A strategic approach to occupational injuries

The development of an integrated risk management approach to occupational injuries at Conrail had an enormously positive impact on injury incidence, lost work days, and company costs. Dr. Comstock describes managed care techniques that facilitate interface between quality assurance and risk management.     

Negative life events and time to recovery from episodes of bipolar disorder.

The authors of the current study examined the impact of severe negative life events on time to recovery from episodes of bipolar disorder. Although negative life events have been shown to influence relapse in bipolar disorder, research has not focused on life events and recovery in bipolar disorder. The authors recruited 67 individuals with bipolar disorder during hospitalization and conducted monthly assessments for at least 1 year. Individuals with severe negative life events took more than 3 times as long to achieve recovery as those without severe life events, and the impact of life events was not mediated by medication compliance. These results reveal that the psychosocial environment may play a much larger role in the course of bipolar disorder than previous biological models have suggested. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adler's psychology (of use) today: Personal history of traumatic life events as a self-handicapping strategy.

Investigated the hypothesis that the reporting of a history of traumatic life events may serve as a strategy to control attributions about performance in an evaluative setting (i.e., self-handicapping). 140 female undergraduates completed the state form of the State-Trait Anxiety Inventory and were randomly assigned to 1 of 4 experimental conditions (i.e., 2 evaluation threats by 2 traumatic history instructions). In groups of 7, Ss received specific (the project concerned development of local norms for measures of social intelligence) or innocuous information. After completion of an initial questionnaire, Ss either were told that traumatic history has no effect on task performance or received no instructions about filling out measures of the traumatic value of past life experiences and 2 manipulation checks. Results, as predicted, show that Ss emphasized the adversity of events and experiences in their background when an uncertain evaluation was expected and when a traumatic background would serve as a suitable excuse for potential failure. Results generally support the hypothesized self-protective reporting of traumatic life events. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Protective effect of respiratory devices in farmers with occupational asthma

To the authors' knowledge there have been no previous reports on the protection afforded by powered filtering respirators in farmers with occupational asthma attributed to the inhalation of organic dust. In order to investigate this question, 26 farmers with occupational asthma were challenged with an exposure to work-related dusts for up to 60 min. This resulted in highly significant increases in airway resistance (Raw), thoracic gas volume (TGV) and specific airway resistance (sRaw) compared to baseline values. After a mean period of 21 weeks the farmers were subjected to a second challenge, this time wearing a protective respiratory device (RD) with a P2 filter. Significant increases in Raw, TGV and sRaw were again observed, but on average these were 50-80% smaller than the increases seen when RDs were not worn. These differences were found to be statistically significant. This shows that the use of a respiratory device in farmers suffering from occupational asthma reduces the development of bronchial obstruction but does not prevent it. The use of this kind of respiratory device cannot substitute for the proper management of asthma since the devices do not offer complete protection.     

An artificial life approach to language

The aim of the paper is to show that an Artificial Life approach to language tends to change the research agenda on language which has been shared by both the symbolic paradigm and classical connectionism. Artificial Life Neural Networks (ALNNs) are different from classical connectionist networks because they interact with an independent physical environment; are subject to evolutionary, developmental, and cultural change, and not only to learning; and are part of organisms that have a physical body, have a life (are born, develop, and die), and are members of genetic and sometimes, cultural populations. Using ALNNs to study language shifts the emphasis from research on linguistic forms and laboratory-like tasks to the investigation of the emergence and transmission of language, the use of language, its role in cognition, and language as a populational rather than as an individual phenomenon.     

Major life events and major chronic difficulties are differentially associated with history of major depressive episodes.

