787 resultados para psycholical distress
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Several agencies specify AASHTO T283 as the primary test for field acceptance of moisture susceptibility in hot mix asphalt. When used in this application, logistical difficulties challenge its practicality, while repeatability is routinely scrutinized by contractors. An alternative test is needed which can effectively demonstrate the ability to screen mixtures based on expected performance. The ideal replacement can be validated with field performance, is repeatable, and allows for prompt reporting of results. Dynamic modulus, flow number, AASHTO T283, Hamburg wheel tracking device (HWTD), and the moisture induced sensitivity test (MIST) were performed on plant produced surface mixes in Iowa. Follow-up distress surveys were used to rank the mixes by their performance. The rankings indicate both the quantity of swelling from MIST conditioning and submersed flow number matched the performance ranking of all but one mixture. Hamburg testing parameters also appear effective, namely the stripping inflection point and the ratio between stripping slope and the creep slope. Dynamic modulus testing was ineffective, followed by AASHTO T283 and ratios produced from flow number results of conditioned samples.
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OBJECTIVES: To assess consequences of physical violence at work and identify their predictors. METHODS: Among the patients in a medicolegal consultation from 2007 to 2010, the subsample of workplace violence victims (n = 185) was identified and contacted again in average 30 months after the assault. Eighty-six victims (47 %) participated. Ordinal logistic regression analyses assessed the effect of 9 potential risk factors on physical, psychological and work consequences summarized in a severity score (0-9). RESULTS: Severity score distribution was as follows: 4+: 14 %; 1-3: 42 %; and 0: 44 %. Initial psychological distress resulting from the violence was a strong predictor (p < 0.001) of the severity score both on work and long-term psychological consequences. Gender and age did not reach significant levels in multivariable analyses even though female victims had overall more severe consequences. Unexpectedly, only among workers whose jobs implied high awareness of the risk of violence, first-time violence was associated with long-term psychological and physical consequences (p = 0.004). Among the factors assessed at follow-up, perceived lack of employers' support or absence of employer was associated with higher values on the severity score. The seven other assessed factors (initial physical injuries; previous experience of violence; preexisting health problems; working alone; internal violence; lack of support from colleagues; and lack of support from family or friends) were not significantly associated with the severity score. CONCLUSIONS: Being a victim of workplace violence can result in long-term consequences on health and employment, their severity increases with the seriousness of initial psychological distress. Support from the employer can help prevent negative outcomes.
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BACKGROUND: Mental disorders, common in primary care, are often associated with physical complaints. While exposure to psychosocial stressors and development or presence of principal mental disorders (i.e. depression, anxiety and somatoform disorders defined as multisomatoforme disorders) is commonly correlated, temporal association remains unproven. The study explores the onset of such disorders after exposure to psychosocial stressors in a cohort of primary care patients with at least one physical symptom. METHOD: The cohort study SODA (SOmatization, Depression and Anxiety) was conducted by 21 private-practice GPs and three fellow physicians in a Swiss academic primary care centre. GPs included patients via randomized daily identifiers. Depression, anxiety or somatoform disorders were identified by the full Patient Health Questionnaire (PHQ), a validated procedure to identify mental disorders based on DSM-IV criteria. The PHQ was also used to investigate exposure to psychosocial stressors (before the index consultation and during follow up) and the onset of principal mental disorders after one year of follow up. RESULTS: From November 2004 to July 2005, 1020 patients were screened for inclusion. 627 were eligible and 482 completed the PHQ one year later and were included in the analysis (77%). At one year, prevalence of principal mental disorders was 30/153 (19.6% CI95% 13.6; 26.8) for those initially exposed to a major psychosocial stressor and 26/329 (7.9% CI95% 5.2; 11.4) for those not. Stronger association exists between psychosocial stressors and depression (RR = 2.4) or anxiety (RR = 3.5) than multisomatoforme disorders (RR = 1.8). Patients who are "bothered a lot" (subjective distress) by a stressor are therefore 2.5 times (CI95% 1.5; 4.0) more likely to experience a mental disorder at one year. A history of psychiatric comorbidities or psychological treatment was not a confounding factor for developing a principal mental disorder after exposure to psychosocial stressors. CONCLUSION: This primary care study shows that patients with physical complaints exposed to psychosocial stressors had a higher risk for developing mental disorders one year later. This temporal association opens the field for further research in preventive care for mental diseases in primary care patients.
