Sense Of Helplessness Research Articles

Pediatric Obesity Update

Welcome to the Pediatric Obesity column! This column’s mission is to provide information and resources to the pediatric surgical nurse caring for children affected by obesity; this information includes strategies that can be incorporated into the practitioner’s daily practice. LITERATURE REVIEW: “BLAME, SHAME, AND LACK OF SUPPORT: A MULTILEVEL STUDY ON OBESITY MANAGEMENT” Nursing has a rich history of using a holistic approach in caring for patients. This holistic view is reflected in this article by Kirk et al. (2014). The authors use semistructured qualitative interviews to examine the lived experiences of patients affected by obesity; elicit perceptions of healthcare providers caring for individuals with obesity; and study the role of social, institutional, and political entities involved in the management of obesity. Specifically, the researchers looked for common themes in study participant responses to these questions: What perceptions do patients with obesity have regarding their weight when they interact with healthcare professionals and the healthcare system? How do health professionals working in a weight management setting perceive interactions between their patients who are obese and the healthcare system? What do policy makers perceive as barriers to weight management care in the current health care system? After analysis of their data, the researchers identified three major themes in the participant responses. The first theme, blame, permeated the conversation across all participant groups. Individuals living with obesity expressed feelings of guilt, shame, and embarrassment of an inability to control their weight successfully. Despite having knowledge of the complexity of weight loss, these individuals placed the final responsibility of weight loss “failure” on themselves, with resulting frustration and low self-esteem. Many reported that their healthcare practitioner did not address weight issues with them. Others stated that, while they received information repeatedly about how to lose weight, they felt they received little support through the process of implementing weight loss instructions. Life was described as a daily, constant battle requiring enormous mental and emotional energy. Healthcare professionals also expressed feelings of blame for not having the time, expertise, and services to care for their patients with obesity. Many felt they let their patients down; most felt inadequately prepared to help their patients effectively. The second identified theme relates to tensions in obesity management and prevention. Healthcare professionals described a sense of helplessness in not possessing a consistent, effective treatment to provide their patients who are overweight. Therefore, many avoided the conversation to escape the potential tension of failed expectations. In addition, patients with obesity felt unsupported by their providers. Both providers and policy makers expressed frustration and confusion because of experts in obesity arguing about prevention versus treatment methodologies to address the obesity epidemic. The third theme centers on discussion of whether obesity is a disease or a risk factor. Time spent on this conversation diverts energy that perhaps is better utilized by developing improved obesity care and programs. How obesity is classified has broad funding and policy implications. Bias and discrimination against individuals with obesity play a large role in this debate. This article is full of rich data that express voices of participants in the patient, provider, and policy maker triad. The researchers’ findings are applicable at the clinical level to improve understanding of struggles faced by both patient and provider. Additionally, this research addresses the concerns of policy makers who seek to make decisions based on data and compassion. Data from this study has the opportunity to guide conversations between individuals affected by obesity, clinicians, and policy makers in their quest to improve obesity care.

Signs of Silence and Resistance in Strawman

Abstract Taiwanese director Wang Tong’s film Strawman (1987) aims at comparing the maimed national identity and sense of helplessness of colonized Taiwanese people to the situation of a “strawman” in the late period of the Pacific War. I explore the relationship between the filmic representation of trivial events involving Taiwanese farmers and the irrepressible power of life and humanity that emerges despite Japanese empirical exploitation and domination. The events become a series of detours of sign processes that represent not just the tangos of life and death but also the tangles of the colonizer and the colonized in the real world, while the film’s Kristevean ideologemes operating through sign functions correlate the cinematographic world and the possible contextualized real world

Psychosocial impact of cancer cachexia.

