932 resultados para Trauma, Posttraumatic Growth, Emergency Service Work, Personality, Coping, Ambulance, Paramedic


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Tutkimuksen tarkoituksena oli selvittää, ovatko asiakkaiden kanssa sovitut kaupintavarastojärjestelyt liiketoiminnallisesti oikeutettuja vai ovatko ne pääasiassa vain asiakkaan palvelua. Tavoitteiksi asetettiin tutkia logististen palveluiden tärkeyttä, etsiä eri näkökohtia asiakaskohtaisten varastojen ja varastopalveluiden tarjoamiselle, löytää mahdollisia korvaavia tai vastaavia palveluita, sekä esitellä menetelmä toimitusketjun palvelutason priorisoimiseksi ja hallitsemiseksi. Työhön tarvittu kaupallinen aineisto koskien tuotteita ja asiakaita saatiin yrityksen tietojärjestelmästä. Muut taustatiedot kerättiin yrityksen toimintaohjeista, keskustelemalla ja haastattelemalla henkilöstöä, sekä seuraamalla yrityksen toimintaa työnteon ohessa. Tutkimus on jaettu kirjallisuus- ja case-osuuteen. Työn case-tulokset osoittavat, että nykyiset kaupintavarastoasiakkaat pääosin ansaitsevat lisäarvoa tuottavan varastopalvelun. Tutkimuksesta saadut kokemukset ja tiedot auttavat tekemään lisäarviointeja, koskien myös yrityksen muita tuotantolaitoksia. Työstä saatuja kokonaishyötyjä on vielä tässä vaiheessa vaikea arvioida.

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Cette thèse porte sur la contribution des caractéristiques individuelles et des situations professionnelles au bien-être. En combinant différentes perspectives théoriques, notamment la théorie de la construction de la carrière, la théorie de la justice organisationnelle, les modèles du bien-être au travail, et les conceptualisations de l'incivilité au travail, un certain nombre d'hypothèses sont proposées concernant le lien entre certaines caractéristiques individuelles et situationnelles et le bien-être général et professionnel. Les deux premières études se focalisent sur la validation d'une échelle d'adaptabilités de carrière et sur le rôle médiateur de cette adaptabilité dans la relation entre des dispositions et le bien-être. La troisième étude évolue l'hypothèse d'un possible effet de médiation de l'adaptabilité mais cette fois de la relation entre insécurité professionnelle et charge de travail d'une part et le bien-être d'autre part. La quatrième étude adopte une perspective longitudinale et analyse les associations entre les dimensions de la personnalité, l'adaptabilité de carrière et le bien-être dans quatre parcours professionnels différents. La cinquième étude porte sur une autre caractéristique individuelle, à savoir la croyance en un monde juste. Cette étude illustre comment la croyance en un monde juste influence les perceptions de justice organisationnelle une année après, qui ont une incidence importante sur le bien-être. Enfin, la dernière étude se concentre sur une population spécifique, les immigrants en Suisse, et souligne qu'être la cible d'incivilité sur le lieu de travail est généralement liée au pays d'origine. Globalement, cette thèse met en évidence que les caractéristiques individuelles ont des effets tant directs qu'indirects sur le bien-être et que ces mêmes caractéristiques explique en partie, les relations entre la situation professionnelle et le bien-être. Plus spécifiquement, des situations professionnelles peuvent influencer l'expression de certaines caractéristiques individuelles, soit en contribuant à leurs activations ou à leurs inhibitions. De plus, l'impact des caractéristiques individuelles sur le bien-être semble dépendre de la situation professionnelle. Il est donc important de considérer les influences simultanées et réciproques des caractéristiques individuelles et de la situation contextuelle et professionnelle pour rendre compte du bien-être général et professionnel. -- This thesis explores how individual characteristics and professional situations correspond to well-being. Drawing from various theoretical backgrounds, such as career construction theory, justice theory, models of job strain, and theories on subtle discrimination, a number of specific hypotheses are put forward pertaining to a selection of individual and professional aspects as well as general and work-related well-being. The six studies presented in this thesis focus on specific aspects and adopt different methodological and theoretical approaches. The first two studies concern the validation of the career adapt-abilities scale and test the potential of career adapt-abilities to mediate the relationship between dispositions and outcomes. The third study extends the hypothesis of career adapt-abilities as a mediator and finds that it mediates the effects of job insecurity and job strain on general and professional well-being. The fourth study adopts a longitudinal approach and tests the associations between personality traits and career adaptability and well-being in four different professional situations. Study five concerns another individual characteristic, belief in a just world, and illustrates how justice beliefs drive perceptions of organizational justice, which in turn impact, on well-being outcomes one year later. The final study focuses on the professional experiences of a specific population, immigrants in Switzerland, and confirms that being a target of incivilities is related to national origin. Globally, this thesis finds that individual characteristics have direct and indirect influences on well-being and that these characteristics may also mediate the associations between professional situations and outcomes. In particular, the professional situation may alter the display of individual characteristics, either by contributing to their activation or their depletion, and the ways in which individual factors influence well-being does seem to depend on the professional situation. It is thus necessary to adopt a "both...and" perspective when studying the impact of individual and professional characteristics as these factors mutually influence each other.

