High Rates Of Stress Research Articles

Análisis sobre la presencia de depresión, estrés o ansiedad y su relación con el desempeño académico en estudiantes de licenciatura

To implement corrective and supportive measures, this educational research is carried out to identify the presence of risky levels of depression, anxiety and / or stress and to evaluate its possible influence on the high rates of failure and drop out of the students of Systems Engineering Computational and Biochemical Engineering. One of the objectives of National Technological Institute of Mexico (TecNM) is to apply teaching strategies that allow a high degree of learning, less dropout and a higher degree of graduation from competent professionals. Applying a systematic stratified random sampling, 262 students were chosen who participated by answering previously assessed surveys (Cronbach's alpha between 0.78 and 0.914). Both programs usually show high rates of failure and low terminal efficiency. Preliminary results show high stress rates and average anxiety in the first grades, this is previously unknown for most of the students; Anxiety and depression presented slight differences between freshman students and the ones of last semesters, without considering that these factors could be determining in their academic performance, the students agree that these problems affect their academic performance, in terms of failure and turn out to be a factor to cause dropout. Objective: to correlate the results obtained in the applied surveys referred to know the degree of depression, anxiety and / or stress among the students of 2 different degrees with their level of academic performance. Methodology.- A stratified random sampling was applied to students of Biochemical Engineering and Computer Systems Engineering. 4 surveys were applied to determine anxiety, stress, depression and influence on their academic performance, the data were analyzed using predetermined scales and the Chi square test to find out the correlation between the mentioned variables. Contribution.- Levels of anxiety, stress and depression were detected in Engineering students and their correlation regarding the affectation in their academic performance, factors to be taken into consideration to avoid failure and desertion.

High-stress creep preceding coseismic rupturing in amphibolite-facies ultramylonites

Coeval pseudotachylytes (solidified melts produced during seismic slip) and mylonites are generally regarded as the geological record of transient seismic events during dominant ductile flow. Thermal runaway has been proposed as a model to explain the pseudotachylyte-mylonite association. In the Mont Mary unit (Western Alps), pseudotachylyte fault veins occur along the amphibolite-facies (ca. 550°C; 0.35 GPa) ultramylonitic foliation of paragneisses. These veins formed at the same metamorphic conditions of the ultramylonites, thus potentially recording thermal runaway. We analysed the microstructure of quartz in ultramylonite and of ultramylonite clasts in pseudotachylyte to investigate the possible occurrence of thermal runaway. Quartz aggregates show an evolution under constant temperature to ultrafine-grained recrystallised grain size (2.5 μm), reflecting creep under high differential stresses (> 200 MPa) and high strain rates (10−9 s−1), along very narrow foliation-parallel layers. In the ultrafine aggregates, viscous grain boundary sliding became dominant and promoted cavitation leading to disintegration of quartz aggregates and precipitation, in the pore space, of biotite, oriented parallel to the main ultramylonitic foliation. The strain rate-limiting process was aseismic fluid-assisted precipitation of biotite. The potential occurrence, at the deformation conditions of the Mont Mary ultramylonites, of thermal runaway in pure quartz layers was investigated by numerical modelling. The models predict a switch from stable flow to thermal runaway at background strain rates faster than 10−9 s−1 for critical differential stresses that are comparable to the brittle strength of rocks. Deformation of ultramylonites occurred close to the conditions for thermal runaway to occur, but based on the microstructural record we conclude that the Mont Mary pseudotachylyte-mylonite association is best explained by brittle failure, triggered by transients of high differential stress and strain rate causing a downward deflection of the brittle-ductile transition.

Enhanced Shear Thickening of Silica Colloidal Suspension Using Polystyrene-Polyacrylamide Particles

Shear thickening (ST) refers to a non-Newtonian behavior of concentrated colloidal suspensions, which exhibits significant viscosity increments at high shear stress or high shear rate. A shear thickening fluid (STF) consists of well-dispersed solid particles in a liquid medium. Silica particles are often used as components of STFs due to the abundance of hydroxyl groups on their surfaces. Polystyrene core-polyacrylamide shell particles (PS-PAAm particles) were prepared to enhance the ST of silica particle-based colloidal suspensions. Addition of PS-PAAm particles to various particle weight fractions of silica particle-based STFs resulted in amplification of ST in all instances. These results suggest that PS-PAAm particles enhance inter-particle interactions due to the abundance of hydrogen-bonding donor groups in polyacrylamide.