BackgroundCancer cachexia has impact on patients and their family members. Patients experience loss of weight often accompanied by anorexia and other debilitating symptoms that have clinical impact and impact everyday life. The importance of understanding this impact lies in (1) the alleviation of cachexia-related suffering and (2) its implications for treating cachexia.ReviewTwo decades of exploratory investigation of the manifestations, meaning and management of cancer cachexia reveal emotional and social impacts for both patients and their carers. Patients can describe change in appearance and loss of physical strength often accompanied by change in eating habits (amount, type and pattern of food intake). The psychosocial effects can include loss of independence, sense of failure, sense of helplessness, conflict with family members over food, social isolation and thoughts of death. They are effects that can distress. Conversely, weight loss, especially early in its course and for those who are obese, can be perceived as beneficial, which inhibits self-management of diet and physical activity.ConclusionModels of the psychosocial effects of cancer cachexia have been developed, leading to, as yet unproven, propositions of how negative patient and family impacts can be addressed. This literature overlooks the potential importance of psychosocial intervention to emerging multimodal treatments for the multicausal syndrome. Psychosocial intervention in cachexia should be tested for potential to help people affected by cancer cachexia feel better but also for potential to make people better by aiding uptake and compliance with multimodal therapy.

Struggling with the Fourth Disaster in East Japan

Co authors of the article: Tomoaki Adachi, Masahiro Nishikawa, Yuki Nakamura, Kayoko, Hige, Kazunori Hashimoto, Kazuki Nishiura, Maya Hashimoto, Toshinori Hanani, Yoshiya Ishikawa, Haruna Sasaki, Kai Ogimoto The triple disasters of earthquake, tsunami and nuclear plant accidents that occurred in East Japan in March 2011 brought victims many complicated and unseen problems to resolve. Victims were very supportive of one another and appeared to calm down astonishingly quickly within a few months after these events. As a result of such an apparently smooth and rapid return to relative tranquillity, governmental concern did not turn to the problem of mental health impairment. No systematic action for prevention and treatment of Post-traumatic Stress Disorder has been undertaken. On the other hand, event-related deaths, illnesses, traffic accidents, and various destructive problems seem to be occurring with increasing frequency in communities located in the stricken area. Victims do not take advantage of what mental health support is available, preferring to maintain their silence regarding their disaster experiences even when mental health care teams visit them directly. Mental health services for victims of the triple disasters have now become quite hopeless and helpless since traditional psychiatric treatment approaches have not worked well. A practical study aimed at opening a gateway to clinical treatment for victims of the triple disaster is introduced in this paper. This sense of helplessness is conceptualized and analysed as a fourth disaster involving hidden social and cultural dynamics. New pre-therapy and support group therapy systems combined with community building approaches to encourage victims to seek necessary treatment are reported.

The 12 Steps of Alcoholics Anonymous as an Adjunctive Treatment for Trauma Survivors: An Experimental Approach

Background and Method: The consequences of surviving trauma are complex, making it difficult to formulate a recovery and treatment plan. The most common defense mechanism, and the toughest one to work through, is denial. Throughout human history, lack of knowledge and non-acceptance of the perpetrators misdeeds has placed the suffering of survivors behind an armored wall, perpetuating traumatic effects. No recovery can occur behind this wall of forced silence, ignorance and lack of helpful resources. Over the last two decades, research has revealed the frequency of traumatic events, and their injurious effects on a survivor?s psyche. Mental health professionals have come to understand the connections between unresolved trauma and serious psychological problems. The role of spirituality in trauma recovery is often misunderstood and subsequently minimized. Trauma survivors usually have a difficult time experiencing their vulnerability and the attending feelings of having once been profoundly helpless and alone. The process of unearthing one?s memories and re-experiencing anguish requires the help of skilled, knowledgeable and spiritually grounded professionals who have done healing work on themselves. Interest and research on the healing effects of applying spiritual tools to the multi-layered consequences of trauma survival - including emotional pain, and interpersonal difficulties - has burgeoned. This is a case report discussing the efficacy of the 12 Steps of Alcoholics Anonymous to address and heal the root causes and conditions of dysfunctional behaviors, lack of meaning in life, and persistent psychic pain. Results: The primary outcome measure was the client?s self-report on improved affect regulation, reduced depression, decrease in maladaptive behaviors, decreased sense of helplessness and hopelessness, increased sense of personal accountability, meaning and purpose in life, and greater ability to modulate arousal; both physical and emotional.

