Association of work related chronic stressors and psychiatric symptoms in a Swiss sample of police officers; a cross sectional questionnaire study

Purpose: (1) To identify work related stressors that are associated with psychiatric symptoms in a Swiss sample of policemen and (2) to develop a model for identifying officers at risk for developing mental health problems. Method: The study design is cross sectional. A total of 354 male police officers answered a questionnaire assessing a wide spectrum of work related stressors. Psychiatric symptoms were assessed using the "TST questionnaire” (Langner in J Health Hum Behav 4, 269-276, 1962). Logistic regression with backward procedure was used to identify a set of variables collectively associated with high scores for psychiatric symptoms. Results: A total of 42 (11.9%) officers had a high score for psychiatric symptoms. Nearly all potential stressors considered were significantly associated (at P<0.05) with a high score for psychiatric symptoms. A significant model including 6 independent variables was identified: lack of support from superior and organization OR=3.58 (1.58-8.13), self perception of bad quality work OR=2.99 (1.35-6.59), inadequate work schedule OR=2.84 (1.22-6.62), high mental/intellectual demand OR=2.56 (1.12-5.86), age (in decades) OR=1.82 (1.21-2.73), and score for physical environment complaints OR=1.30 (1.03-1.64). Conclusions: Most of work stressors considered are associated with psychiatric symptoms. Prevention should target the most frequent stressors with high association to symptoms. Complaints of police officers about stressors should receive proper consideration by the management of public administration. Such complaints might be the expression of psychiatric caseness requiring medical assistance. Particular attention should be given to police officers complaining about many stressors identified in this study's multiple mode

Music performance anxiety among full-time music students

Introduction Music performance anxiety (MPA, often referred to as "stage fright") is one of the leading severe medical problems among musicians. For about 15-25% of musicians MPA is a serious problem. Particularly high levels of MPA are observed among music students. Musical performance can induce negative emotions, including anxiety, which in some individuals can approach extreme levels of terror and take the form of panic attack, impair the quality of the performance, lead to avoidance of performance situations, and consequently have debilitating effects on the career. Coping efforts used by musicians in their attempts to manage MPA, such as sedatives, alcohol, and β-blockers can have deleterious health side-effects. Music ranks high in the cultural and economic life of Switzerland. In ten university music schools, students from all around the world are educated to become professional musicians. Despite the importance of musical education in Switzerland, data concerning the phenomenon of MPA are largely lacking. Goal and Methods The main goal of this research was to survey the occurrence, experience, and management of MPA among full-time music students in French Swiss conservatories. A questionnaire was developed based on the literature and interviews with music students and teachers and distributed to all the students of the conservatories of Fribourg, Geneva, Lausanne, and Neuchâtel in the spring 2007. 194 students (61% women) returned the questionnaire. Results The size of the problem: MPA is a major problem for 1/3 of the students (ranks 3 and 4). The consequences of MPA: 22% and 35% of the students think that they have failed exams and auditions, respectively, because of MPA. Further, 25% of the students have already avoided performing and 11% have interrupted public performances because of MPA. Coping with MPA: 90% of the students have never used alcohol prior to performing, whereas 97% and 81%, respectively, have never used recreation drugs and medication. The majority of students use relaxation exercises, respiratory exercises, and meditation techniques to prepare themselves. About ¾ of the students think that the use of alcohol and recreational drugs to manage MPA is never justified. 53% of the students think that the use of medication is justified on some occasions. Need for information and support: 66% of the students would like to receive more support and help to cope with music performance situations. This support should mainly come from their teachers and specialists. 53% of the students know nothing or little about possible means for the management of MPA. About 50% consider themselves not at all or little informed about the possible risks associated with the consumption of alcohol, recreational drugs, and medication for the management of performance situations. 89% would like to know more about MPA and 94% think that this topic should be discussed much more in their musical education at the conservatory. Conclusions The results of this survey indicate that MPA is a major problem for 1/3 of the students with serious consequences on their career. There is a huge need for more information and support on how to manage the stress due to performance situations. The use of alcohol, recreational drugs, and medication is modest but the students are poorly informed about possible side-effects of these coping strategies. It seems clear that more should be done in the French Swiss conservatories about music performance anxiety to inform, educate, and prepare the students for their future professional career

Mortality Differences Between Traditional Medicare and Medicare Advantage: A Risk-Adjusted Assessment Using Claims Data.