Major life events have been found to precede onsets of a 1st lifetime episode of depression more commonly than subsequent recurrences. Despite general empirical support for this finding, few data directly address how the role of major life events may change over successive recurrences. Further, little research has examined major chronic difficulties in relation to a 1st lifetime episode versus a recurrence of depression. The present study tested the associations between major life events and major difficulties in relation to lifetime history of depressive episodes in a sample of 96 individuals diagnosed with major depression. Using investigator-based measures of life stress, the authors found that, whereas major life events were associated with fewer lifetime episodes, major chronic difficulties were related to more prior episodes. These findings are discussed in terms of underlying mechanisms that may account for the changing role of major life stress over successive recurrences of depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The history of occupational health service in Korea

Dialysate and serum levels of granulocyte-colony stimulating factor (G-CSF), granulocyte macrophage colony stimulating factor (GM-CSF) and leukemia inhibitory factor (LIF) were analyzed in patients with continuous ambulatory peritoneal dialysis (CAPD). Samples from the peritoneal effluent and from serum were obtained during the first months of dialysis and during peritonitis from the first three dialysate bags drained on the day of admittance and form nightbags on days three and ten. Serum samples were drawn on days one and ten. On the first day of infection G-CSF was detected in twelve out of fifteen samples in the dialysate and reached its peak median level, 443 pg/ml, in the first drained bag and thereafter decreased significantly. Also in serum a peak, 190 pg/ml, was observed on the first day. LIF was found in six of ten analyzed dialysate samples, with a peak median level of 77 pg/ml on day one, while only four of ten patients had detectable GM-CSF. Peripheral blood mononuclear cells from non-infected CAPD patients were stimulated with lipopolysaccharide and G-CSF levels in the supernatants increased significantly (P < 0.05) after 6 h stimulation. We conclude that G-CSF is produced locally in the dialysate during the acute stage of peritonitis and to a lesser extent also systemically. These findings are in line with G-CSF production after LPS stimulation of peripheral blood mononuclear cells.     

Use of videotape in occupational therapy

The use and production of videotapes in occupational therapy are expected to increase in the future. A survey of 54 occupational therapy curricula and 59 hospital-clinics showed that 71 percent of the respondents use videotapes. Of that group, 70 percent produce videotapes for occupational therapy. Forty-six percent of the producers of occupational therapy videotapes make them available to others. Ninety-two percent of the respondents indicated a need for reviews of films and videotapes pertinent to occupational therapy, either in a directory--or a directory, with monthly reviews of new materials in the Occupational Therapy Newspaper or AJOT. A listing of subject areas most needed in a videotape format was also compiled.     

The special study module: a novel approach to undergraduate teaching in occupational medicine

Difficulties in teaching occupational medicine to undergraduates stem from the reduced availability of teaching time and the perception of the specialty. Recent changes in the General Medical Council curricular framework have permitted the development of a special study module (options course) in occupational medicine, in which a small number of motivated undergraduates elected to participate and which was adequately resourced. This course laid particular emphasis on changing students' attitudes towards the specialty, self-learning techniques, problem-solving and other skills such as workplace assessment. The objectives, content and teaching methods of the course are described, as is a preliminary evaluation. It is suggested that other medical schools should adopt and refine this approach in order to improve the quality of undergraduate training in at least a proportion of the output of medical schools.     

Subjective evaluation of life events.

Surveyed 50 medical/surgical patients (mean age 59.6 yrs) concerning the occurrence of life events during the preceding year. Their subjective evaluations of the events were obtained for the dimensions of desirability, adjustment, anticipation, and control. (Psychosocial adjustment was measured by a modification of the Profile of Adjustment and Role Skills.) Substantial overlap was found among the 4 dimensions, with the degree of overlap varying as a function of whether persons or events were taken as the units of observation. Overlap was greater when events rather than persons served as the units of observation. This finding has implications for the choice of normative versus idiographic approaches to weighting events. Regarding the evaluative dimensions themselves, overlap was greatest for desirability and least for control. Psychological impairment was the area of psychosocial adjustment primarily associated with subjective evaluations, specifically with desirability and adjustment. It is concluded that results are not promising for the inclusion of anticipation and control as major dimensions of stressfulness. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A novel approach to data collection in a case-control study of cancer and occupational exposures

