Mental health treatment seeking by military members with posttraumatic stress disorder : findings on rates, characteristics, and predictors from a nationally representative Canadian military sample

Objective: The goal of this study was to identify rates, characteristies, and predictors of mental health treatment seeking by military members with posttraumatic stress disorder (PTSD). Method: Our sample was drawn from the 2002 Canadian Community Health Survey-Canadian Forces Supplement (CCHS-CF) dataset. The CCHS-CF is the first epidemiologic survey of PTSD and other mental health conditions in the Canadian military and includes 8441 nationally representative Canadian Forces (CF) members. Of those, 549 who met the criteria for lifetime PTSD were included in our analyses. To identify treatment rates and characteristics, we examined frequency of treatment contact by professional and facility type. To identify predictors of treatment seeking, we conducted a binary logistic regression with lifetime treatment seeking as the outcome variable. Results: About two-thirds of those with PTSD consulted with a professional regarding mental health problems. The most frequently consulted professionals, during both the last year and lifetime, included social workers and counsellors, medical doctors and general practitioners, and psychiatrists. Consultations during the last year most often took place in a CF facility. Treatment seeking was predicted by cumulative lifetime trauma exposure, index traumatic event type, PTSD symptom interference, and comorbid major depressive disorder. Those with comorbid depression were 3.75 times more likely to have sought treatment than those without. Conclusions: Although a significant portion of military members with PTSD sought mental health treatment, 1 in 3 never did. Trauma-related and illness and (or) need factors predicted treatment seeking. Of all the predictors of treatment seeking, comorbid depression most increased the likelihood of seeking treatment.

Putting plays (and more) in cyberspace : an overview of the British women playwrights around 1800 project

The british women playwrights around 1800 Web project has had a split allegiance from its beginning. Its beginnings lay in our interest in sustaining over time a community that had begun exploring the histories and writing of women in late-eighteenth and early-nineteenth century British theater. [...]

Why us? Perceived injustice is associated with more sexual and psychological distress in couples coping with genito-pelvic pain.

Introduction Provoked vestibulodynia (PVD) is the most frequent cause of genito-pelvic pain/penetration disorder (GPPPD) and is associated with negative psychological and sexual consequences for affected women and their partners. PVD is often misdiagnosed or ignored and many couples may experience a sense of injustice, due to the loss of their ability to have a normal sexual life. Perceiving injustice has been documented to have important consequences in individuals with chronic pain. However, no quantitative research has investigated the experience of injustice in this population. Aim The aim of this study was to investigate the associations between perceived injustice and pain, sexual satisfaction, sexual distress, and depression among women with PVD and their partners. Methods Women diagnosed with PVD (N = 50) and their partners completed questionnaires of perceived injustice, pain, sexual satisfaction, sexual distress, and depression. Main Outcome Measures (1) Global Measure of Sexual Satisfaction Scale; (2) Female Sexual Distress Scale; (3) Beck Depression Inventory-II; and (4) McGill-Melzack Pain Questionnaire. Results After controlling for partners' age, women's higher level of perceived injustice was associated with their own greater sexual distress, and the same pattern was found for partners. Women's higher level of perceived injustice was associated with their own greater depression, and the same pattern was found for partners. Women's higher perceived injustice was not associated with their own lower sexual satisfaction but partners' higher perceived injustice was associated with their own lower sexual satisfaction. Perceived injustice was not associated with women's pain intensity. Conclusion Results suggest that perceiving injustice may have negative consequences for the couple's sexual and psychological outcomes. However, the effects of perceived injustice appear to be intra-individual. Targeting perceived injustice could enhance the efficacy of psychological interventions for women with PVD and their partners.

