Biofeedback Training in Crisis Managers: A Randomized Controlled Trial.

Working in crisis environments represents a major challenge, especially for executive personnel engaged in directing disaster operations, i.e. crisis managers. Crisis management involves operating under conditions of extreme stress resulting, for instance, from high-level decision-making, principal responsibility for personnel, multitasking or working under conditions of risk and time pressure. The present study aimed to investigate the efficacy of a newly developed biofeedback training procedure based on electrodermal activity, especially designed for the target group of crisis managers. The training comprised exercises promoting acquisition of control over sympathetic arousal under resting conditions and during exposure to visual, acoustic and cognitive stressors resembling situations related to crisis management. In a randomized controlled design, 36 crisis managers were assigned to either a biofeedback training group or waiting list control group. Subjective stress was assessed using the Perceived Stress Scale. In the training group, stress level markedly decreased; the decrease remained stable at follow-up 2 months after the training. The results indicate that biofeedback training in crisis management is an effective method for stress management that may help to reduce vulnerability to stress-related performance decline and stress-related disease.

[Nutrition and IBD-Consensus of the Austrian Working Group of IBD (Inflammatory Bowel Diseases) of the ÖGGH]. / Ernährung und chronisch entzündliche Darmerkrankungen - ein Konsensus der Arbeitsgruppe chronisch entzündliche Darmerkrankungen der Österreichischen Gesellschaft für Gastroenterologie und Hepatologie (Austrian Guidelines for nutrition in IBD).

This is a consensus of the Austrian working group of IBD (inflammatory bowel diseases) of the ÖGGH on nutrition in IBD. Malnutrition should be assessed in case of IBD (in 20 - 70 % of Crohn's patients) and weight loss(> 5 % within 3 months) or nutritional deficiencies or after extensive bowel resection and afterwards also treated. Malnutrition should be treated with medical therapy of IBD and also adequate - as far as possible - with oral nutritional therapy particularly because of reduced life quality, risk of opportunistic infections, osteopenia/osteoporosis, longer hospitalisations and higher mortality. Iron homeostasis, serum levels of Vitamin B12- and folic acid, 25-hydroxyvitamin D and zinc should be checked. Therapy with enteral liquid diets is only indicated as therapy of first choice in children and adolescents, but only in rare situations in adults with IBD. There is - up to now - no proven oral diet for maintenance of remission in IBD. Probiotics as E. coli Nissle could be used as alternative to mesalazine for maintenance of remission in patients with ulcerative colitis. A specific dietary counselling is mandatory in patients with ileostoma or short bowel syndrome. Malnutrition of short bowel patients is particularly dependent on the function and length of the remaining bowel, therefore the most effective medical therapy should be administered.

Sequence based high resolution chromosomal CGH.

We aimed to directly align a chromosomal CGH (cCGH) pattern with the gene mapping data by taking advantage of the clustering of the GGCC motif at certain positions in the human genome. The alignment of chromosomal with sequence data was achieved by superimposition of (i) the fluorescence intensity of the sequence specific fluorochrome, Chromomycin A3 (CMA3), (ii) the cCGH fluorescence intensity profile of individual chromosomes and (iii) the GGCC density profile extracted from the Ensembl genome sequence database. The superimposition of these three pieces of information allowed us to precisely localize regions of amplification in the neuroblastoma cell line STA-NB-15. Two prominent cCGH peaks were noted, one at 2p24.3, the position 15.4 mega base (Mb), and the other at 2p23.2, 29.51 Mb. FISH and high resolution array CGH (aCGH) experiments disclosed an amplification of MYCN (16 Mb) and ALK (29.2-29.9 Mb), thus confirming the cCGH data. The combined visualization of sequence information and cCGH data drastically improves the resolution of the method to less than 2 Mb.

Efficacy of a single oral dose of a live bivalent E. coli vaccine against post-weaning diarrhea due to F4 and F18-positive enterotoxigenic E. coli.