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There is much evidence that alcohol use disorders (AUD) often co-occur with posttraumatic stress disorders (PTSD), and that the comorbid condition is associated with a more severe clinical profile than that of PTSD without AUD. However, little is known about the role of childhood adversities as specific risk factors for the development of AUD in individuals presenting with PTSD. The aim of the study was to explore whether specific stressors from the spectrum of trauma and childhood adversities contribute to the development of AUD among subjects with PTSD. From a large community sample, of N=140 individuals with PTSD, N=24 (17.14%) received an additional diagnosis of AUD with an onset after the onset of PTSD. Those with comorbid PTSD/AUD and those with PTSD only were compared regarding type and features of their trauma, childhood adversities and psychiatric comorbidity. Compared to PTSD alone, PTSD/AUD was associated with higher levels of stress in terms of childhood adversities; in particular, sexual abuse below the age of 16, but also with having been brought up in a foster home. PTSD/AUD was also associated with an earlier age of adverse events. Treatment of AUD should include standardized assessments of trauma, especially of trauma experienced during childhood.

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This study examined the role of posttraumatic stress disorder (PTSD) symptoms of re-experience, avoidance, and hyperarousal in the relationship between different types of trauma and alcohol use disorders (AUD). We used data from 731 trauma-exposed individuals who participated in the first wave of the PsyCoLaus-study. Trauma characteristics were assessed relatively to the occurrence of lifetime PTSD symptoms and AUD. The results suggest that lifetime and childhood sexual abuse as well as overall childhood trauma were directly linked to AUD and PTSD symptoms, in particular to avoidance symptoms. From single symptom clusters PTSD avoidance was found to specifically mediate the trauma-AUD pathway. Both childhood and sexual trauma strongly contribute to the comorbidity of PTSD and AUD and avoidance-type symptoms appear to play a central role in maintaining this association. Hence, the alleviation of avoidance symptoms might be an important target for therapeutic intervention among victims of sexual abuse before specific addiction treatment is initiated.

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Growth arrest-specific 6 (Gas6) is widely expressed in leukocytes, platelets, endothelial cells, and monocytes. It regulates various processes including granulocyte adhesion to the endothelium, cell migration, thrombus stabilization, and cytokine release. In humans, increased plasma Gas6 levels have been described in patients with sepsis and septic shock. In this study, Gas6 concentrations were measured in postmortem serum from femoral blood in a series of sepsis-related fatalities and control cases. The aims were twofold: first, to determine whether Gas6 can be reliably determined in postmortem serum; and second, to assess its diagnostic potential in identifying sepsis-related deaths. Two study groups were prospectively formed, a sepsis-related fatalities group (24 cases) and a control group (24 cases) including cases of deep vein thrombosis and fatal pulmonary embolism, cases of systemic inflammatory response syndrome in severe trauma, cases of end-stage renal failure, and cases of hanging (non-septic, non-SIRS, non-end stage renal failure cases). The preliminary results of this study seem to indicate that Gas6 can be effectively measured in postmortem serum. However, Gas6 levels in sepsis-related fatalities do not appear to be clearly distinguishable from concentrations in pulmonary embolism, severe trauma, and end-stage renal failure cases. These findings tend to support previous reports that indicated that Gas6 behaves as an acute phase reactant and can be considered a general marker of inflammation rather than a specific biomarker of sepsis.