Queues with Customer Induced Interruption

In this thesis we have introduced and studied the notion of self interruption of service by customers. Service interruption in queueing systems have been extensively discussed in literature (see, Krishnamoorthy, Pramod and Chakravarthy [38]) for the most recent survey. So far all work reported deal with cases in which service interruptions are generated by sources other than customers. However, there are situations where interruptions are due to the customers rather than the system. Such situations are especially arise at doctors clinic, banks, reservation counter etc. Our attempt is to quantify a few of such problems. Systematically we have proceed from single server queue (in Chapter 2) to multi-server queues (Chapter 3). In Chapte 4, we have studied a very general multiserver queueing model with service interruption and protection of service phases. We also introduced customer interruption in a retrial setup (in Chapter 5). All models (from Chapter 2 to Chapter 4) that were analyzed involve 'non-preemptive priority' for interrupted customers where as in the model discussed in Chapter 5 interruption of service by customers is not encouraged. So the interrupted customers cannot access the server as long as there are primary customers in the system. In Chapter 5 we have obtained an explicit expression for the stability condition of the system. In all models analyzed in this thesis, we have assumed that no more than one interruption is allowed for a customer while in service. Since the models are not analytically tractable, a large number of numerical illustrations were given in each chapter it illustrate the working of the systems. We can extend the models discussed in this thesis to several directions. For example some of the models can be analyzed with both server induced and customer induced interruptions the results for which are not available till date. Another possible extension of work is to the case where there is no bound on the number of interruptions a customer is permitted to have before service completion. More complex is the case where a customer is permitted to have a nite number (K ≥ 2) of We can extend the models discussed in this thesis to several directions.

Professional Services

This is a study on “Professional Services: Civil Liability for Deficiency”. This study is made with special reference to medical profession. The importance of qualitative professional services does not require any emphasis. It is a matter of great concern for the people as they are consumers.This study is divided into 12 chapters. The introductory chapter deals with characteristics of profession, basis of professional liability and international efforts to check abuse of position by professional men. Consumers as laymen can not perceive the intricacies of professional services. As a result professional men could misuse their superior position to expose consumers to hardship through deficient services. This is obvious from the fact that deficiency in professional services has assumed a menacing proportion. It is indicative of failure of internal control through self-regulation to check the abuse of position by the professional men. The professional bodies entrusted with the task of enforcing disciplinary measures show a very callous and indifferent attitude towards the repressive conduct of their members. These bodies are more concerned to protect the interest of their members. They are not free from institutional bias. They have put the interest of consumers into oblivion. In effect remedies through professional bodies has become a myth. All these factors make the external control of professional services mandatory to protect the consumers from the clutches of unscrupulous professional men, who abuse their superior position. The professional men who abuse their position are exposed to liability. Their liability arises under contract, tort and statutory law. The present study substantially concentrates on professional liability of medical men. The obvious reason is that of all professional services medical services are the frequently availed services by the consumers. Medical negligence cases account for bulk of the professional negligence cases. ln India also large number of cases are coming before consumer forae. The legal principles evolved in this sphere of professional service confers an insight into legal control of other professional services as well. The same principles are applied to other professions also, as by and large all the professions share common characteristics. Such principles are modified wherever necessary to make room for differential aspects of particular profession

Alkali insoluble glucan extracted from Acremonium diospyri is a more potent immunostimulant in the Indian White Shrimp, Fenneropenaeus indicus than alkali soluble glucan

E¡ect of an extraction method on the structure of glucan and its immunostimulatory response in Fenneropenaeus indicus was investigated. Here we extracted alkali insoluble glucan (AIG) and alkali soluble glucan (ASG) from a ¢lamentous fungi Acremonium diospyri following alkali^acid hydrolysis and the sodium hypochlorite oxidation and dimethyl sulphoxide extraction method respectively. Structural analysis showed that 85% of glucan in AIG was a (1 !3)-b-D-glucan and it increased the prophenoloxidase and reactive oxygen intermediate activity when administered to F. indicus. On the other hand, ASG, which contained 93% (1 !3)-a-glucan, did not induce signi¢cant immune response in shrimp. Here we report that the di¡erence in immunostimulatory potential between AIG and ASG is due to the di¡erence in the percentage of (1 !3)-b-D-glucans present in each preparation, which varies with the method of extraction employed. Also our observations suggest that glucan can be used as a potential immunostimulant to shrimp, provided it contains (1 !3)-b-D-glucan as the major fraction.