Views of Conventional Medicine and Integrative Medicine among Informal Dementia Caregivers and Healthcare Professionals in NW England

The urgent need for innovative approaches to dementia treatment that are acceptable, effective and affordable underlies this research. Growing evidence supports ‘integrative medicine’ as a potential treatment approach aligned with and including conventional medicine. However, success will depend on addressing barriers, recognising needs of diverse communities and involving people in co-creating desired interventions. The three aims of this study were to, 1) describe conventional allopathic medicine and integrative or functional medicine (I/FM) approaches for dementia treatment in NW England; 2) to explore the views of informal dementia caregivers and service users, compared to healthcare professionals on the benefits and barriers to providing and receiving these two approaches. Thirdly, we engaged caregivers and service users in co-creating a vision for dementia treatment based on their needs and expectations. We conducted semi-structured interviews, focus groups and a deliberative workshop. Data were analysed using framework analysis. A total of 49 participants reported benefits and barriers to providing and receiving treatments. Themes related to inequalities of socioeconomics and access, cultural influences, disempowerment, demotivation and physician pressures. For instance, the NHS conventional medicine approach provided free nearby access, highly rated post-diagnostic support and good quality web-based information. Barriers included limited discussion of non-pharmaceutical treatment options, low-morale and high rates of stress and burnout among GPs who felt de-motivated as they could not slow or stop the progression. I/FM benefits included time for in-depth investigations to determine the underlying causes of a patient’s dementia, and practitioners trained in addressing them. Barriers included limited access to I/FM practitioners, need to pay for services, difficulties of making lifestyle changes such as diet, need for strong support from caregivers (or payment for a health coach) and poor compliance. Participants co-created a vision for dementia treatment including the wider environmental, social and cultural context. Neither conventional NHS medicine nor I/FM provided consistently beneficial treatment outcomes for dementia. Findings support the development of a model of dementia treatment that includes the benefits provided by both existing approaches, but further informed by patient, caregiver and practitioner experience and co-design. Such an approach must consider a complexity of cultural and generational needs, ensuring empowerment, making available current evidence, resources and support.

Prevalence and characteristics of prediabetes in workers in industry.

To examine the prevalence of work stress and prediabetes in computer technology company employees; to analyse the relationships among stress, work stress, and prediabetes; and to explore the potential mediating effects sleep on the relationship between work stress and prediabetes. A descriptive, cross-sectional design was used. A convenience sample included employees from a large computer technology company in central Texas. Data collection during March-October 2015 included: retrospective electronic medical record review and online surveys. Electronic medical record review data included: height, weight, waist circumference, blood pressure, high-density lipids, triglycerides, and fasting glucose. Online surveys collected demographic, global stress, diet, exercise, coping, sleep and work stress data from participants. Spearman rho calculations analyzed associations between demographic, socio-cultural factors, health behaviours, work stress, and prediabetes variables. Logistic regression analyses identified probability variables. A structural equation model examined mediating variables. Prediabetes prevalence was lower and prevalence of work stress was higher in the participant sample than in the USA population. Findings suggested that low job imbalance increases the probability for prediabetes. Job imbalance was inversely related to prediabetes. Three variables increased the probability prediabetes: alcohol, job imbalance, and sleep. Sleep potentially modified the relationship between job imbalance and prediabetes. Participants were college-educated males working in white-collar, technical jobs. Participants had high rates of work stress. Job imbalance was inversely related to prediabetes, which challenges previous empirical data. Future research should continue to explore the relationship between work stress and prediabetes in this population. This study explored the relationship between work stress and prediabetes in a white-collar worker population in technical industry. Findings suggested that workers in industry have a unique type of stress. Nurses who learn to recognize the non-traditional risk factors for prediabetes can improve screening for prediabetes by including work stress and poor sleep questions.

