Posttraumatic Growth: A Mediated-Moderation Model

The primary goal was to test a mediated-moderation model in which dispositional optimism was the moderator and its role was mediated by problem-focused coping. A secondary goal was to demonstrate that posttraumatic growth could be differentiated from maturation and normal development. Two groups of participants were recruited and completed questionnaires twice with a 60-day interval: One group (Trauma), described a traumatic experience and the second group (Non-trauma), described a significant experience. Contrary to the hypothesis, only problem-focused coping and deliberate rumination predicted posttraumatic growth, and these findings were only observed in concurrent analyses. Furthermore, the results indicated that there was no significant difference between groups on growth scores at either Time 1 or Time 2. The findings suggest that the term “posttraumatic growth” may refer to the context in which growth occurs rather than to some developmental process that uniquely follows trauma.

Coping, rumination and posttraumatic growth in people affected by an earthquake

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Screening for pulmonary tuberculosis in Teresópolis, RJ, Brazil: the search for respiratory symptomatic patients in emergency service of "Hospital das Clínicas de Teresópolis Costantino Ottaviano, Fundação Educacional Serra dos Órgãos"

The aim of the present study was to investigate the detection percentage of tuberculosis among patients that are respiratory symptomatic (TB suspects). In this work, we present the preliminary results of research carried out at "Hospital das Clínicas de Teresópolis Costantino Ottaviano da Fundação Educacional Serra dos Órgãos (FESO)" from November 2003 to April 2004. Among the 40 respiratory symptomatic individuals identified and referred to the Tuberculosis Control Program in Teresópolis, two (5.0%) were characterized as smear-positive. These results confirm reports in the literature and underscore the need for and importance of this strategy.

Protocol for the psychotherapeutic group intervention for facilitating posttraumatic growth in nonmetastatic breast cancer patients

Breast cancer can be perceived as a traumatic event with disturbing effects on psychological domains such as depression, anxiety, and Posttraumatic Stress Disorder. In contrast, growing evidence has shown that posttraumatic growth can occur as a result of coping with breast cancer. Challenging the assumptive world, deliberate rumination, and emotional disclosure are recognized as strong predictors of posttraumatic growth. Group interventions may also increase social support, distress disclosure, and posttraumatic growth. The aim of this study is to evaluate how group-based interventions can facilitate posttraumatic growth and promote improved psychosocial adjustment to breast cancer. This article describes the study protocol and the applied research methods.

EZ-IO(®) intraosseous device implementation in a pre-hospital emergency service: A prospective study and review of the literature.

INTRODUCTION: Intraosseous access is increasingly recognised as an effective alternative vascular access to peripheral venous access. We aimed to prospectively study the patients receiving prehospital intraosseous access with the EZ-IO(®), and to compare our results with those of the available literature. METHODS: Every patient who required an intraosseous access with the EZ-IO from January 1st, 2009 to December 31st, 2011 was included. The main data collected were: age, sex, indication for intraosseous access, localisation of insertion, success rate, drugs and fluids administered, and complications. All published studies concerning the EZ-IO device were systematically searched and reviewed for comparison. RESULTS: Fifty-eight patients representing 60 EZ-IO procedures were included. Mean age was 47 years (range 0.5-91), and the success rate was 90%. The main indications were cardiorespiratory arrest (74%), major trauma (12%), and shock (5%). The anterior tibia was the main route. The main drugs administered were adrenaline (epinephrine), atropine and amiodarone. No complications were reported. We identified 30 heterogeneous studies representing 1603 EZ-IO insertions. The patients' characteristics and success rate were similar to our study. Complications were reported in 13 cases (1.3%). CONCLUSION: The EZ-IO provides an effective way to achieve vascular access in the pre-hospital setting. Our results were similar to the cumulative results of all studies involving the use of the EZ-IO, and that can be used for comparison for further studies.

Leisure as a Facilitator of Posttraumatic Growth in Individuals Living with Cancer

Although there is a growing body of literature that shifts the focus of chronic illness and trauma research to personal growth, there is limited literature on the role that leisure has in this process (e.g., Tedeschi & Calhoun, 2004). This qualitative study explored the role of leisure in the phenomenon of posttraumatic growth (PTG) for individuals living with cancer. The findings revealed that leisure influences PTG in four domains: (a) building meaningful relationships, (b) providing experiences to develop and maintain a sense of self, (c) creating opportunities to experience positive emotions, and (d) finding purpose in life. Findings provide insight on how individuals living with cancer perceive the role that leisure has in facilitating positive change after diagnosis. These findings will better enable healthcare and leisure providers to understand the unique needs of individuals living with cancer, and help them to facilitate meaningful leisure programs to encourage PTG.