More than irrigation - The Balinese Subak system as a unique form of cooperative water resource management in Indonesia

For over 1,000 years, the Balinese have developed a unique system of democratic and sustainable water irrigation. It has shaped the cultural landscapes of Bali and enables local communities to manage the ecology of terraced rice fields at the scale of whole watersheds. The Subak system has made the Balinese the most productive rice growers in Indonesia and ensures a high level of food sovereignty for a dense population on the volcanic island. The Subak system provides a vibrant example of a diverse, ecologically sustainable, economically productive and democratic water management system that is also characterized by its nonreliance on fossil fuel derivatives or heavy machinery. In 2012, UNESCO has recognized five rice terraces and their water temples as World Heritage site and supports its conservation and protection. However, the fragile Subak system is threatened for its complexity and interconnectedness by new agricultural practices and increasing tourism on the island.

Discurs del rector de la Universitat de Girona, Dr.Joan Batlle, en l'acte d'investidura com doctors honoris causa de Robert Brian Tate, Joan Bertran Rusca i Jaume Gil Aluja

Discurs d'investidura de doctors honoris causa per la Universitat de Girona, del rector Joan Batlle

Discurs de la rectora de la Universitat de Girona, Dra. Anna M. Geli, en l'acte d'investidura com doctors honoris causa d' Eric J. Hobsbawm i Miquel Roca i Junyent

En el discurs d'investidura dels doctors honoris causa, Eric J. Hobsbawm i Miquel Roca i Junyent, la rectora explica que aquests actes tracten de proclamar a quin tipus d’ensenyament o d’exemple ens remetem, quins són els referents intel·lectuals o morals als quals s’acull una institució com la Universitat de Girona. Comenta que per al Claustre Universitari, la investidura de doctors honoris causa significa el compromís d’acceptar, de manera crítica i constructiva, la transmissió de saber i de coneixement que ens lleguen les persones que han merescut l’elogi públic, el compromís de treballar amb aquest llegat i d’introduir-lo en el debat universitari

Discurs de la rectora de la Universitat de Girona, Dra. Anna M. Geli, en l'acte d'investidura com doctors honoris causa de Raimon Panikkar i Carmina Virgili

En el discurs d'investidura dels doctors honoris casusa, Raimon Panikkar i Carmina Virgili, la rectora de la Universitat de Girona comenta que aquest tipus d'actes fonamenten la vigència de la institució universitària i del que representa. Reflexiona sobre l'assumpció d'experiència i saviesa, per part de la universitat, dels nous doctors a través de la seva voluntat crítica i del seu esforç per transmetre el coneixement

Síndrome de Burnout en médicos generales de consulta externa

Objetivos : Establecer la prevalencia de Síndrome de Burnout en 17 médicos de consulta externa de una IPS de Bogotá, antes de la jornada laboral y después de la misma. Determinar las dimensiones del Síndrome de Burnout y relacionarlas con las variables sociodemográficas escogidas para este caso. Metodología: Se realizó un estudio longitudinal con una población de 17 médicos generales de consulta externa de una IPS de la cuidad de Bogotá Colombia, en el año 2009. Se les aplicó el Test de Maslach, para determinar las tres dimensiones del Síndrome de Burnout las cuales son: agotamiento emocional, despersonalización y realización personal para establecer la relación con las variables escogidas previamente. Para el análisis estadístico se usó el Software Epi Info Versión 3.51. Las variables cuantitativas fueron resumidas teniendo en cuenta medidas de tendencia central y las variables cuantitativas se expresaron en forma de proporciones. Para realizar las comparaciones se utilizó la prueba Ji cuadrado con ajuste por Test de Fischer. Se consideró significancia estadística con p ‹ 0.05. Resultado : La población estudiada fue en su mayoría de género femenino, con una mediana de edad de 30 años. El 41.2% de los médicos trabajan 8 horas diarias y el 35.3% trabajan más de 8 horas al día. Se calificaron las tres dimensiones que propone el test de Maslach, las cuales son agotamiento emocional, despersonalización y realización personal dando un puntaje de alto medio y bajo según las respuestas de los médicos evaluados. . Dentro de las dimensiones analizadas del test de Maslach antes de la jornada laboral el 35.3 % presentan agotamiento emocional dentro de la puntuación alta y después de la jornada se aumenta a 47.1%. En cuanto al puntaje para medio en esta misma dimensión fue de 23.5 % y bajo 41.2% previo a la jornada , con un porcentaje al finalizar de la jornada de 17.6% y 35.3% respectivamente. La dimensión de despersonalización antes de la jornada fue de 29,4% para alto, 23.5% para medio y 47.1% para bajo. Al finalizar la jornada no se observan cambios significativos en los porcentajes de esta dimensión. No se obtuvo prevalencia significativa entre las variables estudiadas y cada una de las dimensiones del Test de Maslach. Discusión : Los resultados muestran que existe un cambio en la dimensión de agotamiento emocional al inicio de la jornada laboral comparado con el final de la misma. Las calificaciones obtenidas tuvieron valores altos, mientras que en los de valores medio y bajo disminuyó este agotamiento al finalizar la jornada. Para la despersonalización los valores no se vieron modificados tras la jornada de trabajo. En cuanto a la realización personal hubo una variación ya que los sujetos que fueron calificados al iniciar la jornada con valores altos disminuyeron al finalizar y los de valores medio y bajo aumentaron su realización personal al finalizar la jornada. De otra parte no se establecieron relaciones significativas con los factores extralaborales e individuales evaluados, teniendo en cuenta probablemente el tamaño de la población de estudio y el tiempo de evaluación.