Self-reported mental health problems and post-traumatic growth among children in Pakistan care homes

ABSTRACTChildren in care experience multiple risk factors, particularly in low-income countries such as Pakistan. The aim was to establish rates of mental health problems and their relationship with posttraumatic growth, as reported by 132 children aged 9–19 years, living in three care homes in Pakistan. Children reported high rates of posttraumatic stress (70.45%) and common mental health symptoms (43.94%) within the clinical range, but also high levels of posttraumatic growth. These findings highlight the high levels of mental health needs among children in residential care, as well as the importance of understanding factors that promote their posttraumatic growth and resilience.

The Effectiveness of Equine-Facilitated Psychotherapy in Adolescents with Serious Emotional Disturbances

ABSTRACTAdolescents with serious emotional disturbances (SED) are a particularly difficult population to treat owing to high comorbidity rates of anxiety, depression, post-traumatic stress, and behavioral conduct disorders. The current study compared the effectiveness of equine-facilitated psychotherapy (EFP) and traditional group therapy (TGT) on levels of positive and negative affect in adolescents with SED. We hypothesized that participants would have higher overall positive affect after EFP compared with TGT and that negative affect would be significantly lower after EFP compared with TGT. Adolescents with SED participated in EFP and TGT sessions once a week over an 8-week period in addition to normative treatment. The Positive and Negative Affect Scale was administered immediately before and after the sessions. Statistical analyses revealed that EFP was just as effective as TGT in increasing positive affect and decreasing negative affect. More importantly, participants had significantly higher positive affect before and after EFP compared with TGT. Even though positive affect scores improved in both therapies, participants arrived to and left EFP with significantly higher positive affect scores than those attending TGT. Owing to its effect on positive affect, EFP may be a beneficial alternative to traditional therapies for adolescents with SED.

Nephroprotective effect of melatonin and L-Ascorbic acid (Vitamin-C) against ampicillin- induced toxicity in Funambulus pennanti

ABSTRACT Ampicillin is one of the most commonly prescribed antibiotics against intra-renal infections. Prolonged use of ampicillin has been found to be associated with a high rate of free-radical generation and oxidative stress induced nephrotoxicity. In the present study, we report the comparative effects of melatonin and vitamin-C (Vit-C) in ameliorating the biochemical and structural alterations in renal tissues caused by ampicillin sodium. Biochemical parameters such as acid phosphatase (ACP), alkaline phosphatase (ALP), creatinine and urea levels in urine and serum as well as oxidative stress parameters such as superoxide dismutase (SOD) activity, catalase activity, total antioxidant status (TAS%) and lipid peroxidation in the renal cortical tissues were accessed upon treatment of melatonin and Vit-C following ampicillin sodium administration in Funambulus pennanti. Ampicillin treatment increased ACP, ALP, creatinine and urea levels in serum and urine, indicating renal damage. It also induced oxidative stress by increasing lipid peroxidation and decreasing the activity of antioxidative enzymes. However, the exogenous melatonin or Vit-C treatment inhibited ampicillin mediated renal damages. Melatonin or Vit-C pre-treatment significantly decreased ACP, ALP, creatinine, urea, TBARS level and increased SOD, catalase activity and TAS%. Our results suggest that the antibiotic induced nephrotoxicity can be ameliorated by melatonin or Vit-C via reduction of oxidative stress in renal tissues.

Stress and Anxiety Among Healthcare Workers Associated with COVID-19 Pandemic in Russia