Work, personality and psychological distress : direct and moderating effects of the Big Five personality traits

L’objectif de ce mémoire est d’examiner les nombreuses associations qui existent entre les conditions de l’organisation du travail, les traits de personnalité et la détresse psychologique au travail. La question de recherche principale était : est-ce que les cinq grands traits de personnalité (Big Five personality traits) ont un effet modérateur sur la relation entre les conditions de l’organisation du travail et la détresse psychologique. De nombreuses autres questions ont aussi été considérées. Pour répondre aux vingt-et-une hypothèses proposées dans cette recherche, nous avons utilisé des données secondaires d’une étude transversale de 395 employés d’un service de police municipal. À la suite d’analyses multivariées, nous avons pu observer quatre associations significatives. Concernant les conditions de l’organisation du travail, nous avons trouvé que les demandes psychologiques en milieu de travail augment la détresse psychologique, tandis que le support d’un superviseur la diminue. En ce qui concerne, les traits de personnalité, nous avons trouvé qu’être névrotique (neuroticism) augmente la détresse psychologique. Finalement, nous avons trouvé un effet modérateur du trait de personnalité, être consciencieux (conscientiousness), sur la relation entre les demandes psychologiques et la détresse psychologique. Bref, nos résultats nous indiquent que les cinq grands traits de personnalité (Big Five personality traits) ont une influence mitigée sur la santé mentale en milieu de travail.

Luxation injuries in primary teeth: a retrospective study in children assisted at an emergency service

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Effects on permanent teeth after luxation injuries to the primary predecessors: a study in children assisted at an emergency service

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Luxation injuries in primary teeth: a retrospective study in children assisted at an emergency service

ABSTRACT: The purpose of this study was to analyze luxation injuries in children between the ages of 0 and 5 years treated at an emergency service department. A total of 1,703 records, corresponding to a period of 10 years at the Emergency Center of the Baby Clinic at Londrina State University, Brazil, were analyzed. The age, gender, etiologic factors, type of injury, injured teeth, treatment and time interval between injury and treatment were determined for each patient. Of the examined records, 409 patients met the study criteria and included a total of 679 injured teeth. Statistical analyses were carried out using the chi-square test with the level of significance set at 5%. Trauma incidence was higher in boys (57.0%) and in children less than two years of age (40.3%). Falling while walking or running was the most predominant etiologic factor (37.7%), and the most prevalent type of injury was subluxation (32.6%). Luxation injuries decreased with increasing age (p = 0.045). Treatment usually occurred within the first 1-15 days and was significantly associated with the type of trauma (p = 0.041). "Monitor only" was the treatment most frequently observed (74.0%). In conclusion, more luxation injuries were found in younger children, predominantly in boys. Falls resulting from walking or running were the etiologic factor most observed, with subluxation as the most common type of trauma. Treatment usually occurred within the first 15 days after the injury. Despite the severity of these injuries, "monitor only" was the eligible treatment.

Psychometric Properties of the Portuguese Version of the Posttraumatic Growth Inventory Short Form Among Divorced Adults

The aim of this study was to develop and validate a Portuguese version of the Short Form of the Posttraumatic Growth Inventory (PTGI-SF). Using an online convenience sample of Portuguese divorced adults (N = 482), we confirmed the oblique five-factor structure of the PTGI-SF by confirmatory factor analysis. The results demonstrated the measurement invariance across divorce initiator status groups. Total score and factors of PTGI-SF showed good internal consistency, with the exception of the New Possibilities factor, which revealed an acceptable reliability. The Portuguese PTGI-SF showed a satisfactory convergent validity. In terms of discriminant validity, posttraumatic growth assessed by the Portuguese PTGI-SF was a distinct factor from posttraumatic psychological adjustment. These preliminary findings suggest the cultural adaptation and also psychometric properties of the present Portuguese PTGI-SF to measure posttraumatic growth after personal crisis.

Psychometric properties of the Portuguese version of the Posttraumatic Growth Inventory Short Form among divorced adults

The aim of this study was to develop and validate a Portuguese version of the Short Form of the Posttraumatic Growth Inventory (PTGI-SF). Using an online convenience sample of Portuguese divorced adults (N = 482), we confirmed the oblique five-factor structure of the PTGI-SF by confirmatory factor analysis. The results demonstrated the measurement invariance across divorce initiator status groups. Total score and factors of PTGI-SF showed good internal consistency, with the exception of the New Possibilities factor, which revealed an acceptable reliability. The Portuguese PTGI-SF showed a satisfactory convergent validity. In terms of discriminant validity, posttraumatic growth assessed by the Portuguese PTGI-SF was a distinct factor from posttraumatic psychological adjustment. These preliminary findings suggest the cultural adaptation and also psychometric properties of the present Portuguese PTGI-SF to measure posttraumatic growth after personal crisis.