F4- and F18-positive enterotoxigenic E. coli strains (F4-ETEC and F18-ETEC) are important causes of post-weaning diarrhea (PWD) in pigs. F4 (antigenic variant ac) and F18 (ab and ac) fimbriae are major antigens that play an important role in the early stages of infection. Herein, the efficacy of a live oral vaccine consisting of two non-pathogenic E. coli strains, one F4ac- and one F18ac-positive, was evaluated using F4ac-ETEC and F18ab-ETEC challenge models. A randomized, masked, placebo-controlled, block design, parallel-group confirmatory study with two different vaccination-challenge intervals (7 and 21 days) was conducted for each challenge model. The vaccine was administered in one dose, to ≥18-day-old piglets via drinking water. Efficacy was assessed by evaluating diarrhea, clinical observations, weight gain and fecal shedding of F4-ETEC or F18-ETEC. Anti-F4 and anti-F18 immunoglobulins in blood were measured. The vaccination resulted in significant reductions in clinical PWD and fecal shedding of F4-ETEC and F18-ETEC after the 7- and 21-day-post-vaccination heterologous challenges, except for after the 21-day-post-vaccination F4-ETEC challenge, when the clinical PWD was too mild to demonstrate efficacy. A significant reduction of mortality and weight loss by vaccination were observed following the F18-ETEC challenge. The 7-day protection was associated with induction of anti-F4 and anti-F18 IgM, whereas the 21-day protection was mainly associated with anti-F4 and anti-F18 IgA. The 7-day onset and 21-day duration of protection induced by this vaccine administered once in drinking water to pigs of at least 18days of age were confirmed by protection against F4-ETEC and F18-ETEC, and induction of F4 and F18-specific immunity. Cross protection of the vaccine against F18ab-E. coli was demonstrated for both the 7- and 21-day F18-ETEC challenges.

Synthesis and biological inactivity of some 4alpha,6-cyclo steroids.

Two different synthetic routes have been used to synthesize a series of cyclopropyl conjugated ketones in which 4alpha,6-unsaturation replaces the usual 4,5-unsaturation. The synthetic routes involve intramolecular ketocarbene addition to a 5-6 double bond and intramolecular 1,3-elimination of 6beta-substituted 5beta-3-keto steroids. Both routes give 5beta products. The analogs of progesterone, testoterone acetate, and norethisterone have been prepared and shown to be remarkably biologically inactive when compared with the corresponding standard. Possible reasons for such inactivity are discussed.

Electrical properties of a light-addressable microelectrode chip with high electrode density for extracellular stimulation and recording of excitable cells.

A light-addressable microelectrode chip with 3600 TiN electrodes was fabricated. Amorphous silicon (a-Si:H) serves as a photo conductor. The electrodes on the chip are addressed by a laser spot and electrical properties of the system are determined. DC measurements show a dark to bright dynamic of 10(6)-10(7). The AC impedance dynamic @ 1 kHz/100 mV and thus the signal-to-noise-ratio is determined to 60. This value is quite sufficient for electrophysiological measurements. For the first time, recordings from cardiac myocytes are reported using the principle of light-addressing. Measurements were done with a standard laser scan microscope (Zeiss LSM 410).

Release of a drug from homogeneous ointments containing the drug in solution.

The rate of release of resorcinol (5%) from hydrogels (Carbopol, sodium carboxymethylcellulose, starch), lipogels (alcoholic-base, esteric-bases containing different amounts of beeswax with and without a spreading additive, respectively) and Labrafils has been examined. For the experimental design adopted the release of the drug is linear between 10 and 70% of the amount of drug released. The results agree well with the mathematical model postulated by Higuchi (1962) for the release of a drug from homogeneous ointments containing the drug in solution.

Bacterial formation of phosphatic laminites off Peru.