Cuidados paliativos na assistência hospitalar: a vivência de uma equipe multiprofissional

Trata-se de um estudo qualitativo, exploratório e descritivo, que objetivou conhecer a vivência de uma equipe multiprofissional no cuidado paliativo no contexto hospitalar. Participaram do estudo seis membros de uma equipe multiprofissional de saúde, que atende pacientes em cuidados paliativos, de um Hospital Escola no Sul do Brasil. Identificou-se que os profissionais, ao iniciarem sua trajetória de cuidado na terminalidade, referiram frustração e impotência. Contudo, a experiência fez com que encontrassem novos significados para o cuidado prestado, passando a entender a morte como evento natural da vida e a importância de garantir qualidade de vida e conforto ao paciente. Os participantes relataram a necessidade do fortalecimento da comunicação, do trabalho em equipe e de um espaço para discutirem a terminalidade. Assim, a atenção hospitalar deve atender as necessidades do paciente em cuidados paliativos e família, articulando e promovendo ações que garantam o alívio dos sofrimentos e uma sobrevida digna.

The coming and going: the work of educational developers when admission criteria and desired outcomes change simultaneously

Higher education is facing a conundrum relevant to the field of educational development: expectations regarding entrance criteria and graduation attributes are changing simultaneously. Biggs' model of constructive alignment can be used to analyze the challenges presented by these shifts in expectation and help educational developers understand their pedagogical implications. In the present article, an expanded model is proposed in which entrance requirements are added to Biggs' original conceptualization. In so doing, the length of the “learning journey” – from entrance to outcomes – can be charted. When entrance requirements and graduate attributes change simultaneously, higher education must accommodate learning journeys of varying lengths and nature. Moving targets such as these can engender a sense of frustration, if not helplessness, for academic staff responsible for curricular and pedagogical enhancement. However, rather than responding with a sense of helplessness, the educational developer should see these shifts as a real opportunity to support the implementation of a broader range of student-centred teaching/learning activities. Recommendations related to educational development consultations are offered.

Systematik somatoformer Störungen des Kindes- und Jugendalters

Somatoform disorders in children and adolescents are common and can cause significantly reduced wellbeing and quality of life. Considerable subjective impairment leads to a high number of doctors' visits, which along with a reoccurrence of negative findings, often results in a sense of helplessness in the patient and a lack of trust towards the physician. The criteria for somatoform disorders are illustrated based on the classification scheme ICD-10 and in consideration of the DSM-V. Referring to Noeker (2008) the special role of the parents for the development of somatoform disorders is explained. The typical clinical profile of somatoform disorders in children and adolescents is described. As a diagnostic instrument the newly developed Screening for Somatoform Disorders in Children and Adolescents (SOMS-CA) (Winter, Pfeiffer, Köberle, Lenz, Lehmkuhl, 2008) is introduced. Furthermore it is demonstrated that patients with somatoform disorders are seen predominantly within consulting and liaison services of the paediatric clinic. The importance of interdisciplinary cooperation between paediatrics and child and adolescent psychiatry and -psychotherapy in early diagnosis and introduction of appropriate treatment is highlighted.