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Foliar shade triggers rapid growth of specific structures that facilitate access of the plant to direct sunlight. In leaves of many plant species, this growth response is complex because, although shade triggers the elongation of petioles, it reduces the growth of the lamina. How the same external cue leads to these contrasting growth responses in different parts of the leaf is not understood. Using mutant analysis, pharmacological treatment and gene expression analyses, we investigated the role of PHYTOCHROME INTERACTING FACTOR7 (PIF7) and the growth-promoting hormone auxin in these contrasting leaf growth responses. Both petiole elongation and lamina growth reduction are dependent on PIF7. The induction of auxin production is both necessary and sufficient to induce opposite growth responses in petioles vs lamina. However, these contrasting growth responses are not caused by different auxin concentrations in the two leaf parts. Our work suggests that a transient increase in auxin levels triggers tissue-specific growth responses in different leaf parts. We provide evidence suggesting that this may be caused by the different sensitivity to auxin in the petiole vs the blade and by tissue-specific gene expression.

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Tämän tutkielman tavoitteena oli selvittää miten asiakkaille suunnattu Internet –pohjainen palvelu muuttaa asiakaspalvelua metsäteollisuudessa, ja mitkä tekijät vaikuttavat tällaisen palvelun omaksumiseen. Tutkimuksesta ilmenee että muutokset asiakaspalvelussa ovat olleet asiakkaiden mielestä pääasiassa positiivisia. Selvisi, että uuden sovelluksen laatuun ollaan tyytyväisiä, mutta että kaikki asiakkaat eivät pidä sen etuja huomattavina verrattuna vanhoihin toimintatapoihin. Esimerkkiyrityksen oma henkilöstö ei keskimäärin koe sovellusta kovin hyödylliseksi oman työnsä kannalta. Jotta sovelluksen käyttöä ja mahdollisia hyötyjä esimerkkiyritykselle saataisiin lisättyä, on sovellukseen tehtävien parannusten lisäksi panostettava tehokkaampaan kommunikointiin ja lisäkoulutukseen asiakkaille. Lisäksi on löydettävä keinoja, joiden avulla asiakkaat kokisivat sovelluksen käytön itselleen edullisemmaksi kuin pitäytymisen vanhoissa toimintatavoissa. Edellä mainitun saavuttaminen edellyttää esimerkkiyrityksen asiakaspalvelu-henkilöstön ja operatiivisen johdon sitoutumista sovelluksen aktiiviseen markkinointiin asiakkaiden suuntaan. Tutkimuksen aineisto kerättiin haastatteluilla ja asiakkaille suunnatulla kyselylomakkeella käyttäen pääasiassa kvalitatiivisia menetelmiä. Haastatteluja tehtiin kahdessa esimerkkiyrityksen yksikössä, kolmessa myyntikonttorissa sekä kahden asiakasyrityksen yhteensä neljässä eri yksikössä. Kyselylomake lähetettiin 215 asiakaskäyttäjälle, joista 30 palautti lomakkeen. Palautusprosentiksi tuli 14.

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Between the mid-nineteenth century and the outbreak of the Spanish Civil War in 1936, Spain undertook a sustained process of economic growth and structural change, but was unable to converge with the core European economies.1 The reasons behind Spain"s failure to converge have been a subject of debate among historians for decades. 2 This dissertation aims to analyze the role played by infrastructure in Spanish economic growth during that period, and tries to find out to what extent the potential shortage or inadequacy of the Spanish infrastructure endowment was one of the factors to blame for the country"s nonconvergence. The dissertation draws on recent research on the economic impact of infrastructure, and on the numerous attempts to measure that impact which have been undertaken in the wake of David Aschauer"s work on the United States.