BACKGROUND: In community and hospital-based case-control studies, the occupational data collected in interviews are usually limited to responses to general questions asked of all study subjects. A procedure is described in which more detailed information can be collected in an efficient, standardized and systematic way. METHODS: A generic work history is initially collected from all subjects using a computer-assisted interview. The work history includes job title, type of business, job activities, materials and chemicals, and tools and equipment used. After responses are entered into the computer by the interviewer, the computer searches a synonym file to identify possible job-specific modules relevant to the reported job. The modules are detailed questionnaires that address specific jobs administered after obtaining the generic work history. The modules are used to ask questions about the work environment; sources of exposure; factors affecting the movement of the agent from the source to the subject, such as local exhaust ventilation; and individual and job characteristics. After the interview is completed, the work history and responses to the modules are sent electronically to an industrial hygienist who reviews the information using a custom-designed software package. Where ambiguities or contradictions occur in information reported by the respondent, or for jobs for which no module had been developed, the industrial hygienist generates up to 10 additional questions per job. These questions are sent back to the interviewer for administration of a short, second interview. CONCLUSIONS: These procedures, which are being successfully implemented in an on-going case-control study of brain tumours, should improve disease risk estimates over those derived from more traditional approaches to exposure assessment.     

Respective influence of occupational and personal factors on respiratory function in dairy farmers

OBJECTIVE: This study proposes to test the hypothesis that early loss of a parent, coupled with poor quality family relationships, would result in long-term increased cardiovascular and cortisol reactivity to stress. METHODS: Subjects included 30 university students who lost one parent before age 16, and 31 control subjects. Blood pressure (BP) was measured continuously during 5-minute baseline and recovery periods, and during each of 2 tasks--viewing a 7-minute video clip depicting the death of a parent, and giving a 3-minute impromptu speech (1-hour rest between tasks). Salivary cortisol samples were collected immediately before each task, and at 5 and 20 minutes posttask. Quality of family relationships (FR) was measured using the Moos Family Environment Scale. RESULTS: Repeated-measures analysis of covariance revealed significant main effects on BP of both parental loss and FR for both tasks (all p values < .05) such that subjects who lost a parent or reported poor quality FR showed higher BP across all periods. The loss by FR by period interaction was not significant. An FR by period interaction was found for cortisol during the movie, in which poor quality FR subjects showed increased cortisol, whereas all others showed decreases. A loss by period interaction was found for cortisol during the speech, in which cortisol increased in loss subjects and decreased in non-loss subjects. CONCLUSIONS: These findings indicate that both childhood loss of a parent and poor quality of caretaking are associated with long-term increases in BP and altered neurohormonal responses to stress.     

Lymphocyte response to mitogens: influence of life events and personality

Several patients with 'progressive loss of speech output' or 'progressive anarthria' of degenerative origin have been reported in the literature. We report 5 clinical cases with slowly progressive loss of speech output and initially no deficit in other cognitive domains. The early clinical features were analysed in an attempt to identify the anatomo-functional systems implied in the degenerative process. The first phase of the disorder was characterised by impaired articulation consistent with speech apraxia, telegraphic style and a difficulty to elaborate a series of orofacial or hand movements. It is argued that these symptoms result from an impairment of complex motor processing due to dysfunction of the ventral premotor system. In the second phase, a decrease in spontaneous speech and self-initiated action was combined with exaggerated dependency on external stimuli, interpreted as dysfunction of the dorsal premotor system. We suggest that the neuropsychological profile of the disorder may result from progressive degeneration of the premotor cortex.     

A social-cognitive theory of depression in reaction to life events.