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Chapter 2 Bankruptcy Initiation In The New Era of Chapter 11 2.1 Abstract The bankruptcy act of 1978 placed corporate managers (as debtor in possession) in control of the bankruptcy process. Between 2000 and 2001 managers apparently lost this control to secured creditors. This study examines financial ratios of firms filing for bankruptcy between 1993 and 2004 and tests the hypothesis that the change from manager to creditor control created or exacerbated the managerial (and dominant creditor) incentive to delay bankruptcy filing. We find a clear deterioration in the financial conditions of firms filing after 2001. This is consistent with managers (or creditors who control them) delaying filing for bankruptcy. We also observe patterns of operating losses and liquidations that suggest adverse economic consequences from such delay. Chapter 3 Bankruptcy Resolution: Priority of Claims with the Secured Creditor in Control 3.1 Abstract We present new evidence on the violation of priority of claims in bankruptcy using a sample of 222 firms that tiled for Chapter 11 bankruptcy over the 1993-2004 period. Our study reveals a dramatic reduction in the violations of priority of claims compared to research on prior periods. These results are consistent with changes in both court practices and laws transferring power to the secured creditors over our sample period. We also find an increase in the time from the date of a bankruptcy filing to reaching plan confirmation where priority is not violated. Chapter 4 Bankruptcy Resolution: Speed, APR Violations and Delaware 4.1 Abstract We analyze speed of bankruptcy resolution on a sample of 294 US firms filing for bankruptcy in the 1993-2004 period. We find strong association between type of Chapter II filing and speed of bankruptcy resolution. We also find that violations to the absolute priority rule reduce the time from bankruptcy filing to plan confirmation. This is consistent with the hypothesis that creditors are willing to grant concessions in exchange for faster bankruptcy resolution. Furthermore, after controlling for the type of filing and violations to the absolute priority rule, we do not find any difference in the duration of the bankruptcy process for firms filing in Delaware, New York, or other bankruptcy districts. Chapter 5 Financial Distress and Corporate Control 5.1 Abstract We examine the replacement rates of directors and executives in 63 firms filing for bank ruptcy during the 1995-2002 period. We find that over 76% of directors and executives are replaced in the four year period from the year prior to the bankruptcy filing through three years after. These rates are higher than those found in prior research and is consistent with changes in bankruptcy procedures and practice (i.e. the increased secured creditors control over the process due to both DIP financing and changes in the Uniform Commercial Code) having a significant impact on the corporate governance of firms in financial distress. Chapter 6 Financial Statement Restatements: Decision to File for Bankruptcy 6.1 Abstract On a sample of 201 firms that restated their financial statements we analyze the process of regaining investor trust in a two year period after the restatement. We find that 20% of firms that restate their financial statements tile for bankruptcy or restructure out of court. Our results also indicate that the decisions to change auditor or management is correlated with a higher probability of failure. Increased media attention appears to partly explain the decision of firms to restructure their debt or tile for bankruptcy.
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Approach slab pavement at integral abutment (I-A) bridges are prone to settlement and cracking, which has been long recognized by the Iowa Department of Transportation (DOT). A commonly recommended solution is to integrally attach the approach slab to the bridge abutment. This study sought to supplement a previous project by instrumenting, monitoring, and analyzing the behavior of an approach slab tied to a integral abutment bridge. The primary objective of this investigation was to evaluate the performance of the approach slab. To satisfy the research needs, the project scope involved reviewing a similar previous study, implementing a health monitoring system on the approach slab, interpreting the data obtained during the evaluation, and conducting periodic visual inspections of the bridge and approach slab. Based on the information obtained from the testing, the following general conclusions were made: the integral connection between the approach slab and the bridge appears to function well with no observed distress at this location and no relative longitudinal movement measured between the two components; the measured strains in the approach slabs indicate a force exists at the expansion joint and should be taken into consideration when designing both the approach slab and the bridge and the observed responses generally followed an annual cyclic and/or short term cyclic pattern over time; the expansion joint at one side of the approach slab does not appear to be functioning as well as elsewhere; much larger frictional forces were observed in this study compared to the previous study.
