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Continuous assessment of back stress (CABS): a new method to quantify low-back stress in jobs with variable biomechanical demands.

Jobs with a high degree of variability in manual materials handling requirements expose limitations in current low-back injury risk assessment tools and emphasize the need for a probabilistic representation of the biomechanical stress in order to quantify both acute and cumulative trauma risk. We developed a hybrid assessment methodology that employs established assessment tools and then represents their evaluations in a way that emphasizes the distributions of biomechanical stress. Construction work activities in the home building industry were evaluated because of the high degree of variability in the manual material handling requirements. Each task was evaluated using the Revised NIOSH Lifting Equation, The University of Michigan Three-Dimensional Static Strength Prediction Program, and the Ohio State University Lumbar Motion Monitor Model. The output from each model was presented as time-weighted histograms of low-back stress, and the assessments were compared. The results showed considerable differences in what were considered high-risk activities, indicating that these 3 assessment tools consider the risk of low-back injury from different perspectives. The time-weighted distribution aspect of this methodology also contributed vital information toward the identification of high-risk activities. These results illustrate the necessity for more advanced low-back injury risk assessment techniques for jobs with highly variable manual materials handling requirements.

Back↗

[Posttraumatic stress disorder in Bosnian war veterans: analysis of stress events and risk factors].

The aim of this study was to determine the incidence of Post-Traumatic Stress Disorder (PTSD), the characteristics of stress-related events, and the risk factors for the development of PTSD. The total patient sample consisted of 100 Bosnian war veterans. Watson's PTSD module was used in establishing PTSD diagnosis. Patients fulfilled the following questionnaires: personal data form, Posttraumatic Symptom Scale PTSS-10 (Holen), Impact of Event Scale (Horowitz), Life Event Scale, and Eysenck Personality Inventory. PTSD was diagnosed in 30% of the examined patients. Larger number of stress-related events, particularly of those regarded as life-threatening, wounding/death of a close person, and material losses were more frequent in persons with PTSD. The risk factors for the development of PTSD in this study were: age (30-40), marital status (married), lower level of education, the front-line combat exposure, neurotic manifestations, family problems in childhood, and neuroticism.

Adolescent↗

Effect of reinstitution of good glycemic control on retinal oxidative stress and nitrative stress in diabetic rats.

Clinical and experimental studies have shown that reinstitution of good glycemic control (GC) after a period of poor glycemic control (PC) does not produce immediate benefits on the progression of retinopathy, and hyperglycemia is sufficient to initiate the development of diabetic retinopathy. In this study, the effect of reinstitution of GC on hyperglycemia-induced increased oxidative stress and nitrative stress was evaluated in the retina of rats maintained in PC before initiation of GC. In diabetic rats, 2 or 6 months of PC (GHb >11.0%) was followed by 7 months of GC (GHb <5.5%). Reinstitution of GC after 2 months of PC inhibited elevations in retinal lipid peroxides and NO levels by approximately 50%, but failed to have any beneficial effects on nitrotyrosine formation. However, reversal of hyperglycemia after 6 months of PC had no significant effect on retinal oxidative stress and NO levels (P < 0.02 vs. normal). In the same rats, inducible nitric oxide synthase expression and nitrotyrosine levels remained elevated by >80% compared with normal rats or rats kept in GC for the duration. This suggests that oxidative and nitrative modifications in retina occur early in the course of development of retinopathy in diabetes. These abnormalities are not easily reversed by reinstitution of GC, and the duration of PC before initiation of GC influences the outcome of the reversal. Characterization of the abnormalities responsible for the resistance of retinopathy to arrest after reinstitution of GC will help identify potential future therapies to inhibit progression of diabetic retinopathy.

Animals↗

Alexithymia and coping with stress in healthy persons: alexithymia as a personality trait is associated with low social support and poor responses to stress.

We examined the relationship between alexithymia and coping with stress among 179 Japanese healthy volunteers. Two correlational analyses indicated that persons scored as alexithymic were more likely to indicate lower social support and poorer responses to stress. Multiple regression analysis also indicated that these lowered coping responses were fully explained by alexithymia scores. These results suggest that alexithymia, as a personality trait, may help to explain these individuals' low social support and poor responses to stress.

Adaptation, Psychological↗

Association between job stress and depression among Japanese employees threatened by job loss in a comparison between two complementary job-stress models.