The Art of Not Being a Difficult Parent

DOI: 10.1200/JCO.2013.52.5246 When my 4-month-old son, Aidan, was diagnosed with a rhabdomyosarcoma at the base of his bladder, I immediately changed sides of the bed, from being the physician to being the parent of the patient. Because I had recently completed 4 years of junior physician training here in Australia, 2 years of which were spent in a hospice as a palliative care resident, I was uniquely positioned among the other parents of children with cancer, with an in-depth knowledge of how hospitals work. I remember one of my thoughts over the first few days after Aidan’s diagnosis was that I did not want to be a difficult parent, much the same as a difficult patient. We all know them—the ones who persistently interfere, question everything, are impatient, are demanding—the ones where you take a deep breath before you enter their room on your ward rounds. I wanted to be cooperative, to show that I understood the tensions and difficulties encountered in a hospital by physicians, nurses, therapists, and other ward staff. But quickly I realized that even more important were my roles of advocate, caregiver, and mum for my son, who was just a baby and not only could not comprehend anything that was happening to him, but also could not have any say in decisions that were being made about his life and well-being. I found that these essential roles were at times absolutely incompatible with not being a difficult parent. Aidan went through 9.5 months of treatment involving more than 7 months as an inpatient, including multiple cycles and lines of chemotherapy. He tolerated the initial treatment well. Unfortunately, the cancer tolerated it very well also, and we had to move on to second-line chemotherapy within 3 months. With the second-line treatment, he lost his hair, his platelets, his white cells, and his red cells, and he suffered multiple complications. But the chemotherapy was working, and so we persevered and experienced somewhat of a honeymoon period where the tumor shrank to half its size, and he seemed to be getting better. Unfortunately, that did not last; the tumor started growing again, and he passed away at 14 months of age. Over the 9.5 months of treatment that we experienced, I learned several things. First, Aidan needed me most of all to be a mother, not a physician. During the misery that he went through, he needed someone to hold him and to love him. He needed someone to pick him up at the end of every 30to 40-minute sleep cycle overnight while he was receiving treatment, someone to comfort him and try and get him back to sleep, someone to ring the nurses’ bell to ask for more antiemetics and more pain relief. Second, Aidan needed an advocate. Although we hadwonderfulconsultantswhomwetrustedwithAidan’s care and treatment, I knew all too well that in hospitals, mistakes happen, that things are inadvertently overlooked or forgotten. My husband and I knew Aidan and his medical history and treatment planbetterthananyoneelse,andIwantedtomakesure that anything that was under my control stayed under control. I monitored medication times and doses and notified the nursing staff if any were missed. I questioned the potassium infusion that was being set up when the consultant had specifically said that morning that Aidan did not require one. If someone wanted to take blood peripherally from his tiny, difficult veins, I reminded him or her that he had a central line. And through all this, I discovered that being a difficultparentwasgoingtobeinevitableattimes.After about 7 months of treatment, we had a meeting with the nursing unit manager of the ward where Aidan spent most of his time in hospital. My husband and I had three pages of items to discuss in this meeting. As I lookbackontheseitemsnow,mostwerefairlyminorif you took them in isolation from one another. But cumulatively, they made our prolonged hospital stays muchharderthantheyneededtobe.Duringthismeeting, I discovered that some of the nurses were scared of being assigned to Aidan and having to come into our room.Iwas initiallydiscouragedto learnthis,becauseI had genuinely attempted to be nice, courteous, and friendly to everyone. On further reflection, however, I started recalling the frustrations that had been experienced and the sense of helplessness over our inability to convey our personal needs as well as our son’s medical needs. The hardest thing that we went through during our whole experience was the utter fatigue and exhaustion. Hospitals are not set up to promote rest and sleep for patients or for parents of patients. In a short-term setting, this is not a major problem and can be survived until you are discharged. However, JOURNAL OF CLINICAL ONCOLOGY A R T O F O N C O L O G Y VOLUME 31 NUMBER 32 NOVEMBER 1

The Effect of Age on Illness Cognition, Subjective Well-being and Psychological Distress among Gastric Cancer Patients