Medicare Advantage (MA) has grown rapidly since the Affordable Care Act; nearly one-third of Medicare beneficiaries now choose MA. An assessment of the comparative value of the 2 options is confounded by an apparent selection bias favoring MA, as reflected in mortality differences. Previous assessments have been hampered by lack of access to claims diagnosis data for the MA population. An indirect comparison of mortality as an outcome variable was conducted by modeling mortality on a traditional fee-for-service (FFS) Medicare data set, applying the model to an MA data set, and then evaluating the ratio of actual-to-predicted mortality in the MA data set. The mortality model adjusted for clinical conditions and demographic factors. Model development considered the effect of potentially greater coding intensity in the MA population. Further analysis calculated ratios for subpopulations. Predicted, risk-adjusted mortality was lower in the MA population than in FFS Medicare. However, the ratio of actual-to-predicted mortality (0.80) suggested that the individuals in the MA data set were less likely to die than would be predicted had those individuals been enrolled in FFS Medicare. Differences between actual and predicted mortality were particularly pronounced in low income (dual eligibility), nonwhite race, high morbidity, and Health Maintenance Organization (HMO) subgroups. After controlling for baseline clinical risk as represented by claims diagnosis data, mortality differences favoring MA over FFS Medicare persisted, particularly in vulnerable subgroups and HMO plans. These findings suggest that differences in morbidity do not fully explain differences in mortality between the 2 programs

Stage fright: its experience as a problem and coping with it

Purpose and method: This questionnaire survey of 190 university music students assessed negative feelings of music performance anxiety (MPA) before performing, the experience of stage fright as a problem, and how closely they are associated with each other. The study further investigated whether the experience of stage fright as a problem and negative feelings of MPA predict the coping behavior of the music students. Rarely addressed coping issues were assessed, i.e., self-perceived effectiveness of different coping strategies, knowledge of possible risks and acceptance of substance-based coping strategies, and need for more support. Results: The results show that one-third of the students experienced stage fright as a problem and that this was only moderately correlated with negative feelings of MPA. The experience of stage fright as a problem significantly predicted the frequency of use and the acceptance of medication as a coping strategy. Breathing exercises and self-control techniques were rated as effective as medication. Finally, students expressed a strong need to receive more support (65%) and more information (84%) concerning stage fright. Conclusion: Stage fright was experienced as a problem and perceived as having negative career consequences by a considerable percentage of the surveyed students. In addition to a desire for more help and support, the students expressed an openness and willingness to seriously discuss and address the topic of stage fright. This provides a necessary and promising basis for optimal career preparation and, hence, an opportunity to prevent occupational problems in professional musician

A Phenomenological Study: Examining Resilience in Native American Women Who Witnessed Domestic Violence in Childhood and Experienced Domestic Violence in Adulthood

Domestic violence has significant acute and long-lasting harmful effects on the well-being of women from all backgrounds with higher rates of psychological effects in ethnic minority populations. Native American women experience domestic violence at disproportionate rates and face unique barriers in overcoming challenges of healing from domestic violence. Even though the impact of domestic violence in children and adults is well-studied, research in rural and Native American populations is scarce. Women who have witnessed or experienced domestic violence in childhood have identified challenges and strengths and developed coping strategies to help them endure and adapt to surviving domestic violence in adulthood. Individuals face a wide range of risk factors and protective variables, which affect how effectively they are able to overcome challenges and develop resilience. As part of a larger study, this research aims to better understand the healing process of Native American women domestic violence survivors. The study examined adverse and protective factors identified by survivors during childhood and how they have shaped resilience in adulthood. The research employed a hermeneutic phenomenology methodology that is centered on the concept that knowledge is achievable via personal experience and insights. The themes that emerged included dysfunctional adaptation, fostering fortitude, and disrupting the cycle. Survivors provided valuable insights into their perspective of the resilience process. The results of the present study suggested that outreach, preventative, and instructional programs should be expanded, with an emphasis on creating conditions that are safe, supportive, and informative for both individuals and the communities

Exploring the Interplay between Testosterone Levels and Gender Role Attitudes

Traditional gender role attitudes align men with resource management and women with nurturing. The Challenge Hypothesis proposes that resource management is associated with higher testosterone levels, whereas nurturing is associated with lower testosterone levels. Therefore, traditional gender role attitudes may be associated with people’s testosterone levels. Furthermore, during the transition to parenthood, traditional gender role attitudes may become particularly salient, as shifting biological, social, and cultural roles during this transition make these attitudes an integral part of daily life. In this longitudinal study of expectant couples, participants completed a baseline survey and baseline session, during which they completed measures and provided saliva samples for testosterone analysis. Although the longitudinal study included additional time points, this analysis focused on baseline data only. Using baseline data from 113 couples (226 individuals), I examined the association between traditional gender role attitudes and testosterone levels. I hypothesized that the association between traditional gender role attitudes and testosterone would be moderated by gender. Among expectant fathers I predicted testosterone would be positively associated with traditional attitudes, emphasizing resource management. Whereas, among expectant mothers, I predicted testosterone would be negatively associated with traditional gender role attitudes, emphasizing nurturing. Additionally, I explored whether these associations would be influenced by a partner\u27s gender role attitudes. I found the actor and partner effects were not significant. That is, the lack of significant effects from traditional gender role attitudes and their interactions in predicting testosterone. Therefore, my hypotheses were not supported