OBJECTIVES: This study compared the separate effects produced by two complementary stress models--the job demand-control model and the effort-reward imbalance model--on depression among employees threatened by job loss. METHODS: A cross-sectional analysis was conducted to examine these associations among 190 male and female employees who responded to a self-administered questionnaire in a small Japanese plant with economic hardship. The employees were engaged in 2 job types--direct assembly line and indirect supportive tasks--and the latter was threatened by job loss because of downsizing. Independent variables were measured by the Japanese versions of Karasek's demand-control questionnaire and Siegrist's effort-reward imbalance questionnaire. Depression was assessed by the Center for Epidemiologic Studies Depression Scale. RESULTS: The employees with indirect supportive tasks (target for downsizing) were more likely to have depressive symptoms than direct assembly-line workers. Job strain, a combination of high demand and low control at work, was more frequent among the latter, while the combination of high effort and low reward was more frequent among the former. After adjustment for work environment factors, low control [odds ratio (OR) 4.7], effort reward imbalance (OR 4.1), and overcommitment (the person characteristic included in the effort-reward imbalance model) (OR 2.6) were independently related to depression. There is some indication that these effects were particularly strong in the subgroup suffering from potential job loss. CONCLUSIONS: This study confirms that the 2 job stress models identify different aspects of stressful job conditions. Moreover, effort-reward imbalance and low control at work are both associated with symptoms of depression.

Adult↗

Superimposed cold stress-induced hypothalamic-pituitary-adrenal response during long-duration restraint stress.

It has been reported that animals exposed to prior stress exhibit enhanced, reduced or equivalent hypothalamic-pituitary-adrenal (HPA) response to a subsequent acute stressor. We demonstrated previously that a long-duration restraint stress (RTS) evoked adaptive change, characterized by transient increase and gradual recovery to basal level in c-fos mRNA/c-fos protein (Fos) expression in the hypothalamic paraventricular nucleus (PVN) and in plasma adrenocorticotropin (ACTH) levels, although circulating corticosterone (CORT) remained at a high level. In order to investigate the HPA response to another stressor during the adaptive phase of long-duration RTS, we superimposed acute cold stressor (CS) to 16 hours RTS rats. Superimposed CS-induced re-expression of c-fos mRNA/Fos in the parvocellular region of the PVN (PVNpv) was observed in 16 hours RTS rats. The degree of expression of c-fos gene in superimposed CS rats was the same as those observed in single CS rats. The plasma ACTH levels induced by superimposed CS in 16 hours RTS rats were significantly higher compared with those in single CS rats. On the other hand, there were no significant differences between plasma CORT levels induced by superimposed CS in 16 hours RTS rats and those in single CS rats, and between plasma CORT levels before and after additional CS exposure in 16 hours RTS rats. The present study indicated that c-fos gene expression in PVN induced by superimposed CS was normo-responsive, ACTH secretion was hyper-responsive (facilitation), CORT secretion was slightly increased, but not hyper-responsive in long-duration RTS rats. These findings suggest that stress response induced by superimposed CS during long-duration RTS may occur in a different way at each level of the HPA.

Adrenocorticotropic Hormone↗

A case-comparison study of the characteristics of children with a short stature syndrome induced by stress (Hyperphagic Short Stature) and a consecutive series of unaffected "stressed" children.

Recently a type of growth failure (Hyperphagic Short Stature) has been described, in which there is potentially reversible severe impairment of growth hormone secretion, in association with excessively high levels of psychosocial stress. This condition is a variant of the disorder formerly known as Psychosocial Dwarfism. In the present study we compared children with Hyperphagic Short Stature (N = 25, aged 9.04 years+/-3.78, 72% male) and a closely matched sample with normal height, drawn from comparably stressful family circumstances (N = 25, aged 10.61+/-3.04, 60% male). Measures of the psychosocial environment, anthropometry, and developmental history from infancy were obtained. Many symptoms thought previously to be characteristics of psychosocial dwarfism were found to be nonspecific stress responses. Hypotonia (p < .05), enuresis/encopresis (p < .01), and sleep cycle disruption (p < .05) did differentiate the groups. Growth, appetite, and sleep are all influenced by hypothalamic nuclei, suggesting hypothalamic pathology could account for most of the clinical features of Hyperphagic Short Stature.

Appetite Regulation↗

Acute Stress Disorder Scale: a self-report measure of acute stress disorder.

The Acute Stress Disorder Scale (ASDS) is a self-report inventory that (a) indexes acute stress disorder (ASD) and (b) predicts posttraumatic stress disorder (PTSD). The ASDS is a 19-item inventory that is based on Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV, American Psychiatric Association, 1994) criteria. The ASDS possessed good sensitivity (95%) and specificity (83%) for identifying ASD against the ASD Interview on 99 civilian trauma survivors. Test-retest reliability of the ASDS scores between 2 and 7 days was strong (r = .94). The ASDS predicted 91% of bushfire survivors who developed PTSD and 93% of those who did not; one third of those identified by the ASDS as being at risk did not develop PTSD, however. The ASDS shows promise as a screening instrument to identify acutely traumatized individuals who warrant more thorough assessment for risk of PTSD.