Presents a theory of reaction to life events based on epidemiological evidence. Depression occurs with events that disrupt roles by which people define their worth, if these people lack alternative sources of self-definition. A disruption has its effect when there is a major discrepancy between the perceived actions of a role other and the cognitive representation of that other. Symptoms of reactive depression occur in 3 sets: a set of cognitive symptoms due to loss or damage of the sense of self, a set of intense emotions, and a set of interpersonal strategies. Data from a study by G. W. Brown and T. Harris (1978) of the link between depression and a provoking agent in the presence of a vulnerability factor are reviewed. Other retrospective and prospective studies of depression and triggering events are also noted. It is proposed that provoking agents increase the risk of depression by posing threats to selfhood, when the sense of self is realized in a role. (105 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The limitation of a positivistic approach to psychoanalytic history: A reply to Naso's commentary.

Replies that a close examination of R. C. Naso's (see record 1993-22647-001) commentary on E. A. Loewenstein's (see record 1992-28313-001) article on psychoanalytic life histories reveals contradictions that point to Naso's lack of a clear philosophical commitment. While Naso's statements appear to be informed by a relativistic perspective, his argument is constrained by an unarticulated positivistic viewpoint. Naso's criticism of Loewenstein's style, which he describes as metaphoric and evocative, is examined. Contrary to Naso's claim, scientific style does not possess a privileged access to psychoanalytic life history. Moreover, the meanings and affective valences of historical events are not fixed and static, as Naso implies, but contextual and dynamic. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship of life events and personal orientations to symptoms of strain.

Data collected from 1,000 managers and nonmanagers through the Life Styles Inventory were analyzed to assess the direct and moderating effects of personal orientations on strain. Neither subgroup analysis nor regression with interaction terms indicated that personal orientations acted as moderators. However, a modest direct relationship between these orientations and symptoms of strain was found. The variance in the number of strain symptoms explained by personal orientations (6%) was only slightly less than that explained by life events (8%) and greater than that explained by background variables (3%). Results suggest that the implications of personal characteristics might not be fully recognized by theoretical models and stress-management programs that regard these variables exclusively as moderators. (60 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A study of life events in mania

After clinical recovery, 46 manic patients were screened for evidence of life events during a period of 6 months before the first episode of mania (DSMIIIR criteria) and 6 months after the episode. Within-patient group comparisons showed that patients who reported life events had a significantly higher presumptive mean stress score before manic episode as compared with the period after the illness. When life events were considered in relation to age, sex, marital status and family history of affective disorder, on a logistic regression equation, it was found that life events before mania were significantly associated with males and with a younger age of onset. The implications of these findings are discussed.     

Regulatory control and adults' stress-related responses to daily life events.

In this study, the authors examined the relations of regulatory control to adults' daily stress-related responses. A physiological index of regulatory control (vagal tone) and daily response of stress and coping were obtained from 92 college students. The results of the study generally confirmed the prediction that individuals who are high in regulatory control were relatively unlikely to experience high levels of negative emotional arousal in response to stressors, but this relation held only for moderate- to high-intensity stressors. Moreover, under conditions of moderate to high stress, highly regulated individuals were likely to cope constructively with the stressor. Mediational analyses suggested that the relation of regulatory control to constructive coping was partially mediated by negative emotional arousal. The results support the conclusion that individual differences in regulatory control interact with situational factors in influencing the prediction of stress-related responses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Individual viewpoints of stressful life events.

Large sample average ratings of the amount of life change caused by experiencing selected events (e.g., marriage, loss of job, and change of residence) have become a popular means for indexing levels of stress in studies relating social factors to physical disease and psychiatric disability. The present investigation assessed whether change alone provides an adequate representation of the salient qualities of life events and whether individuals differ systematically in their perceptions of qualitative features of events. A 3-mode factor analysis was applied to ratings by 85 undergraduates of 44 events on 6 bipolar scales. Three S factors, 3 event factors, and 3 scale factors were obtained, with the pattern of interrelations among the 3 sets of factors indicating that different types of individuals rated qualities of events in different ways. It is concluded that important characteristics of events may vary widely among individuals and that future assessment of the properties of life stress be both multidimensional and specific for individuals. (30 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)