JISC TechDis Accessibility essentials guide: Making electronic documents more readable

The TechDis Accessibility Essentials Guide for Reading has been divided into the following three sections: Font colours and styles; Enlarging text and Navigating documents. These guides have been designed to give practical step-by-step information to enable anyone reading electronic material to amend its look and feel into a style which suits them, their audience or the context in which it is used.

Hemorragia postparto en pacientes con obesidad y/o anemia durante el embarazo: revisión sistemática

Introducción: actualmente la anemia y la obesidad durante el embarazo se consideran factores de riesgo modificables para hemorragia postparto. Estos pueden ser evitados desde el control prenatal y su manejo preconcepcional contribuye de una forma importante en la reducción de la morbimortalidad materno y perinatal. Metodología: se realizó una revisión sistemática de literatura con componente meta-analítico según la evidencia disponible hasta la fecha. Los términos mesH incluyeron postpartum hemorrhage, severe anemia, overweight, obesity entre otros. Todos los artículos fueron clasificados por su evidencia antes de calcular el componente meta-analítico. Resultados: se encontraron un total de 321 artículos relacionados con anemia, y 276 para obesidad, de los cuales 8 y 14 respectivamente cumplieron criterios para su selección. La mayoría de artículos fueron clasificados como evidencia IV para anemia y II-III para obesidad. Las causas más frecuentes de exclusión fueron el título y el tipo de estudio. Tanto la anemia como la obesidad (clasificada por IMC) muestran OR conjuntos no estadísticamente significativo y con intervalos de confianza amplios, aunque la tendencia de riesgo conjunto es a mayor peso, mayor riesgo de hemorragia. Discusión: los resultados de la revisión sistemática permiten mostrar tanto a la anemia como la obesidad como factores que muestran una tendencia al riesgo para hemorragia postparto, sin resultados estadísticamente significativos. Faltan más estudios sobre el tema en el país.MetodologíaSe realizó una revisión sistemática de literatura con componente meta-analítico según la evidencia disponible hasta la fecha. Los términos mesH incluyeron postpartum hemorrhage, severe anemia, overweight, obesity entre otros. Todos los artículos fueron clasificados por su evidencia antes de calcular el componente meta-analítico. ResultadosSe encontraron un total de 321 artículos relacionados con anemia, y 276 para obesidad, de los cuales 8 y 14 respectivamente cumplieron criterios para su selección. La mayoría de artículos fueron clasificados como evidencia IV para anemia y II-III para obesidad. Las causas más frecuentes de exclusión fueron el título y el tipo de estudio. Tanto la anemia como la obesidad (clasificada por IMC) muestran OR conjuntos no estadísticamente significativo y con intervalos de confianza amplios, aunque la tendencia de riesgo conjunto es a mayor peso, mayor riesgo de hemorragia. DiscusiónLos resultados de la revisión sistemática permiten mostrar tanto a la anemia como la obesidad como factores que muestran una tendencia al riesgo para hemorragia postparto, sin resultados estadísticamente significativos. Faltan más estudios sobre el tema en el país.