Acute Disease↗

[Low cortisol production in chronic stress. The connection stress-somatic disease is a challenge for future research].

There is a general assumption that distressing events or situations (stress) evoke the hypothalamic-pituitary-adrenal (HPA) system, with a resulting increase in cortisol secretion. However, our increasing understanding of the complexity of the HPA axis physiology raises questions as to the validity of this model. An increasing number of studies imply that after long-term exposure to stress, the HPA axis will eventually become dishabituated, resulting in a disruption of central regulatory systems and a net decrease of cortisol output. These findings have major implications for the interpretation of stress-induced neuroendocrine response patterns.

Acute Disease↗

Comparison of voice stress reactivity under psychological stress test and simulated Mir docking manoeuvre.

The relation between the results of laboratory tests and results of the interesting professional work is a very difficult one. The same is true for the relation between training and real performance. The pilot controlled MIR-docking manoeuvre is in reality a very seldom but very important one. The training of this manoeuvre is a very special professional work and only for cosmonauts available. But the objective estimation of the performance and the used objective and subjective needs is nevertheless necessary. Even for the subjective "stress"-feelings during task solving it is often impossible to get reliable data without any physiological measurements. The use of electrodes, cables and equipments is hardly limited during real work. Sometimes only the voice is available over more or less quality communication channels. So it is the case during the training and the real pilot controlled MIR-docking manoeuvre. Based on findings in the literature and own experiments analyzing the relation between fundamental voice frequency (F0) and subjective stress feelings we tested the hypothesis that a on-line measurement of F0 can be used for stress evaluation during standardised training sessions of MIR-docking manoeuvres.

Astronauts↗

Chronic stress influences cardiovascular and neuroendocrine responses during acute stress and recovery, especially in men.

This study tests the influence of chronic stress on cardiovascular and neuroendocrine responses to and recovery from acute stressors and whether the effects are gender specific. Sixty-two healthy, middle-aged persons (50% women) performed mental-arithmetic and public-speaking tasks and relaxed thereafter for 1 hr while their cardiovascular and neuroendocrine function was measured. Participants with higher levels of chronic stress showed lower systolic blood pressure (SBP) and epinephrine (E; men only) and marginally lower levels of norepinephrine (NE) responses to the tasks and showed lower levels of cortisol and marginally lower NE responses during recovery. Relative to women, men had high diastolic blood pressure (DBP) responses to the tasks and high SBP, DBP, and E responses during recovery. Gender differences in cardiovascular disease in midlife may be due to gender differences in the inability to recover quickly, in addition to enhanced acute-stress response.

Acute Disease↗

Differential effects of benzodiazepines on immune responses in non-stressed and stressed animals.

Benzodiazepines (BZDs) used extensively as antianxiety agents are known for their low toxicity. However, a long lasting depression of mitogen stimulated secretion of macrophage-derived cytokines has been shown in offsprings of rats that were exposed to diazepam during pregnancy. The Present study investigates the effects of long term administration of diazepam and alprazolam on humoral and cell-mediated immune responses in adult male Wistar rats and Swiss albino mice. Administration of diazepam (5 mg/kg/day x 7-14 d) and alprazolam (1 mg/kg/day x 7-14 d) produced a significant reduction of anti-SRBC antibody titre, a measure of humoral immune response, and foot pad thickness and % leucocyte migration inhibition (% LMI), measures of cell-mediated immune responses. Administration of diazepam (5 mg/kg, i.p.) or alprazolam (1 mg/kg, i.p.) before subjecting the animals to restraint stress (RS) reversed the immunosuppressive effects of RS. Both per se immunosuppressive effects and attenuation of RS-induced immunosuppression of BZDs was antagonized by flumazenil (10 mg/kg, i.p.), a central BZD receptor antagonist. Thus, BZDs appear to modulate the immune system in non-stressed and stressed adult animals in a differential manner and these effects are mediated via central benzodiazepine receptors.

Animals↗

Similarity of parent and child self-views in stress-affected and stress-resilient urban families.

This study was conducted with a sample of highly stressed 4th-6th grade urban children consisting of matched subsamples previously classified as stress affected (SA) or stress resilient (SR). Separate in-depth interviews with parents and children provided objective self-ratings of a number of personal characteristics and expressive motor behavioral styles. Based on subsets of identical items from the two interviews, discrepancy (D)-scores were computed between parents' and children's self-ratings of ten personal descriptors, seven expressive motor behaviors, and their sum. Significantly lower D-scores were found for SR, compared to SA, parent-child dyads on all three of these measures. For the total sample, small parent-child D-scores also related significantly to indicators of fewer child problem behaviors and more competencies, assessed across multiple rater sources (i.e., parents, former teachers, and current teachers).