Knowledge and attitude regarding standard precautions in a Brazilian public emergency service: a cross-sectional study

The purpose of this study was to assess the knowledge and attitude of health care professionals regarding their use of universal precaution measures at a public emergency service. The study also aimed to assess the rates of occupational accidents involving biological substances among those workers. This study was performed with 238 workers, from June to November 2006, using univariate and multivariate analysis. The chance of not adopting precaution measures was 20.7 (95% CI: 5.68 - 75.14) times greater among drivers compared to physicians. No significant association was found between adopting universal precaution measures. The occupational accident rate was 20.6% (40.8% involving sharp-edged objects). The risk of physicians having an occupational accident was 2.7(95% CI: 1.05 - 7.09) times higher than that of drivers. The fact that a staff member had adequate knowledge about universal precaution measures was insufficient to foster compatible attitudes towards reducing the risk of transmitting infectious agents and causing occupational accidents.

Analysis of patient physical restraints usage in a Swiss emergency service

Introduction: Emergency services (ES) are often faced with agitated,confused or aggressive patients. Such situations may require physicalrestraint. The prevalence of these measures is poorly documented,concerning 1 to 10% of patients admitted in the ES. The indications forrestraint, the context and the related complications are poorly studied.The emergency service and the security service of our hospital havedocumented physical restraint for several years, using specific protocolsintegrated into the medical records. The study evaluated the magnitudeof the problem, the patient characteristics, and degree of adherence tothe restraint protocol.Methods: Retrospective study of physical restraint used on adultpatients in the ES in 2009. The study included analysis of medical anddemographic characteristics, indications justifying restraint and qualityof restraint documentation. Patients were identified from computerizedES and security service records. The data were supplemented byexamination of patients' medical records.Results: In 2009, according to the security service, 390 patients (1%)were physically restrained in the ES. The ES computerized systemidentified only 196 patients. Most patients were male (62%). The medianage was 40 years (15-98 years; P90 = 80 years). 63 % of the situationsoccurred between 18h00 and 6h00, and most frequently on Saturday(19%). Substance or alcohol abuse was present in 48.7% of cases andacute psychiatric crisis was mentioned in 16.7%. In most cases,restraint was motivated by extreme agitation or auto / hetero-aggressiveviolence. Most patients (68 %) were restrained with upper limb andabdominal restraints. More than three anatomic restraints werenecessary in 52 % of the patients. Intervention of security guards wasrequired in 77% of the cases. 61 restraint protocols (31 %) were missingand 57% of the records were incomplete. In many cases, the protocolsdid not include the signature of the physician (22%) or of the nurse(43.8%). Medical records analysis did not allow reliable estimation ofthe number of restraint-induced complications.Conclusions: Physical restraint is most often motivated by majoragitation and/or secondary to substance abuse. Caregivers regularlycall security guards for help. Restraint documentation is often missing orincomplete, requiring major improvement in education and prescription.

Analysis of patient physical restraints usage in a Swiss emergency service

Introduction: Emergency services (ES) are often faced with agitated,confused or aggressive patients. Such situations may require physicalrestraint. The prevalence of these measures is poorly documented,concerning 1 to 10% of patients admitted in the ES. The indications forrestraint, the context and the related complications are poorly studied.The emergency service and the security service of our hospital havedocumented physical restraint for several years, using specific protocolsintegrated into the medical records. The study evaluated the magnitudeof the problem, the patient characteristics, and degree of adherence tothe restraint protocol.Methods: Retrospective study of physical restraint used on adultpatients in the ES in 2009. The study included analysis of medical anddemographic characteristics, indications justifying restraint and qualityof restraint documentation. Patients were identified from computerizedES and security service records. The data were supplemented byexamination of patients' medical records.Results: In 2009, according to the security service, 390 patients (1%)were physically restrained in the ES. The ES computerized systemidentified only 196 patients. Most patients were male (62%). The medianage was 40 years (15-98 years; P90 = 80 years). 63 % of the situationsoccurred between 18h00 and 6h00, and most frequently on Saturday(19%). Substance or alcohol abuse was present in 48.7% of cases andacute psychiatric crisis was mentioned in 16.7%. In most cases,restraint was motivated by extreme agitation or auto / hetero-aggressiveviolence. Most patients (68 %) were restrained with upper limb andabdominal restraints. More than three anatomic restraints werenecessary in 52 % of the patients. Intervention of security guards wasrequired in 77% of the cases. 61 restraint protocols (31 %) were missingand 57% of the records were incomplete. In many cases, the protocolsdid not include the signature of the physician (22%) or of the nurse(43.8%). Medical records analysis did not allow reliable estimation ofthe number of restraint-induced complications.Conclusions: Physical restraint is most often motivated by majoragitation and/or secondary to substance abuse. Caregivers regularlycall security guards for help. Restraint documentation is often missing orincomplete, requiring major improvement in education and prescription.