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Background: General practitioners play a central role in taking deprivation into consideration when caring for patients in primary care. Validated questions to identify deprivation in primary-care practices are still lacking. For both clinical and research purposes, this study therefore aims to develop and validate a standardized instrument measuring both material and social deprivation at an individual level. Methods: The Deprivation in Primary Care Questionnaire (DiPCare-Q) was developed using qualitative and quantitative approaches between 2008 and 2011. A systematic review identified 199 questions related to deprivation. Using judgmental item quality, these were reduced to 38 questions. Two focus groups (primary-care physicians, and primary-care researchers), structured interviews (10 laymen), and think aloud interviews (eight cleaning staff) assured face validity. Item response theory analysis was then used to derive the DiPCare-Q index using data obtained from a random sample of 200 patients who were to complete the questionnaire a second time over the phone. For construct and criterion validity, the final 16 questions were administered to a random sample of 1,898 patients attending one of 47 different private primary-care practices in western Switzerland (validation set) along with questions on subjective social status (subjective SES ladder), education, source of income, welfare status, and subjective poverty. Results: Deprivation was defined in three distinct dimensions (table); material deprivation (eight items), social deprivation (five items) and health deprivation (three items). Item consistency was high in both the derivation (KR20 = 0.827) and the validation set (KR20 = 0.778). The DiPCare-Q index was reliable (ICC = 0.847). For construct validity, we showed the DiPCare-Q index to be correlated to patients' estimation of their position on the subjective SES ladder (rs = 0.539). This position was correlated to both material and social deprivation independently suggesting two separate mechanisms enhancing the feeling of deprivation. Conclusion: The DiPCare-Q is a rapid, reliable and validated instrument useful for measuring both material and social deprivation in primary care. Questions from the DiPCare-Q are easy to use when investigating patients' social history and could improve clinicians' ability to detect underlying social distress related to deprivation.
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AIM: This study assessed the mental health of parents of children with inflammatory bowel disease (IBD), compared their mental health with age-matched and gender-matched references and examined parental and child predictors for mental health problems. METHODS: A total of 125 mothers and 106 fathers of 125 children with active and inactive IBD from the Swiss IBD multicentre cohort study were included. Parental mental health was assessed by the Symptom Checklist 27 and child behaviour problems by the Strengths and Difficulties Questionnaire. Child medical data were extracted from hospital records. RESULTS: While the mothers reported lower mental health, the fathers' mental health was similar, or even better, than in age-matched and gender-matched community controls. In both parents, shorter time since the child's diagnosis was associated with poorer mental health. In addition, the presence of their own IBD diagnosis and child behaviour problems predicted maternal mental health problems. CONCLUSIONS: Parents of children with IBD may need professional support when their child is diagnosed, to mitigate distress. This, in turn, may help the child to adjust better to IBD. Particular attention should be paid to mothers who have their own IBD diagnosis and whose children display behaviour problems.
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The use of a thin bonded concrete overlay atop an older surface has been widely incorporated for pavement rehabilitation in Iowa since the early 70's. Two test sections were constructed in 1985 on county road T61 on the Monroe-Wapello County line without the use of grout as a bonding agent to determine if adequate bond could be achieved and structural capacity uncompromised. Both test sections have performed well with one section having higher bond strengths, lower roughness values, higher structural capacity, and less debonding at the joints than the other section. Overall, both ungrouted sections have performed well under substantial truck traffic with minimal surface distress. More attention should be given, however, to rectifying apparent debonding at the joints when no grout is used as a bonding agent.