Adaptation, Psychological↗

A comparison of urodynamic parameters and lower urinary tract symptoms in urodynamic genuine stress incontinence women with or without stress urinary incontinence.

BACKGROUND: The aim of this study was to investigate the urodynamic parameters and lower urinary tract symptoms (LUTS) of women with urodynamic genuine stress incontinence (GSI). METHODS: A cross-sectional study involving 3323 women with LUTS was conducted. We recruited 1261 women with urodynamic GSI and were further grouped as with or without symptomatic stress urinary incontinence (SUI). The LUTS and urodynamic measurements between the two groups were analyzed and compared. RESULTS: Women with symptomatic SUI had a greater maximal flow rate, larger voided volume, larger maximal cystometric capacity, and smaller maximal urethral closure pressure (MUCP) during both rest and stress. The amount of urine leakage during the 1-hour pad test of GSI women with symptomatic SUI was much greater than women without symptomatic SUI (26.0 g vs 7.2 g, p < 0.001). The significant differences in other lower urinary tract symptoms including nocturia, diurnal frequency, incomplete emptying, poor stream, urgency, urge incontinence, and post-void dribbling in women without symptomatic SUI were all less than women with symptomatic SUI. CONCLUSIONS: The urodynamic parameters and LUTS between the GSI women with or without symptomatic SUI are different. Approximate 15% of the GSI women do not complain of symptomatic SUI. The lower urinary tract symptoms of women with GSI without symptomatic SUI were less prominent than for the GSI women with symptomatic SUI.

Adult↗

Treating posttraumatic stress in post-conflict countries and countries that accepted refugees. Report on the STOP-study, a multi-site study on treatment seeking and treatment outcome in people suffering from posttraumatic stress following war and migration in former Yugoslavia.

War and migration in the Balkans caused traumatic experiences in great parts of it's population. About four million people living in former Yugoslavia as well as about 100,000 refugees living in different European countries are estimated to suffer from on-going and severe psychological symptoms of post-traumatic stress. Although in need of treatment, many of these people do not seek treatment. Given the fact that, if untreated, post-traumatic stress reactions tend to persist for many years, often resulting in impairment and disability secondary to the symptom complex, offering appropriate care is a special challenge to health services. With regard to this context, an EC-funded multi-centre study including partners from Belgrade (SCO). Dresden (D), London (UK), Rijcka (HR), Sarajevo (BIH), and Zagreb (HR) aims (a) to provide an empirical basis for designing care programmes for people suffering from post-traumatic stress following war and migration in the Balkans who currently do not seek treatment, and (b) to improve the cost-effectiveness of treatment programmes for those patients who are cared for in specialised treatment centres. The paper presents the aims and the design of the STOP study. The first results of the study will be available in 2005.

Europe↗

[Stress and stress prevention in occupational practice from the viewpoint of occupational experts].

Stress is a common and widespread phenomenon in today's life and work. In a company it is present in all divisions and at all levels of activity. How to tackle stress is a difficult and by no means uniform problem. Some companies offer their employees possibilities to prevent or reduce stress. It is shown what this can look like and what are the pre-requisites and general conditions to achieve it.

Health Education↗

[Spatial urethral rest pressure and stress pressure profile in women with stress incontinence. Doppler microtransducer studies].

The functional urethral length (FUL), the maximum urethral closure pressure (MUCP), and the urethro vesical quotient (u/v) have been measured in 32 women suffering from urinary stress incontinence. The pressure was registrated in four different sectors of the urethra (left, posterior, right, anterior). We found statistical significant differences (t-Test, Wilcoxon-Test). The average FUL at the anterior urethral wall was 27.5 mm, at the posterior wall 30.2 mm. Concerning the UVDR and the u/v-quotient we found higher values at the ventral wall than at the posterior and lateral sides (9.79 kPa and 6.87 kPa and 1.63 and 1.14 resp.). Because of spatial different results of pressure distribution along the urethra walls the microtransducer had to be marked to enable the investigator to localize the direction of the pressure chip during registration. The pressure profile should be registrated only at the dorsal or dorsolateral parts of the urethra. Measurements at the anterior walls of the urethra showed no correlation between history, clinical tests, and urodynamic measurements. By reason of the submitted results we developed a new 5-channel microtransducer for simultane measurements of the urethra pressure profile at rest and at stress in four directions and we proved it in patients with and without urinary stress incontinence. New aspects are visible concerning the functional and morphological states of the urethra by use of the spatial urethral pressure profile.

Adult↗