Stress Management Competency Framework in English policing.

BACKGROUND: The UK Health and Safety Executive's Stress Management Competency Framework and associated questionnaire, the Stress Management Competency Indicator Tool (SMCIT), address line managers' behaviours across four competency areas. The application in policing remains unexplored. AIMS: This study profiled English police officers' perception of their line managers' competencies in the framework areas. The odds of experiencing poor mental wellbeing and work attitudes associated with having a line manager with a development need on each competency area were tested. METHODS: Two hundred and sixty-three police officers completed a survey comprising the SMCIT and measures of psychological distress, resilience and work engagement. Bivariate correlations were calculated to identify patterns of relationships between variables. Binary logistic regression analyses tested the odds of psychological distress caseness, low resilience and low work engagement being associated with officers' perception of their line manager having a development need on the SMCIT criteria. RESULTS: Approximately half the participants reported their line manager had a development need on the 'Managing and Communicating Existing and Future Work', 'Managing the Individual Within the Team' and 'Reasoning and Managing Difficult Situations' competencies, and one quarter on the 'Respectful and Responsible: Managing Emotions and Having Integrity' competency. Officers' rating of their line manager having a development need on the four competency areas was associated with up to four-fold elevated odds of each undesirable state. CONCLUSIONS: The framework competency areas are relevant to English policing and offer a basis for stress reduction interventions targeted at line managers' behaviours.

An evolving view of Saturn's dynamic rings.

We review our understanding of Saturn's rings after nearly 6 years of observations by the Cassini spacecraft. Saturn's rings are composed mostly of water ice but also contain an undetermined reddish contaminant. The rings exhibit a range of structure across many spatial scales; some of this involves the interplay of the fluid nature and the self-gravity of innumerable orbiting centimeter- to meter-sized particles, and the effects of several peripheral and embedded moonlets, but much remains unexplained. A few aspects of ring structure change on time scales as short as days. It remains unclear whether the vigorous evolutionary processes to which the rings are subject imply a much younger age than that of the solar system. Processes on view at Saturn have parallels in circumstellar disks.

Water vapour jets inside the plume of gas leaving Enceladus.

A plume of water vapour escapes from fissures crossing the south polar region of the Saturnian moon Enceladus. Tidal deformation of a thin surface crust above an internal ocean could result in tensile and compressive stresses that would affect the width of the fissures; therefore, the quantity of water vapour released at different locations in Enceladus' eccentric orbit is a crucial measurement of tidal control of venting. Here we report observations of an occultation of a star by the plume on 24 October 2007 that revealed four high-density gas jets superimposed on the background plume. The gas jet positions coincide with those of dust jets reported elsewhere inside the plume. The maximum water column density in the plume is about twice the density reported earlier. The density ratio does not agree with predictions-we should have seen less water than was observed in 2005. The ratio of the jets' bulk vertical velocities to their thermal velocities is 1.5 +/- 0.2, which supports the hypothesis that the source of the plume is liquid water, with gas accelerated to supersonic velocity in nozzle-like channels.

Enceladus' water vapor plume.

The Cassini spacecraft flew close to Saturn's small moon Enceladus three times in 2005. Cassini's UltraViolet Imaging Spectrograph observed stellar occultations on two flybys and confirmed the existence, composition, and regionally confined nature of a water vapor plume in the south polar region of Enceladus. This plume provides an adequate amount of water to resupply losses from Saturn's E ring and to be the dominant source of the neutral OH and atomic oxygen that fill the Saturnian system.

Treatment for the procoagulant state in type 2 diabetes.

