Objectives : Firefighters frequently experience traumatic events, high-tension situations and shift work. Therefore, the prevalence of insomnia of firefighters is higher than one of general population. Not only does the quality of sleep affect the satisfaction of personal life, but it also influences their performance for the public's safety. We investigated which factors affect the quality of sleep of firefighters. Methods : After personally delivering 120 questionnaires to 3 fire stations, the survey was conducted when the consents were signed. It inquired about alcohol use, smoking, shift work, sleep quality, depression, anxiety, and experience of traumatic events. We then divided the firefighting officers in two groups according to the quality of sleep and compared the variables examined to conduct the logistic regression analyses according to the results. Results : The poor sleeper group reported a higher level of current alcohol consumption, depression, anxiety and experience of traumatic events. Logistic regression analyses showed that the current alcohol intake (Crude odds ratio=3.707, 95% confidence interval=1.288-10.672, p=0.015 ; Adjusted odds ratio=3.288, 95% confidence interval=1.011-10.694, p=0.048) has a significant effect on sleep quality. Conclusions : Current alcohol consumption, depression, anxiety and experience of traumatic events were respectively associated with sleep quality of firefighters. When all significant factors considered, the current alcohol use was the only statistically significant. To improve the quality of sleep for firefighters, it will be necessary to evaluate alcohol intake, educate the poor sleep quality caused by alcohol, and provide specific interventions to reduce consumption.
Posttraumatic syringomyelia may result from a variety of inherent conditions and traumatic events, or from some combination of these. Many hypotheses have arisen to explain this complex disorder, but no consensus has emerged. A 28-year-old man presented with progressive lower extremity weakness, spasticity, and decreased sensation below the T4 dermatome five years after an initial trauma. Magnetic resonance imaging (MRI) revealed a large, multi-septate syrinx cavity extending from C5 to L1, with a retropulsed bony fragment of L2. We performed an L2 corpectomy, L1-L3 interbody fusion using a mesh cage and screw fixation, and a wide decompression and release of the ventral portion of the spinal cord with an operating microscope. The patient showed complete resolution of his neurological symptoms, including the bilateral leg weakness and dysesthesia. Postoperative MRI confirmed the collapse of the syrinx and restoration of subarachnoid cerebrospinal fluid (CSF) flow. These findings indicate a good correlation between syrinx collapse and symptomatic improvement. This case showed that syringomyelia may develop through obstruction of the subarachnoid CSF space by a bony fracture and kyphotic deformity. Ventral decompression of the obstructed subarachnoid space, with restoration of spinal alignment, effectively treated the spinal canal encroachment and post-traumatic syringomyelia.
Various mucosal lesions are originated in oral cavity and trauma is most common cause of these lesions. Definitive treatment of these lesions is stop of traumatic events and removal. There are two representative removal methods in medical fields; conventional mess or LASER. Compare to conventional mess technique, LASER has several advantages such as bleeding control, pain reduction. Of the various LASER systems, $CO_2$ LASER is regarded as best choice for general practitioners due to its convenience, universal use and high cost/benefit effects. In these article, we report the treatment cases of mucocele, fibroma, and leukoplakias using $CO_2$ LASER. Eventhough there are malignancy potential of oral mucosal lesion especially leukoplakias, careful history taking, clinical examination, and regular check-up will help the general practitioners to manage these lesions. Simple and relatively safe oral mucosal lesions have to be treated more in general dental practitioners.