The current study examined illness cognition-thoughts and perceptions-patients hold regarding their illness and psychological adaptation in various age groups. More specifically, we aimed to examine whether illness cognition among cancer patients is related to their age. In addition, such association of illness cognition and age was also examined with respect to subjective well-being and psychological distress. A cross-sectional sample comprised of 123 consecutive post-treatment gastric outpatients. Their mean age was 57.31 (SD = 12.74), 56.9% (n = 70) were men and 81.3% (n = 100) were married. The results indicated a higher level of acceptance and a lower level of psychological distress among the young-old participants (60-69) compared with their counterparts. The oldest group (70+ years) had the highest level of helplessness and psychological distress, and the lowest level of acceptance, satisfaction and affect balance compared with the young-old participants. Among gastric cancer patients, age was found to be a factor relevant to the understanding of illness cognitions (acceptance and sense of helplessness) along with subjective well-being and psychological distress. These findings have practical implications for working with older cancer patients. Implications of these results are discussed.

Making of Victim a Patient: Sexually Abused Children and the Consequences of Unprofessional Help

The disclosure of sexual abuse by a child not only disturbs the mental peace of the family members but influences their attitudes towards the victim as well. This article explores how the diverse types of attitudes of the family members towards the victim and un-fulfillment of role expectation of a victim from his/her family members make him/her a patient. An attempt has also been made to analyse how the reluctance of parents to take any professional help impedes the recovery of the child along with the strategy a child adopts to cope with this traumatic event of his/her life. The child wants love and support from his/her close relatives, besides expecting protection from them. In such circumstances even a little negligence from any of the family members or their unsupportive and unpractical attitudes towards the victim, makes him/her a silent sufferer. A sense of helplessness develops in her/him and later on this sense of helplessness makes him/her a patient of depression.

The Study of Effect of the Main Factors on Problem Solving Self-Confidence Using Cooperative Learning

Low self-confidence in problem solving is one of the main issues in terms of mathematics education among high school students and this issue led to decreasing learning mathematics. Mathematics educators always faced to learners that not being proactive for solving the problems and avoid it hence the main aim of this paper is exploring the main influence factors on self-confidence problem solving. Twenty questions of questionnaire were designed based on different literature and principle component and confirmatory factor analysis were used for analysis data. The results of the study indicated the main influenced factors are; ability, motivation, perseverance, sense of helplessness and inhibitor. Finally recommendations and some policies presented to increasing the self-confidence in educational system.

Infrequent near death experiences in severe brain injury survivors - A quantitative and qualitative study

Background:Near death experiences (NDE) are receiving increasing attention by the scientific community because not only do they provide a glimpse of the complexity of the mind-brain interactions in ‘near-death’ circumstances but also because they have significant and long lasting effects on various psychological aspects of the survivors. The over-all incidence-reports of NDEs in literature have varied widely from a modest Figure of 10% to around 35%, even up to an incredible Figure of 72% in persons who have faced close brush with death. Somewhat similar to this range of difference in incidences are the differences prevalent in the opinions that theorists and researchers harbor around the world for explaining this phenomena. None the less, objective evidences have supported physiological theories the most. A wide range of physiological processes have been targeted for explaining NDEs. These include cerebral anoxia, chemical alterations like hypercapnia, presence of endorphins, ketamine, and serotonin, or abnormal activity of the temporal lobe or the limbic system. In spite of the fact that the physiological theories of NDEs have revolved around the derangements in brain, no study till date has taken up the task of evaluating the experiences of near-death in patients where specific injury has been to brain. Most of them have evaluated NDEs in cardiac-arrest patients. Post-traumatic coma is one such state regarding which the literature seriously lacks any information related to NDEs. Patients recollecting any memory of their post-traumatic coma are valuable assets for NDE researchers and needs special attention.Materials and Methods:Our present study was aimed at collecting this valuable information from survivors of severe head injury after a prolonged coma. The study was conducted in the head injury department of Guangdong 999 Brain hospital, Guangzhou, China. Patients included in the study were the ones Recovered from the posttraumatic coma following a severe head injury. A total of 86 patients were chosen. Near death experience scale (NDES) score of 7 or more was used as the criteria of screening NDE experiences. After identifying such individuals, the Prakash-modification of the Interpretative Phenomenological Analysis (IPA) was used to interview and record the data for qualitative analysis.Results:We found that contrary to earlier incidence reports, NDEs in post head injury patients were markedly low. Only 3 out of 86 of the patients recruited had a clear and confident experience of NDE. We conducted a qualitative study to explore further into these experiences. IPA of these 3 patients revealed four master themes: 1. Unique light visions 2. Intense feelings of astonishment, pleasure, and fear 3. The sense of helplessness 4. Supernatural but rationality of experience.Conclusion:NDE is uncommon in head-injury cases as compared to other near-death conditions. But the persons experiencing it have immense impacts on their belief systems and emotions. This experience should be further explored by studies of larger samples.