A procoagulant state has been found to exist in diabetes mellitus. There may be activation of the intrinsic coagulation system, decreased fibrinolytic activity, or alterations in platelet function. Intensive glycemic control with insulin is effective in reducing the impact of this procoagulant state by favorably affecting all three components of the system. Decreased fibrinolytic activity, as influenced by plasma PAI-1 levels, may be favorably affected by weight loss, exercise, a low-GI diet, or by metformin, thiazolidinediones, gemfibrozil, and ACE inhibitor therapy. Insulin has variable effects on plasma PAI-1 activity. Estrogens will lower the elevated PAI-1 levels seen in the menopausal state. Collaborative trial evidence supports the use of low-dose aspirin as a primary or secondary prevention strategy in diabetic persons who are at high cardiovascular risk. A recent study suggests that this category includes virtually every type 2 diabetic individual in the United States. The American Diabetes Association recommends enteric-coated aspirin, 81 to 325 mg/day, as the first choice. In the case of aspirin allergy, clopidrogel is an alternate choice. Thus, recognition of and therapy for a procoagulant state in diabetes mellitus is likely to result in a decrease in the atherothrombotic events that characterize the later stages of this disease.

Aerodynamical sticking of dust aggregates.

We present results of collision experiments of a dense beam of aggregated 1.2 microm SiO2 particles entrained in a gas flow with metal targets of different widths. Depending on the target width (d=25.4, 50.8, and 127 microm) and the ambient gas pressure (p=0.5-2.0 mbar), the growth of a dust pile on the target begins at a threshold impact speed (v(imp)=6-12.5 m/s). These threshold velocities for sticking exceed the limit for total disruption of aggregates by more than a factor of 5-10 for the given parameters. We found that a significant number of fragments (single particles) from the collisions had a very low coefficient of restitution c(r) at least down to c(r)<0.05 that is much lower than the value c(r)>0.5 that one of the single solid micron-sized particles would have while impinging a rigid target. Due to the drag of the gas flow these slow fragments are forced back to the target a second time resulting in sticking that eventually leads to the formation of the dust pile in spite of the high impact velocities. Together, the fragmentation, the low coefficients of restitution of a significant number of fragments, and the gas flow provide an efficient growth mechanism for bodies that would otherwise lose mass. We consider this an important mechanism for the formation of planetesimals in the solar nebula.

The state of the standard diversion.

A fecal or urinary diversion is frequently recommended for a variety of patient conditions. This article will review some of the history of stoma creation, discuss current practices in stoma care, and summarize the current literature regarding stomal complications. Outcomes of fecal and urinary diversion procedures will be depicted, and postoperative quality of life will be described. An update of current ostomy equipment will be presented, along with the crucial role of the WOC nurse in stoma care rehabilitation. Areas for future research in the ongoing drive for evidence-based practice will be highlighted.

Effect of intensive glycemic control on microalbuminuria in type 2 diabetes. Veterans Affairs Cooperative Study on Glycemic Control and Complications in Type 2 Diabetes Feasibility Trial Investigators.

OBJECTIVE: Microalbuminuria can reflect the progress of microvascular complications and may be predictive of macrovascular disease in type 2 diabetes. The effect of intensive glycemic control on microalbuminuria in patients in the U.S. who have had type 2 diabetes for several years has not previously been evaluated. RESEARCH DESIGN AND METHODS: We randomly assigned 153 male patients to either intensive treatment (INT) (goal HbA(1c) 7.1%) or to standard treatment (ST) (goal HbA(1c) 9.1%; P = 0.001), and data were obtained during a 2-year period. Mean duration of known diabetes was 8 years, mean age of the patients was 60 years, and patients were well matched at baseline. We obtained 3-h urine samples for each patient at baseline and annually and defined microalbuminuria as an albumin:creatinine ratio of 0.03-0.30. All patients were treated with insulin and received instructions regarding diet and exercise. Hypertension and dyslipidemia were treated with similar goals in each group. RESULTS: A total of 38% of patients had microalbuminuria at entry and were evenly assigned to both treatment groups. INT retarded the progression of microalbuminuria during the 2-year period: the changes in albumin:creatinine ratio from baseline to 2 years of INT versus ST were 0.045 vs. 0.141, respectively (P = 0.046). Retardation of progressive urinary albumin excretion was most pronounced in those patients who entered the study with microalbuminuria and were randomized to INT. Patients entering with microalbuminuria had a deterioration in creatinine clearance at 2 years regardless of the intensity of glycemic control. In the group entering without microalbuminuria, the subgroup receiving ST had a lower percentage of patients with a macrovascular event (17%) than the subgroup receiving INT (36%) (P = 0.03). Use of ACE inhibitors or calcium-channel blockers was similarly distributed among the groups. CONCLUSIONS: Intensive glycemic control retards microalbuminuria in patients who have had type 2 diabetes for several years but may not lessen the progressive deterioration of glomerular function. Increases in macrovascular event rates in the subgroup entering without albuminuria who received INT remain unexplained but could reflect early worsening, as observed with microvascular disease in the Diabetes Control and Complications Trial.