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In this article, Rosa Cabré discusses Marçal¿s novel and illustrates how, according to the author, the desire of love, which is a source of pleasure often accompanied by guilt and distress, can lead to the creation or the illusion of an absolute beauty, like poetry. She explains in what way the mirror and the mask, recurring motifs in Marçal¿s work, symbolise identity and ¿otherness¿ and how these unite the real and the symbolic level. The novel contains an infinite number of mirrors, both external and internal ones, which enable the characters to see themselves reflected. This reflection is linked to feminity and to the possibilities of discovering one¿s own identity.
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The Iowa Department of Transportation is responsible for maintaining approximately 3800 bridges throughout the State. Of these bridges approximately 3200 have concrete decks. The remaining bridges have been constructed or repaired with a Portland Cement (P. C.) concrete overlay. Surveys of the overlays have indicated a growing incidence of delaminations and surface distress. The need to replace or repair the overlay may be dictated by the amount of delamination in the deck. Additionally, the concrete bridges are periodically inspected and scheduled for the appropriate rehabilitation. Part of this analysis is an assessment of the amount of delamination present in the deck. The ability to accurately and economically identify delamination in overlays and bridge decks is necessary to cost-effectively evaluate and schedule bridge rehabilitation. There are two conventional methods currently being used to detect delaminations. One is ref erred to as a chain drag method. The other a electro-mechanical sounding method (delamtect). In the chain drag method, the concrete surface is struck using a heavy chain. The inspector then listens to the sound produced as the surface is struck. The delaminated areas produce a dull sound as compared to nondelaminated areas. This procedure has proved to be very time consuming, especially when a number of small areas of delamination are present. With the · electro-mechanical method, the judgement of the inspector has been eliminated. A· device with three basic components, a tapping device, a sonic receiver, and a system of signal interpretation has been developed. This· device is wheeled along the deck and the instrument receives and interprets the acoustic signals generated by the instrument which in turn are reflected through the concrete. A recently developed method of detecting delaminations is infrared thermography. This method of detection is based on the difference in surface temperature which exists between delaminated and nondelaminated concrete under certain atmospheric conditions. The temperature difference can reach 5°C on a very sunny day where dry pavement exists. If clouds are present, or the pavement is wet, then the temperature difference between the delaminated and nondelaminated concrete will not be as great and therefore more difficult to detect. Infrared thermography was used to detect delaminations in 17 concrete bridge decks, 2 P. C. concrete overlays, and 1 section of continuously reinforced concrete pavement (CRCP) in Iowa. Thermography was selected to assess the accuracy, dependability, and potential of the infrared thermographic technique.
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Emigrating and having to leave children behind may be a risk factor for the mental health of immigrants. This study aimed to compare the psychological symptoms reported by immigrants mothers and fathers who took their children with them with those who left their children behind. The sample comprised 213 Latin American immigrants (123 women and 90 men). The results showed that mothers who did not have children with them reported more psychological symptoms than those who did. Few differences were observed in the case of fathers, except that those who had their children with them reported more symptoms related with somatization. After controlling for possible confounding variables ('time since immigration', ·having a job', 'legal status', and social support') it is concluded that for mothers not being accompanied by own's children explains the largest proportion of the psychological synptoms analyzed, although the time since immigration also accounts for some of the variance in the case of depressive sympthomatology and general distress. It is likely that the despair and frustation felt by mothers grows as time goes on and they remain unable to reunite the family. These results may be useful in terms of designing prevention and intervention programs with immigrants mothers.
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In 1987, 1.5 km (0.935 mi.) of Spruce Hill Drive in Bettendorf, Iowa was reconstructed. It is an arteriel street with commercial usage on both termini with single family residential dwellings along most of the project. A portland cement concrete (PCC) pavement design was selected, but a 14 day curing period would have been an undue hardship on the residents and commercial businesses. An Iowa DOT Class F fast track concrete was used so the roadway could be used in 7 to 10 days. The Class F concrete with fly ash was relatively sticky and exhibited early stiffening problems and substantial difficulty in obtaining the target entrained air content of 6.5%. These problems were never completely resolved on the project. Annual visual field reviews were conducted through 1996. In November 1991, severe premature distress was identified on the westbound two lanes of the full width replacement. The most deteriorated section in a sag vertical, 152 m (500 ft.) of the westbound roadway, was replaced in 1996. Premature distress has been identified on a dozen other conventional PCC Iowa pavements constructed between 1983 and 1989, so the deterioration may not be related to the fact that it was fast track pavement.