Industrial Disputes, Causes and Settlement: An Indian Perspective

An industrial dispute is a manifestation of a disagreement and a difference of opinion between the two disputants, namely the employer and the workmen. The potential for conflicts exist in all human situations and organizations. A passive and subdued workforce is not conducive for good relationships. The relationships in the industrial relations system start with cooperation, soon change between the two into conflicts, and after they are resolved, change again into one of cooperation. This changing process is a continuous feature of the industrial relations system. Industrial disputes arise due to various causes, which may be classified into economic, organizational, physical, technical, political, psychological and market-oriented conditions. The workers are especially interested in higher wages, congenial working conditions, and opportunities for career advancement, welfare facilities, job satisfaction and the like. When these are denied to them, the workers are forced to assert their rights, which then lead to industrial disputes. In the present economic scenario, there is a situation of rising input costs and declining output prices. Productivity improvement becomes imperative even to maintain the existing levels of profitability. The resultant squeeze in employment, wages, dearness allowance, bonus and benefits create a sense of helplessness and result in disputes in the industrial setup. The present research paper analyses the causes and settlement of disputes from the perspectives of both - the workers and the management and suggests measures for maintaining good relations between the management and the workmen. The Findings of the study show that bonus, wages and allowances are the major causes responsible for industrial disputes from the perspective of both the workers and the management. Inter-union rivalry is the prime factor which influences disputes, and arbitration is the best way for the settlement of disputes.

Why Adolescents Don't Disclose Incidents of Bullying and Harassment

While bullying among students is a recalcitrant problem in U.S. schools, research indicates that many students do not disclose bullying they experience or witness despite repeated efforts on the part of adults. The preponderance of research tends to neither include the perceptions of students nor provide understanding about their reluctance to tell or rely on adults for intervention. This qualitative study explored the perspectives of adolescents on their reasons for not reporting incidents or seeking help with bullying. Grounded theory was utilized for data analysis and for detection of patterns in the data. Results revealed several themes: (a) the ubiquitous nature of bullying, (b) a sense of helplessness, (c) concerns over inappropriate adult action, (d) self-reliance, (e) shame, (f) parental omniscience, and (g) a different definition of bullying than adults use. Conclusions reflect the need to understand bullying from the multiple perspectives of adolescents to minimize it and encourage reporting.

Grandparents’ Experiences of Childhood Cancer, Part 1

In this study, the authors examined the experiences of grandparents who have had, or have, a grandchild with childhood cancer. Sixteen grandparents were interviewed using unstructured interviews, and the data were analyzed according to hermeneutic-phenomenological tradition, as guided by the philosophical hermeneutics of Hans-Georg Gadamer. Interpretive findings indicate that grandparents suffer and worry in many complex ways that include a doubled worry for their own children as well as their grandchildren. According to the grandparents in this study, this worry was, at times, silenced in efforts to protect the parents of the grandchild from the burden of concern for the grandparent. Other interpretations include the nature of having one's universe shaken, of having lives put on hold, and a sense of helplessness. The grandparents in this study offer advice to other grandparents as well as to the health care system regarding what kinds of things might have been more helpful to them as one level of the family system, who, like other subsystems of the family, are also profoundly affected by the event of childhood cancer.