Photoelectric charging of dust particles in vacuum.

Photoelectric charging measurements are presented of dust grains in vacuum for isolated grains and for grains near a photoemissive surface. Isolated grains reach a positive-equilibrium floating potential, dependent upon the work function of the particle, which causes the emitted electrons to be returned. Grains dropped past a photoemitting surface reach a negative floating potential for which the sum of the emitted and collected currents is zero. The particles tested are 90-106 microm in diameter and are composed of Zn, Cu, graphite, and glass.

Two years of intensive glycemic control and left ventricular function in the Veterans Affairs Cooperative Study in Type 2 Diabetes Mellitus (VA CSDM).

OBJECTIVE: The Veterans Affairs Cooperative Study in Type 2 Diabetes Mellitus (VA CSDM) was a multicenter randomized prospective study of 153 male type 2 diabetic patients to assess the ability to sustain clinically significant glycemic separation between intensive and standard treatment arms. A trend toward an excess of combined cardiovascular events in the intensive treatment arm of this trial was reported earlier. The present analysis was done to evaluate the effect of 2 years of intensive glycemic control on the left ventricular (LV) function. RESEARCH DESIGN AND METHODS: The patients were randomized to intensive step treatment with insulin alone or with sulfonylurea (intensive treatment arm [INT], n = 75) or to standard once-daily insulin injection (standard treatment arm [STD], n = 78) treatment. A total of 136 patients (standard treatment arm [STD], n = 70; INT, n = 66) had radionuclide ventriculography at entry and at 24 months for the assessment of LV function. RESULTS: There was no difference in the mean LV ejection fraction (at entry: STD 57.1+/-9.51%; INT 58.1+/-8.7%; at 24 months: STD 57.3+/-10.8%, INT 59.5+/-10.7%), peak filling rate (at entry: STD 2.6+/-0.7 end diastolic volume per second, INT 2.4+/-0.8 end diastolic volume per second; at 24 months: STD 2.7+/-1.0 end diastolic volume per second, INT 2.5+/-0.7 end diastolic volume per second), or time to peak filling rate (at entry: STD 195.3+/-69.5 ms, INT 185.6 +/-62.4 ms; at 24 months: STD 182.6+/-64.8 ms, INT 179.2+/-61.2 ms) between the 2 treatment arms. A subgroup analysis of 104 patients (STD, n = 53; INT, n = 51) that omitted individuals with intervening cardiac events/revascularization or a change in cardioactive medications also showed no difference in the LV function at entry and at 24 months between the 2 groups. Abnormal LV ejection fraction at baseline predicted cardiac events (interval between cardiac beats [RR] = 2.5). CONCLUSIONS: Two years of intensive glycemic control does not affect the LV systolic or diastolic function in patients with type 2 diabetes.

Negative correlates of computer game play in adolescents.

There is some concern that playing computer games may be associated with social isolation, lowered self-esteem, and aggression among adolescents. Measures of these variables were included in a questionnaire completed by 204 year eight students at a North London comprehensive school. Principal components analysis of a scale to assess needs fulfilled by game play provided some support for the notion of 'electronic friendship' among boys, but there was no evidence that game play leads to social isolation. Play was not linked to self-esteem in girls, but a negative relationship was obtained between self-esteem and frequency of play in boys. However, self-esteem was not associated with total exposure to game play. Aggression scores were not related to the number of games with aggressive content named among three favourite games, but they were positively correlated with total exposure to game play. A multiple regression analysis revealed that sex and total game play exposure each accounted for a significant but small amount of the variance in aggression scores. The positive correlation between playing computer games and aggression provides some justification for further investigation of the causal hypothesis, and possible methodologies are discussed.