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Mobile technologies have brought about major changes in police equipment and police work. If a utopian narrative remains strongly linked to the adoption of new technologies, often formulated as 'magic bullets' to real occupational problems, there are important tensions between their 'imagined' outcomes and the (unexpected) effects that accompany their daily 'practical' use by police officers. This article offers an analysis of police officers' perceptions and interactions with security devices. In so doing, it develops a conceptual typology of strategies for coping with new technology inspired by Le Bourhis and Lascoumes: challenging, neutralizing and diverting. To that purpose, we adopt an ethnographic approach that focuses on the discourses, practices and actions of police officers in relation to three security devices: the mobile digital terminal, the mobile phone and the body camera. Based on a case study of a North American municipal police department, the article addresses how these technological devices are perceived and experienced by police officers on the beat.

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Accurate prediction of mortality following burns is useful as an audit tool, and for providing treatment plan and resource allocation criteria. Common burn formulae (Ryan Score, Abbreviated Burn Severity Index (ABSI), classic and revised Baux) have not been compared with the standard Acute Physiology and Chronic Health Evaluation II (APACHEII) or re-validated in a severely (≥20% total burn surface area) burned population. Furthermore, the revised Baux (R-Baux) has been externally validated thoroughly only once and the pediatric Baux (P-Baux) has yet to be. Using 522 severely burned patients, we show that burn formulae (ABSI, Baux, revised Baux) outperform APACHEII among adults (AUROC increase p<0.001 adults; p>0.5 children). The Ryan Score performs well especially among the most at-risk populations (estimated mortality [90% CI] original versus current study: 33% [26-41%] versus 30.18% [24.25-36.86%] for Ryan Score 2; 87% [78-93%] versus 66.48% [51.31-78.87%] for Ryan Score 3). The R-Baux shows accurate discrimination (AUROC 0.908 [0.869-0.947]) and is well-calibrated. However, the ABSI and P-Baux, although showing high measures of discrimination (AUROC 0.826 [0.737-0.916] and 0.848 [0.758-0.938]) in children), exceedingly overestimates mortality, indicating poor calibration. We highlight challenges in designing and employing scores that are applicable to a wide range of populations.

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There is much evidence that alcohol use disorders (AUD) often co-occur with posttraumatic stress disorders (PTSD), and that the comorbid condition is associated with a more severe clinical profile than that of PTSD without AUD. However, little is known about the role of childhood adversities as specific risk factors for the development of AUD in individuals presenting with PTSD. The aim of the study was to explore whether specific stressors from the spectrum of trauma and childhood adversities contribute to the development of AUD among subjects with PTSD. From a large community sample, of N=140 individuals with PTSD, N=24 (17.14%) received an additional diagnosis of AUD with an onset after the onset of PTSD. Those with comorbid PTSD/AUD and those with PTSD only were compared regarding type and features of their trauma, childhood adversities and psychiatric comorbidity. Compared to PTSD alone, PTSD/AUD was associated with higher levels of stress in terms of childhood adversities; in particular, sexual abuse below the age of 16, but also with having been brought up in a foster home. PTSD/AUD was also associated with an earlier age of adverse events. Treatment of AUD should include standardized assessments of trauma, especially of trauma experienced during childhood.

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This study examined the role of posttraumatic stress disorder (PTSD) symptoms of re-experience, avoidance, and hyperarousal in the relationship between different types of trauma and alcohol use disorders (AUD). We used data from 731 trauma-exposed individuals who participated in the first wave of the PsyCoLaus-study. Trauma characteristics were assessed relatively to the occurrence of lifetime PTSD symptoms and AUD. The results suggest that lifetime and childhood sexual abuse as well as overall childhood trauma were directly linked to AUD and PTSD symptoms, in particular to avoidance symptoms. From single symptom clusters PTSD avoidance was found to specifically mediate the trauma-AUD pathway. Both childhood and sexual trauma strongly contribute to the comorbidity of PTSD and AUD and avoidance-type symptoms appear to play a central role in maintaining this association. Hence, the alleviation of avoidance symptoms might be an important target for therapeutic intervention among victims of sexual abuse before specific addiction treatment is initiated.