Grandparents’ Experiences of Childhood Cancer, Part 2

In this study, the authors examined the experiences of grandparents who have had, or have, a grandchild with childhood cancer. Sixteen grandparents were interviewed using unstructured interviews, and the data were analyzed according to a hermeneutic-phenomenological tradition, as guided by the philosophical hermeneutics of Hans-Georg Gadamer. In Part 1 of this report, interpretive findings around worry, burden, silence, the nature of having one's universe shaken, of having lives put on hold, and a sense of helplessness were addressed. In Part 2, the authors discuss interpretations related to the notions of support, burden, protection, energy, standing by, buffering, financial shouldering, and relationship. The study concludes with implications that the grandparents in the study bring to pediatric nurses in their practices with families in pediatric oncology.

Comparative study of text to speech system for Indian language

Speech synthesis is a process of converting an input text into speech waveforms. This technology is a great help to people with physical impairments like visually handicapped and vocally disabled. The ability to convert text to voice reduces the dependency, frustration, and sense of helplessness of these people. In this paper four Indian languages text-to-speech systems, namely Dhvani, Shruti, HP Lab system based on Festival framework and Vani system are discussed. These systems are compared on the basis of languages it support, size of the speech units, methodologies used to code, store and synthesize the speech and prosody.

Concern over radiation exposure and psychological distress among rescue workers following the Great East Japan Earthquake Concern over radiation exposure and distress

BackgroundOn March 11, 2011, the Great East Japan Earthquake and tsunami that followed caused severe damage along Japans northeastern coastline and to the Fukushima Daiichi nuclear power plant. To date, there are few reports specifically examining psychological distress in rescue workers in Japan. Moreover, it is unclear to what extent concern over radiation exposure has caused psychological distress to such workers deployed in the disaster area.MethodsOne month after the disaster, 424 of 1816 (24%) disaster medical assistance team workers deployed to the disaster area were assessed. Concern over radiation exposure was evaluated by a single self-reported question. General psychological distress was assessed with the Kessler 6 scale (K6), depressive symptoms with the Center for Epidemiologic Studies Depression Scale (CES-D), fear and sense of helplessness with the Peritraumatic Distress Inventory (PDI), and posttraumatic stress symptoms with the Impact of Event Scale-Revised (IES-R).ResultsRadiation exposure was a concern for 39 (9.2%) respondents. Concern over radiation exposure was significantly associated with higher scores on the K6, CES-D, PDI, and IES-R. After controlling for age, occupation, disaster operation experience, duration of time spent watching earthquake news, and past history of psychiatric illness, these associations remained significant in men, but did not remain significant in women for the CES-D and PDI scores.ConclusionThe findings suggest that concern over radiation exposure was strongly associated with psychological distress. Reliable, accurate information on radiation exposure might reduce deployment-related distress in disaster rescue workers.

Systematics of somatoform disorders

Somatoform disorders in children and adolescents are common and can cause a significant reduction in wellbeing and quality of life. Considerable subjective impairment leads to a high number of doctors’ visits which, together with recurrently negative findings, often results in a sense of helplessness in the patient and a lack of trust towards the physician. The criteria for somatoform disorders are discussed on the basis of the International Classification of Diseases and Related Health Problems (ICD)-10 and taking the upcoming Diagnostic and Statistical Manual of Mental Disorders (DSM-V) into consideration. Parents play a particular role in the development of somatoform disorders in childhood and adolescence. The importance of the paediatrician’s role in early diagnosis and introduction of appropriate treatment is underlined. The newly developed Screening for Somatoform Disorders in Children and Adolescents (SOMS-CA) is presented. Patients with somatoform disorders are seen predominantly within consulting and liaison services of the paediatric clinic.