Background: The first COVID-19 cases were diagnosed in Russia on 31 January 2020. By the end of March, many hospitals cancelled all scheduled procedures and started receiving patients with COVID-19. Large group of healthcare workers were involved in the treatment of patients with the novel virus. The mental health of medical workers treating patients with COVID-19 is now becoming an issue of increasing concern worldwide. However, the available data on stress and anxiety symptoms among healthcare workers during the COVID-19 are relatively limited and have not been evaluated in Russia yet. This study had two objectives: first, we aimed to evaluate stress and anxiety symptoms among healthcare workers directly involved in the diagnosis and treatment of patients with COVID-19 during the outbreak in Russia. A second objective was to validate the Russian version of new Stress and Anxiety to Viral Epidemics – 9 (SAVE-9) scale. Methods: The study was a cross-sectional hospital-based anonymous on-line survey between May 12th and May 26th, 2020 of 1,090 healthcare workers - 548 physicians [50.2%] and 542 nurses [49.8%] directly involved in the diagnosis and treatment of patients with COVID-19 . All the participants were directly involved in the treatment of such patients. Stress and anxiety symptoms were assessed using the Russian versions of SAVE-9 and GAD-7 scales. Logistic regression, Kaiser-Meyer-Olkin two component factor model, Cronbach's alpha and ROC-analysis were performed to determine the influence of different variables, internal structure and consistency, sensitivity and specificity of SAVE-9 compared with Generalized Anxiety Disorder – 7 (GAD-7). Findings: The median scores on the GAD-7 and SAVE-9 were 5 and 14, respectively. 535 [49.1%] respondents had moderate and 239 [21.9%] had severe anxiety according to selected SAVE-9 total score interpretation by percentiles. 134 participants [12.3%] had severe anxiety, 144 [13.2%] had moderate according to GAD-7. 707 [64.9%] participants often or always have been worried about their family or friends getting infected because of them, 387 [35.5%] – have been more sensitive towards minor physical symptoms. The component model (Kaiser-Meyer-Olkin adequacy criterion = 0.847, Barletts' sphericity criterion, pInterpretation: Healthcare workers in Russia fighting with COVID-19 reported high rates of stress and anxiety similar to other countries and are in need in urgent supportive programs. The Russian version of the SAVE-9 displayed a good ratio of sensitivity to specificity compared with GAD-7 and can be recommended as a screening instrument for detection of stress and anxiety symptoms in healthcare workers during viral outbreak. Funding Statement: The authors received no funding for this work.Declaration of Interests: This research had no specific funding, and all authors declare no competing interests.Ethics Approval Statement: The study and the form of the survey were approved by Local Ethical Committee of Moscow Research Institute of Psychiatry, and written informed consent for participation was waived

Co-morbid mental health issues in a clinical sample of Latinx adults: implications for integrated behavioral health treatment

ABSTRACT Latinx adults in the U.S. encounter barriers to quality behavioral healthcare despite high rates of trauma exposure and co-morbid mental health issues in clinical samples. Engaging Latinx adults in treatment requires understanding the clinical issues facing this population. This study analyzed clinical records from 120 Latinx adults referred for mental health assessment during a primary care visit. Nearly two-thirds met criteria for partial- or full-PTSD, which was significantly associated with higher rates of stress, depression and anxiety. Integrating behavioral health services within primary care settings serving Latinx adults to increase access to trauma-informed care for this population is discussed.

Assessment of the burden of caregiving among parents of children with Autism Spectrum Disorder attending Child Autism Center in Sulaimani city

Background: A growing body of evidence suggests that parent’s caregivers of a child affected with autism spectrum disorder experience high rate of anxiety, stress and poorer overall well-being. Autism spectrum disorder is a lifelong neurodevelopmental disability that includes deficits in social, communication and repetitive behaviors. 
 Objective: To assess the type and severity levels of caregiving burden as perceived by parents of children with autism spectrum disorder.
 Methods: A quantitative descriptive design is used in this study. A non-probability, purposive sample size of (40) parents (24mothers and 16fathers) assuming the role of caregivers of (40) children with autism spectrum disorder attending Sulaimani Autistic Center. A questionnaire was developed including the Montgomery family caregivers burden scale to measure parent’s burden. An intervention method was used to collect data from parent’s participants. The statistical analysis was performed by statistical package of social science spss-22. 
 Results: The children with autism spectrum disorder mostly male, mean age 7.5 years and first child ranking in the family. The mother caregivers mostly housewife and mean age 36.8 years. And father mostly governmental employed and mean age 43.9 years. The parent’s experience high severity level of objective burden (3.37± 1.18) and moderate level of stress burden (2.37± 1.30) and demand burden(2.28± 1.22), no statistically significant difference between total burden scale of caregiving in regard to parents socio-demographic characteristics (P˃0.05
 Conclusion: The parent’s caregivers of children with autism spectrum disorder experiencing high severity level of objective burden of caregiving was mainly related to decrease time for their personal and social life, and moderate level of subjective stress burden was related to anxiety, worry and nervousness.