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The incorporation of the Spanish university system into the European Higher Education Areahas brought about a series of adaptations. Among the recommendations is the inclusion ofan external training period in a company, which has resulted in significant changes in thedegree syllabus in order to balance the theoretical and practical education required by thestudents. This new framework has been legally confirmed by the Spanish Government and, inthe case of the University of Barcelona, by the publication of internal guidelines. Takingadvantage of this new opportunity to adapt the Pharmacy degree to real-world problems inindustry, the Dean’s team of the Faculty of Pharmacy, with the support of the Facultyadministrative staff and the Students Advisory Service, have assumed the challenge ofincluding a new subject in the syllabus entitled Training in Companies.In parallel, a new activity has been set up to ensure that the students choose the mostsuitable company department/job for them and to help them pass the company interview.Under the name of Passport to a Profession, a series of ten explanatory talks has beenscheduled every academic year. These talks deal with a broad range of topics aimed atproviding the students with the basic tools they will need to make the most of a companytraining period and to make headway in the professional world when they finish theirdegree. In addition, three Faculty of Pharmacy-Pharmaceutical company workshops and tworound-table conferences have been held in the last two years in order to bring the universityand industry together. Notably, the project to provide students with company training isexpanding on an international level, with two to three undergraduate students contractedevery year by a United Kingdom-based multinational pharmaceutical company.The statistical data of the whole process has been analysed for a more in-depthunderstanding of the activity and to improve the programme.

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The operational aspects of psychological assessment are well documented (e.g. Murphy and Davidshofer, 1994). Essentially, the process involves the administration of one or more valid psychological tests in order to assess a person’s suitability to a task or situation. The resulting data and report are then used by police psychologists to assist in determining the suitability of the applicant for police duties. In Catalunya, this task is carried out during basic training for police career agent in the evaluation of psychological conditions for the use of the weapon. Police work can be one of the most stressful jobs, and it frequently leads to the development of burnout syndrome. In their day-to-day tasks, police officers are constantly subjected to various stressors (de la Fuente, Aguayo, Vargas and Cañadas, 2013). The most widely accepted definition of the burnout syndrome is one that describes it as a response to chronic work stress made up of three components: emotional exhaustion, depersonalisation and low personal accomplishment (Maslach & Jackson, 1981). Some studies showed that personality characteristics, and positive and negative affectivity explained significant variance in each of the burnout dimensions (Alarcon, Eschleman and Bowling, 2009).

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The purpose of this study was to evaluate the competence of nurse teachers, who are teaching nursing at polytechnic level in Finland. The following research questions were framed for the study: What kind of evaluation nurse teachers of their nursing competence, teaching skills, evaluation skills, personality factors and relationships with students. The data were collected by a questionnaire (A Tool for Evaluation of Requirements of Nurse Teacher, ERNT). The questionnaire regarded background factors and 20 statements divided in five categories. The five competence categories were: Nursing competence, Teaching skills, Evaluation skills, Personality factors and Relationships with students. The evaluation scale was a 5-point Likert-scale. The respondents were nurse teachers, teacher for emergency nursing, public health nurse and midwifery teachers from all polytechnics in Finland. Response rate to the questionnaire was 46 % (n=342). The data were analysed by using descriptive statistics. Mean scores and standard deviations for each item were calculated. Category scores were obtained by summing scores of all items within a category. The results of this study showed that nurse teacher evaluated their competence on a high level. Concerning the category Relationships with students (mean 4.61, standard deviation 0.71) they got the highest averages. The lowest scores were gained regarding the requirements associated with teaching skills (mean 4.30, standard deviation 0.82). Concerning a single question, the best score was achieved in ability to take students seriously (mean 4.66, standard deviation 0.71) and the lowest score was achieved for their guidance of students to advance in decision making (mean 4.15, Std 0.69). The nurse teachers evaluated themselves with relatively high scores concerning competence categories as a hole. In future it is important to study nurse teacher competence with students or authorities of health service.