Objective : Disaster causes psychological distress to a large number of people in a short period of time, by both direct and indirect exposure to traumatic events embedded in various realms of disaster experience. Optimal, well-planned treatment interventions should follow from the early acute period to recovery phase, extending up to several months later. In this context, there is an increasing need for systemic review to gain comprehensive insights for disaster interventions. These need to be added to public policy, and for the prevention and treatment of disaster-related psychopathology. Here, we review the published studies on psychological interventions for disaster-related posttraumatic stress disorder. Methods : Specific psychological interventions regarded as effective treatments for have been selected for this review, such as CBT (Cognitive-Behavior Therapy), Exposure Therapy, EMDR (Eye Movement Desensitization & Reprocessing), SIT (Stress Inoculation Therapy) and Psychoeducation. In addition, natural disasters, industrial disasters, and accidents involving aircraft and ships were also categorized as disasters, along with war and combat trauma. Results : Cognitive behavior therapy and exposure therapy had the strongest research support for effectiveness, and could be considered as the first-choice treatment for disaster-related PTSD. The second line of treatment is EMDR, although this treatment modality has the advantage of reaching certain treatment improvements in fewer sessions. However, the effects of SIT and psychoeducation to the survivors of disasters, remains unclear at this point. Additionally, we propose the possibilities of using virtual reality component and imagery rescripting as modified forms of traditional cognitive behavior therapy and exposure therapy. Conclusion : Cognitive behavior therapy and exposure therapy, deemed effective treatments for various trauma, are considered to be effective for survivors from disasters. However, the efficacy of other interventions has not yet been examined methodologically in well-designed studies, such as randomized controlled trials. In particular, future empirical studies are needed, since it is difficult to conclude that psychological interventions have similar effects on different types of disasters.
Kim, Jin-Hyung;Sue, Joo-Hee;Lee, Go-Eun;Kim, Nam-Kwen;Choi, Sung-Youl;Lyu, Yeoung-Su;Kang, Hyung-Won
Journal of Oriental Neuropsychiatry
/
v.26
no.1
/
pp.49-61
/
2015
Post traumatic stress disorder (PTSD) is an anxiety disorder that usually occurs after suffering from a psychological trauma that can not threatening events, which is one of the individual's subjective pain and their families and the larger society due to the chronic disease burden results. Treatment with a medication, as well as cognitive behavioral therapy (CBT), exposure therapy, prolonged exposure therapy (PE), eye-movement desensitizing, and reprocessing (EMDR) are preferentially performed, including psychotherapy. Korean medical psychotherapy consists of a wide range of manual therapy, but it does not have systematically screening limits. This study was developed by Korean medical psychotherapy program for PTSD, and it was carried out as a preliminary clinical trial for validity. The Korean medical psychotherapy program for PTSD consists of four stages as follows: building chapter of safety, flow and send, accept, and integration. Based on this preliminary clinical study of PTSD, seven patients were treated for 2 hours per week for 5 weeks. We report the meaningful results gained by observing the changes in IES-RK points, questionnaire on five-faceted mindfulness, quality of life, anxiety, depression, insomnia, hwabyung scale, HRV, and EEG, before and after the Korean medical psychotherapy program.
Ryu, Je Il;Kim, Choong Hyun;Kim, Jae Min;Cheong, Jin Hwan
Journal of Trauma and Injury
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v.28
no.4
/
pp.223-231
/
2015
Purpose: Delayed, traumatic, intraparenchymal hemorrhage (DTIPH) is a well-known contributing factor to secondary brain damage that evokes severe brain edema and intracranial hypertension. Once it has occurred, it adversely affects the patient's outcome. The aim of this study was to evaluate the prognosis factors for DTIPH by comparing clinical, radiological and hematologic results between two groups of patients according to whether surgical treatment was given or not. Methods: The author investigated 26 patients who suffered DTIPH during the recent consecutive five-year period. The 26 patients were divided according to their having undergone either a decompressive craniectomy (n=20) or continuous conservative treatment (n=6). A retrospective investigation was done by reviewing their admission records and radiological findings. Results: This incidence of DTIPH was 6.6% among the total number of patients admitted with head injuries. The clinical outcome of DTIPH was favorable in 9 of the 26 patients (34.6%) whereas it was unfavorable in 17 patients (65.4%). The patients with coagulopathy had an unexceptionally high rate of mortality. Among the variables, whether the patient had undergone a decompressive craniectomy, the patient's preoperative clinical status, and the degree of midline shift had significant correlations with the ultimate outcome. Conclusion: In patients with DTIPH, proper evaluation of preoperative clinical grading and radiological findings can hamper deleterious secondary events because it can lead to a swift and proper decompressive craniectomy to reduce the intracranial pressure. Surgical decompression should be carefully selected, paying attention to the patient's accompanying injury and hematology results, especially thrombocytopenia, in order to improve the patient's neurologic outcomes.
