medicine (CAM), particularly herbal and alternative medicine supplements, for preconception care and fertility management is becoming increasingly ...common.
Aims
To determine the factors associated with the use of CAMs by women for preconception care.
Materials and Methods
412 women who had visited an antenatal ‘first visit’ clinic situated at a Brisbane obstetric hospital or had visited a private ultrasound clinic in the same city for the purposes of a routinely indicated ultrasound scan in the first trimester were recruited into the study. Data were collected via a cross‐sectional questionnaire.
Results
Complementary and alternative medicines (not including multivitamins) were used during preconception by 8.3% of women attending for obstetric care. Approximately half (55.8%) of women taking herbal and alternative medicines ceased these medications on discovery of their pregnancy, though fewer (17.4%) ceased taking multivitamin supplements. Baseline characteristics (age, education and income) are not significantly different between CAM users and those who did not take CAMs preconception. The results of statistical analyses showed that only visiting a practitioner to check for health (OR = 2.00; 95% CI: 1.33, 3.00) and trying to lose weight prior to pregnancy (OR = 1.53; 95% CI: 1.00, 2.36) were the key predictors for women using CAM during preconception.
Conclusions
Women do consume CAMs to enhance preconception care to a certain extent, though CAM users remain in the minority. CAM users also tend to cease use once pregnant.
Artificial recognition of facial expression has attracted a lot of attention in the last few years and different facial expression detection methods have been developed. The current study uses a ...feature point tracking technique separately applied to the five facial image regions (eyebrows, eyes and mouth) to capture basic emotions. The used dataset contains a total 60 facial images from subject’s different genders and nationality not wearing glasses and/or facial hair. Results show that the used point tracking algorithm separately applied to the five facial image regions can detect emotions in image sequences.
Lack of concentration in a driver due to fatigue is a major cause of road accidents. This paper investigates approaches that can be used to develop a video-based system to automatically detect driver ...fatigue and warn the driver, in order to prevent accidents. Ocular cues such as percentage eye closure (PERCLOS) are considered strong fatigue indicators; thus, accurately locating and tracking the driver’s eyes is vital. Tests were carried out based on two approaches to track the eyes and estimate PERCLOS: (1) classification approach and (2) optical flow approach. In the first approach, the eyes are tracked by finding local regions, the state (open or closed) of the eyes in each image frame is estimated using a classifier, and thereby the PERCLOS is calculated. In the second approach, the movement of the upper eyelid is tracked using a newly proposed simple eye model, which captures image velocities based on optical flow, thereby the eye closures and openings are detected, and then the eye states are estimated to calculate PERCLOS. Experiments show that both approaches can detect fatigue with reasonable accuracy, and that the classification approach is more accurate. However, the classification approach requires a large amount of suitable training data. If such data are unavailable, then the optical flow approach would be more practical.
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