Experimental study on rate-dependent uniaxial whole-life ratchetting and fatigue behavior of polyamide 6

Rate-dependent whole-life ratchetting and fatigue failure of polyamide 6 were explored by conducting a series of stress-controlled uniaxial fatigue tests at room temperature. Meanwhile, the temperature rises on the surface of specimens were recorded to reflect the self-heating occurred during the fatigue tests. The experimental results demonstrate that ratchetting strain rate is sensitive to the variation of prescribed stress rate, and the whole-life ratchetting of PA6 presents a tri-staged evolution feature at high stress rate but a four-staged one at low stress rate. Two failure modes (i.e., the necking controlled by unstable self-heating and resultant large ratchetting strain; and the fracture controlled by the low-cycle fatigue damage) are experimentally observed in the tests at different stress rates. By considering the relationship between ratchetting evolution and temperature rise, it is found that whether increasing the stress rate retards or promotes the ratchetting is dependent on the magnitude of self-heating produced at each fatigue stage, and whether it will be beneficial or detrimental to the total fatigue life is determined by the competition of resultant strain hardening and self-heating softening.

Premature ejaculation among patients with genital warts: a pilot study

Objective To assess the frequency of premature ejaculation (PE) in patients with genital warts (GWs) and to hypothesize the potential relation between GWs and PE. Materials and Methods: This study was designed as a pilot prospective cross-sectional clinical study. It was done on 56 male patients with GWs and 50 male healthy control subjects. All included patients and controls were assessed by intravaginal ejaculatory latency time (IELT), Premature Ejaculation Diagnostic Tool (PEDT), sexual satisfaction and Beck Anxiety Inventory (BAI). Results: According to PEDT, 37 (66.07%) patients with GWs diagnosed with PE and 19 (33.92%) patients with GWs had no PE. This study showed that the means of BAI and PEDT total scores were statistically significant higher in patients with GWs and PE than patients with GWs and no PE, and healthy control subjects (P value =0.001). There was a positive correlation between PEDT total scores and BAI total scores in patients with GWs and PE (P value = 0.001). Conclusion: This study concluded that PE is a frequent male sexual dysfunction among male patients with GWs. Patients with PE and GWs have high rates of anxiety and psychological stress.

Association Between High Perceived Stress Over Time and Incident Hypertension in Black Adults: Findings From the Jackson Heart Study.

BackgroundChronic psychological stress has been associated with hypertension, but few studies have examined this relationship in blacks. We examined the association between perceived stress levels assessed annually for up to 13 years and incident hypertension in the Jackson Heart Study, a community‐based cohort of blacks.Methods and ResultsAnalyses included 1829 participants without hypertension at baseline (Exam 1, 2000–2004). Incident hypertension was defined as blood pressure≥140/90 mm Hg or antihypertensive medication use at Exam 2 (2005–2008) or Exam 3 (2009–2012). Each follow‐up interval at risk of hypertension was categorized as low, moderate, or high perceived stress based on the number of annual assessments between exams in which participants reported “a lot” or “extreme” stress over the previous year (low, 0 high stress ratings; moderate, 1 high stress rating; high, ≥2 high stress ratings). During follow‐up (median, 7.0 years), hypertension incidence was 48.5%. Hypertension developed in 30.6% of intervals with low perceived stress, 34.6% of intervals with moderate perceived stress, and 38.2% of intervals with high perceived stress. Age‐, sex‐, and time‐adjusted risk ratios (95% CI) associated with moderate and high perceived stress versus low perceived stress were 1.19 (1.04–1.37) and 1.37 (1.20–1.57), respectively (P trend<0.001). The association was present after adjustment for demographic, clinical, and behavioral factors and baseline stress (P trend=0.001).ConclusionsIn a community‐based cohort of blacks, higher perceived stress over time was associated with an increased risk of developing hypertension. Evaluating stress levels over time and intervening when high perceived stress is persistent may reduce hypertension risk.

The Association between CD-4 Level, Stress and Depression Symptoms among People Living with HIV/AIDS.