Objectives : Indirect contact with trauma may occur when a person empathically listens to detailed descriptions, exposing the person to intense emotional pain from trauma victims. Although less severe than direct trauma, indirectly traumatized persons may experience the same fear, rage, and despair as direct trauma victims. This phenomenon has been variously termed vicarious trauma, traumatic countertransference, burnout, compassion fatigue, and secondary traumatic stress. Using a psychiatric symptoms questionnaires, this study investigated the effects of indirect exposure to co-worker's trauma on the mental health of firefighters who had not directly experienced traumatic events in the previous year. Methods : We administered self-report questionnaires, such as the Impact of Event Scale-Revised (IESR) and Alcohol Use Disorder Identification Test (AUDIT), to firefighters working at two fire stations in a metropolitan city. We analyzed 188 of 232 collected surveys, after excluding falsely entered data (28 cases) and questionnaires by directly-traumatized victims (16 cases). Results : Alcohol consumption and posttraumatic stress disorder (PTSD) symptoms, as determined by the AUDIT and IES-R, were significantly higher in the indirectly-traumatized group. The ratio of high-risk members scoring higher than 23 in IES-R was larger in the indirectly traumatized group, although this was not statistically significant. Conclusion : Alcohol consumption was significantly higher in the indirectly traumatized group. This group also included more members at high risk for PTSD. Further research, with a larger group of indirectly traumatized firefighters and ongoing investigation of PTSD development and other psychiatric symptoms, is needed.
Purpose: This study was designed to investigate that the prevalence of Post-traumatic stress disorder (PTSD) and occupational environmental factors that contribute to the developing of PTSD in workers who worked in emergency room in Korea. Methods: This study is a multicenter cross-sectional study that was conducted in three emergency rooms. Data was collected by self-response method through questionnaire. The Impact Event Scale-Revised was used to screen the high-risk group of PTSD. Univariate and multivariate regression analysis was used to identify the factors associated with the developing of high-risk group of PTSD. Results: Total 211 subjects responded to the questionnaire. Of these, 170 subjects experienced psychological trauma event (PTE) in the working environment. And 60 subjects classified as high risk group of PTSD, so a prevalence of high risk group for PTSD was 28.4%. Factors related to the high risk group of PTSD were the frequency of psychological trauma events experienced over the past 1 year and the high score of QIDS-SR16. Conclusion: The prevalence of high risk group for PTSD among emergency room workers in Korea is very high. This may adversely affect the safety of patients, so early screening and intervention are necessary.
Journal of the Korean Institute of Landscape Architecture
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v.45
no.2
/
pp.1-10
/
2017
This study used a quasi-experimental method to investigate if both travel involvement and the degree of recall of a traumatic event affect subjective well-being. For this, independent variables such as positive affect, negative affect, and life satisfaction were established. Four waves of data collection were performed with two to three weeks intervals, then the collected longitudinal data were analysed by repeated measure ANOVA. The study results indicated that travel involvement increases positive affect and life satisfaction, with the effect lasting four weeks or more, which means that travel is an effective tool to boost subjective well-being. Respondents who thought about a traumatic event more frequently had a much higher negative affect following the disaster, and such increased negative affect was maintained over seven weeks or longer. Therefore, this study finds that negative events produce larger, more consistent, or more lasting effects than positive events. As well as travel participation, visiting an urban park is a pleasurable experience. Therefore, the study also finds that urban parks could be utilized for increasing and maintaining subjective well-being in the middle and long term as well as lessening personal stress.
The 119 emergency medical services(EMS) personnel studied in this research are constantly exposed to traumatic events, which can lead to a variety of psychosocial problems and poor quality of life. In this study, we examined the effects of the Mind Subtraction Meditation Program on post-traumatic growth and resilience of 119 EMS personnel. In this study, we measured the conditions of 26 EMS personnel of A firefighting headquarters based on post-traumatic growth and resilience before and after implementing the short-term intensive for 2 nights and 3 days in $201^*$. The results showed that there was a significant increase in post-traumatic growth from $2.85({\pm}.67)$ to $3.60({\pm}.72)$ and resilience from $2.45({\pm}.39)$ to $2.83({\pm}.48)$ of the subjects between before and after the Mind Subtraction Meditation. In conclusion, the Mind Subtraction Meditation Program was effective in improving the posttraumatic growth and resilience of 119 EMS personnel. Therefore, Mind Subtraction Meditation Program could be proposed as a mental health promotion program for EMS personnel.
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