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An 11.6 km research project was constructed in 1994 on a portion of Iowa Highway 21 in Iowa County, from U.S. 6 to Iowa Highway 212. This research is intended to evaluate the effect of four primary variables on long term performances of the PCC concrete overlay, commonly called whitetopping. The variables are thickness (50 mm, 100 mm, 150 mm, and 200 mm), joint spacing (0.6 m squares, 1.2 m squares, 1.8 m squares, and 4.6 m spacing), fiber use (concrete with and without polypropolene fibers) and surface preparation (patch only, scarifying the surface, and cold-in-place recycling). After two years, only two sections exhibit a small amount of debonding and distress cracking. Both sections are 50 mm thick. Within each of these two sections, only 2% of the area is affected. Two other 50 mm thick sections have a small number of cracks but no debonding has been found. No adverse effects of these cracks are evident. Three asphalt overlay sections were also constructed. In each asphalt section, transverse cracks have recently been found. At two years of age, the research sections are performing very well. An insignificant number of cracks and no distressed areas have been found in any research sections thicker than 50 mm.
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Portland Cement Concrete (PCC) pavement has served the State of Iowa well for many years. The oldest Iowa pavement was placed in LeMars in 1904. Beginning in 1931, many miles of PCC pavement were built to "get out of the mud". Many of these early pavements provided good performance without deterioration for more than 50 years. In the late 1950s, Iowa was faced with severe PCC pavement deterioration called D cracking. Research identified the cause of this deterioration as crushed limestone containing a bad pore system. Selective quarrying and ledge control has alleviated this problem. In 1990, cracking deterioration was identified on a three-year-old pavement on US 20 in central Iowa. The coarse aggregate was a crushed limestone with an excellent history of performance in PCC pavement. Examination of cores showed very few cracks through the coarse aggregate particles. The cracks were predominately confined to the matrix. The deterioration was identified as alkali-silica reactivity (ASR) by a consultant. To investigate the cause of the deterioration, the Iowa DOT and Iowa State University jointly purchased a high resolution, low vacuum Hitachi Scanning Electron Microscope (SEM) with an energy dispersion detector. Subsequent evaluation identified no concentration of silica gel (silicon-Si), but did identify substantial amounts of sulfur-S and aluminum-AL (assumed to be ettringite) in the air voids. Some of these voids have cracks radiating from them leading us to conclude that the ettringite filled voids were a center of pressure causing the crack. The ettringite in the voids, after being subjected to sodium chloride (NaCl), initially swells and then dissolves. This low vacuum SEM research of PCC pavement deterioration supports the following conclusions: (1) A low vacuum SEM and an energy dispersion detector are very important for proper evaluation of PCC pavement deterioration; (2) There are instances today where PCC pavement deterioration is mistakenly identified as ASR; (3) Ettringite initially expands when subjected to NaCl; and the ettringite filled voids are a center-of-pressure that cracks the PCC; and (4) The deterioration of some current premature PCC pavement distress locations is caused by factors related to the formation of excessive ettringite.
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Pulmonary edema is a problem of major clinical importance resulting from a persistent imbalance between forces that drive water into the airspace of the lung and the biological mechanisms for its removal. Here, we will first review the fundamental mechanisms implicated in the regulation of lung fluid homeostasis, namely, the Starling forces and the respiratory transepithelial sodium transport. Second, we will discuss the contribution of hypoxia to the perturbation of this fine balance and the role of such perturbations in the development of high-altitude pulmonary edema, a disease characterized by a very high morbidity and mortality. Finally, we will review possible interventions aimed to maintain/restore lung fluid homeostasis and their importance for the prevention/treatment of pulmonary edema.