A review of radiation proctitis in the treatment of prostate cancer.

Pelvic radiation is a common therapy for the treatment of prostate cancer. A complication of this therapy, radiation proctitis, may be limited to the direct posttreatment period or it may appear as serious complications that occur months to years after therapy has been completed. Mucosal damage, present with both acute and chronic radiation proctitis, produces a variety of symptoms including mucoid diarrhea, pain upon defecation, serious rectal bleeding, stenosis, and fistula formation. The treatment of radiation proctitis is symptom related, and the goals of therapy include the prevention or correction of mucosal changes and eradication of rectal bleeding. This article will review the pathophysiology of radiation proctitis and its treatment.

The ability to detect unseen staring: a literature review and empirical tests.

There is evidence to suggest that individuals not only believe in their ability to detect an unseen gaze, but may genuinely be able to do so. The present study reviewed past research and sought to determine whether such a phenomenon was empirically demonstrable. In Expt 1, 12 participants responded to 12 sequences (with feedback in the last nine) of 20 trials each, with staring or non-staring episodes based on Sheldrake's random number sequences. No effects were obtained when no feedback was given. With feedback, more accurate than mean chance expectation (MCE) results were obtained on staring, but no difference on non-staring trials. However other 'normal' explanations of ESP phenomena discuss the possibility of matching in bias between experimental sequences and participants' representations of randomness. Tests of the sequences found more alternations than expected, a feature typical of subjective randomness, but the increase in accuracy found on staring trials only was not consistent with this explanation. It was concluded that the improvement in accuracy with feedback is likely to be due to implicit learning, given the structure in non-random sequences. This hypothesis was supported in Expt 2 where 12 participants responded to 12 'genuinely random' sequences, and no differences in accuracy from MCE were obtained.

Dental endosseous implant assessments in a type 2 diabetic population: a prospective study.

Diabetes mellitus, a prevalent disorder worldwide, is associated with systemic adverse sequelae, such as wound healing alterations, which may affect osseointegration of dental implants. This prospective multicenter study assessed the success of 2-stage endosseous root-form implants (3 different implant systems) placed in the mandibular symphysis of 89 male type 2 diabetic subjects. The implants were uncovered approximately 4 months after placement, restored with an implant-supported, Hader bar clip-retained overdenture, and maintained at scheduled follow-up data collection examinations for 60 months after loading. Sixteen (9.0%) of the 178 implants failed. Life table methods calculated implant survival at approximately 88%, from prosthesis placement through the 60-month follow-up, and at approximately 90% from implant placement through the observation period. No implants failed between surgical placement and uncovering, 5 failed at uncovering, 7 failed after uncovering before prosthesis placement, and 4 failed after prosthesis placement. Fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c) values were determined before implant placement (baseline) and approximately 4 months later at surgical uncovering (follow-up). The 5-year implant outcomes (successes versus failures) were analyzed against the following predictor variables: (1) baseline and follow-up FPG values, (2) baseline and follow-up HbA1c values, (3) subject age, (4) duration of diabetes (years), (5) baseline diabetic therapy, (6) smoking history, and (7) implant length. Regression analysis found only duration of diabetes (P < .025) and implant length (P < .001) to be statistically significant predictors of implant failure. There was no statistically significant difference in failure rates between the 3 different implant systems used. This study supports the use of dental implants in type 2 diabetic patients.

Pathogenesis of vascular disease.

Only recently are we beginning to understand the complex interplay of factors involved in vascular disease and diabetes. Insulin resistance provides a starting point to explain the many factors that lead to the more severe vascular disease characteristic of diabetes. Insulin resistance syndrome comprises insulin resistance and compensatory hyperinsulinaemia as well as hypertension, dyslipidaemia, macrovascular disease, and increased plasminogen activator inhibitor-1 activity. The development of type 2 diabetes may be viewed as the inability of the pancreas to continue to overcome insulin resistance, even with excessive insulin production.