BACKGROUND:The lives of individuals diagnosed with HIV and the subsequent illness, AIDS, were often chaotic because these individuals deal with the physical, emotional, and interpersonal sequelae of this illness. Depressive symptoms and stress were common and impact on functioning, quality of life, and health status, highlighting the importance of diagnosis and treatment of patients with HIV infection. Psychiatric clinical practice and rating scales have come to play an ever-increasing role both in determining specific symptoms and diagnosing an individual condition. Descriptive reports of psychiatric morbidity among those with HIV infection, that relied primarily on self-report rating scales, described high rates of symptomatic depression and stress.AIM:This study aimed to determine the proportion of depression among people living with HIV/AIDS using the BDI-II and PSS to determine a relationship between symptoms of depression and stress with CD4 counts.METHODS:This study was a numerical correlative analytic study with a cross-sectional study approach that assessed the correlation between stress, depression and CD4 level in people with HIV/AIDS that were receiving ARV therapy in the Voluntary Counselling Test (VCT) Polyclinic of General Hospital Haji Medan by recruiting 46 subjects. CD4 level was examined in the Pramita Medan laboratory.RESULTS:When analysis of BDI-II level and CD4 scores were done, a significant correlation was found (P < 0.05). The strength of the relationship between the BDI score and the CD4 score was 0.548 revealing a positive correlation with moderate correlation strengthCONCLUSION:We have shown a significant relationship between depression, stress and CD4 level among people with HIV/AIDS in Medan, Indonesia. Psychological distress may affect the immunity in infected people, leading to the disease progressivity.

Stress Distribution in Four Restorative Methods in Endodontically Treated Maxillary Premolar: A 3D Finite Element Analysis

Introduction: the Restoration of endodontically treated teeth is critical, and the Awareness of stresses developed by oblique and vertical forces in restorative methods take a great role in treatment plans. Due to the anatomical shape and inherent form of the stress distribution premolars, could be lost by fractures. Some fractures such as vertical fracture which is probable in endodontically treated teeth, makes the teeth a candidate for extraction and other surgical procedures. According to this fact that the dental restorations should be conservative, the aim of this study was to determine stress distribution using four composite restorative methods. Methods: Endodontically treated maxillary second premolars were restored with composite resin using four methods. For restoration, the models representing standard Mesio-occlusal-distal (MOD) restoration, cusps capping with thickness of 1 and 2mm, and the use of woven fiber in occlusal part, were prepared. The effects of the different restorative approaches on stress distribution were analyzed using three-dimensional finite element stress analysis. Results: the highest stress rate was observed in MOD tooth restoration and the amount of stress in natural parts of the tooth in woven fiber was found the lowest. Conclusion: The simulation results show that in all models, oblique forces caused more stress than vertical forces. Moreover, there was a slight difference between different types of restorations regarding the magnitude of stress; however, the results obtained from this study showed that woven fiber could partly reduce stresses.

Experiences of trauma, discrimination, microaggressions, and minority stress among trauma-exposed LGBT veterans: Unexpected findings and unresolved service gaps.

LGBT veterans experience high rates of trauma, discrimination, and minority stress. However, guidelines for case conceptualization and treatment remain limited. The aim of the current study was to examine the experiences of trauma and other high impact experiences among LGBT veterans to inform case conceptualization and treatment. We recruited 47 LGBT veterans with a history of exposure to LGBT-related Criterion A trauma and performed semistructured interviews about their experiences in trauma treatment, barriers to engagement, and treatment needs and preferences. We used thematic analysis of qualitative codes guided by inductive and deductive approaches to characterize the variety of trauma and high impact experiences reported. LGBT veterans disclosed a range of clinically relevant stressors, including Criterion A traumatic events, minority stress, and microaggression experiences, including interpersonal and institutional discrimination perpetrated by fellow service members/veterans, citizens, therapy group members, and health care providers. These data provide a unique account of LGBT veteran's identity-related trauma and concomitant interpersonal and institutional discrimination, microaggression experiences, minority stress, and traumatic stress symptoms. Findings highlight existing service gaps regarding evidence-based treatments for the sequalae of trauma, discrimination, microaggressions, and minority stress. In addition, we noted past and present issues in military and health care settings that may lead to or exacerbate trauma-related distress and discourage treatment seeking among LGBT veterans. We provide suggestions for clinical work with LGBT veterans and encourage ongoing research and development to eliminate remaining service gaps. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Capturing Real-Time Emergency Department Sentiment: A Feasibility Study Using Touch-Button Terminals

Providing care in emergency departments (EDs) affects patients and providers. Providers experience high rates of work-related stress. Little is known about the feasibility of measuring real-time sentiment within busy clinical environments. We test the feasibility of measuring sentiment with touch-button terminals in an academic, urban ED. Terminals offered a choice of 4 sentiment buttons (very positive, positive, negative, and very negative). They were placed central to physician workstations, nursing workstations, and the patient exit. Pearson correlation coefficients (r) were calculated to estimate correlation between sentiment and volume metrics (arrivals, length of stay, waiting patients, and number of boarding patients) over time. A total of 13,849 sentiments were recorded (June 2018 to October 2018); 9,472 came from providers (52.6% nursing) and 4,377 from patients. The majority of provider sentiments were negative (58.7%). Negative provider sentiment was associated with increasing number of patients waiting to be seen (r=0.45) and boarding (r=0.68). Positive provider sentiment was associated with increasing numbers of patients who left without being seen (r=0.48). Increased boarding was associated with more recorded sentiments (r=0.73). Negative patient sentiment was associated with increasing number waiting (r=0.55), boarding (r=0.67), and leaving without being seen (r=0.46). This study demonstrates the feasibility of a novel approach to measuring "on-shift" sentiment in real time and provides a sample comparison to traditional volume metrics.

Prevalence of Post-Traumatic Stress Disorder in Emergency Physicians in the United States.

IntroductionThere is increasing concern about the effects of occupational stressors on the wellness of healthcare providers. Given high patient acuity, circadian rhythm disruption, and other workplace stressors, emergency physicians (EP) would be predicted to have high rates of occupational stress. We conducted this study to assess the prevalence of post-traumatic stress disorder (PTSD) in attending EPs practicing in the United States.MethodsA link to an electronic questionnaire was distributed through the emergency medicine-centric publication Emergency Medicine News. We compared the prevalence of PTSD in EPs to the general population using a chi-square goodness of fit test, and performed logistic regression to assess for significance of risk factors.ResultsWe received survey responses from 526 persons. In this study, EPs had a PTSD point prevalence of 15.8%. Being a victim of a prior trauma or abuse is the primary predictor of PTSD (odds ratio [OR] [95% confidence interval {CI}, 2.16 (1.21 – 3.86)], p = 0.009) and PTSD severity score (OR [95% CI, 1.16 (1.07 – 1.26)], p <0.001).ConclusionEmergency physicians have a substantial burden of PTSD, potentially jeopardizing their own health and career longevity. Future studies should focus on identifying subgroups at higher risk for PTSD and modifiable risk factors. Prevention and treatment strategies should be developed and tested in healthcare providers.

Laser-Shock-Induced Nanoscale Kink-Bands in WSe2 2D Crystals.

The response of materials to high stress and strain rates in nature has been a long-term scientific interest. The formation of kinks is a common deformation feature under high pressure and strain rates among foliated structures, such as rock-forming minerals. Although deformation of foliated rock layers in geology has been investigated for a century, the deformation behavior of their nanoscale counterparts, such as two-dimensional (2D) layered materials, under high stress and strain rates has not been investigated. 2D transition metal dichalcogenides have very strong in-plane rigidity, whereas the interlayer shear modulus is 3 orders of magnitude lower than their in-plane Young's modulus. Here, we study the structure and property changes in multilayer WSe2 2D layers during a 3D nanoshaping process where laser-shock pressure at the GPa level is applied to imprint the 2D multilayers into a designed nanomold, forming a large local bending strain of 5-6%. The microstructure of the 2D multilayers after laser shock is observed to be a nanoscale kink-band, similar to that of strained geological layered crystals, due to the high-pressure-induced bending and shearing. The deformed kink-band structure is investigated experimentally by high-resolution transmission electron microscopy and atomic force microscopy and validated by molecular dynamics simulations. The changes in the resulting electronic band structure are investigated by first-principles calculations. The laser-shock straining technology to induce kink-band structures can enrich the understanding and facilitate the applications of many 2D materials.