Authigenic phosphatic laminites enclosed in phosphorite crusts from the shelf off Peru (10 degrees 01' S and 10 degrees 24' S) consist of carbonate fluorapatite layers, which contain abundant sulfide minerals including pyrite (FeS(2)) and sphalerite (ZnS). Low delta(34)S(pyrite) values (average -28.8 per thousand) agree with bacterial sulfate reduction and subsequent pyrite formation. Stable sulfur isotopic compositions of sulfate bound in carbonate fluorapatite are lower than that of sulfate from ambient sea water, suggesting bacterial reoxidation of sulfide by sulfide-oxidizing bacteria. The release of phosphorus and subsequent formation of the autochthonous phosphatic laminites are apparently caused by the activity of sulfate-reducing bacteria and associated sulfide-oxidizing bacteria. Following an extraction-phosphorite dissolution-extraction procedure, molecular fossils of sulfate-reducing bacteria (mono-O-alkyl glycerol ethers, di-O-alkyl glycerol ethers, as well as the short-chain branched fatty acids i/ai-C(15:0), i/ai-C(17:0) and 10MeC(16:0)) are found to be among the most abundant compounds. The fact that these molecular fossils of sulfate-reducing bacteria are distinctly more abundant after dissolution of the phosphatic laminite reveals that the lipids are tightly bound to the mineral lattice of carbonate fluorapatite. Moreover, compared with the autochthonous laminite, molecular fossils of sulfate-reducing bacteria are: (1) significantly less abundant and (2) not as tightly bound to the mineral lattice in the other, allochthonous facies of the Peruvian crusts consisting of phosphatic coated grains. These observations confirm the importance of sulfate-reducing bacteria in the formation of the phosphatic laminite. Model calculations highlight that organic matter degradation by sulfate-reducing bacteria has the potential to liberate sufficient phosphorus for phosphogenesis.

The professional image of medical record practitioners.

The medical record profession is currently being provided with an excellent opportunity for growth. The recognition of professional status by others is an important objective in the growth of any occupation. This article reports on a study undertaken to examine the perceptions of the professional image of medical record practitioners by members of the profession and by members of other health care disciplines.

The professional image of medical record practitioners: perceptions from administrative officers, financial officers, and chiefs of medical staffs.

The study's findings provide insights into the relationship between medical record practitioners and the disciplines whose members were surveyed. This relationship is an important one. Much has been written about the team concept in the provision of care. Teamwork and maintaining a mutually respectful relationship is just as important to the administrative aspects of health care. A positive professional image is a prerequisite for gaining respect. Nurturing a positive professional image is the responsibility of individual practitioners as well as the medical record profession as a collective entity. One way in which these findings can be utilized is for self analysis of MRPs: how would they evaluate themselves and how they perceive others would evaluate them. Answers to these questions may suggest areas where improvement in necessary. A second way in which findings can be used is in the recruitment arena. Positive findings can be used as recruiting and marketing tools to attract potential members into the medical record profession. Efforts in the recruitment area are necessary to meet predicted manpower shortages in the profession. While the study assisted in the understanding of the relationship of MRPs and other professionals with whom they must work closely, further study is necessary. This study's response rate and limitations to the parameters may preclude generalization; therefore, replication of the study is needed before findings can be universally applied. Additional study is necessary to determine others' perceptions of not only the image of MRPs but the identity as well. Are MRPs perceived as safekeepers of medical records or as health information leaders?

The use of work teams: a help or hindrance to performance?

The use of work teams is a popular topic in business literature. Although there is a growing literature on this topic, the team concept is not new to organizations. The article examines historical developments in the use of teams for performance of work. The use of work teams is discussed in the context of the movement away from hierarchical, bureaucratic management structures and toward participative decision making. The benefits of and problems with self-directed teams, in particular, are explored.

Health care-oriented telecommunications: the wave of the future.

This article has examined the impact that telecommunications technologies may have on the way in which health care services are delivered. A number of scenarios of how that might occur were discussed. Some of these scenarios are already being realized. Telemedicine, for instance, is being used in certain geographic regions of the United States. Various community health information networks are in the developmental stages or at varying degrees of operability. Two such networks in Colorado and Wisconsin were offered as examples. The impact of these developments on confidentiality and security of patient information, issues central to the responsibilities of health information managers, has been discussed. These technological advancements will have consequences for health information managers in other ways, too. The types of tasks that are performed and how those tasks are performed related to storing and retrieving information will be different in the future. In the transition period, blurring of job functions may occur as different types of practitioners strive to carve their niche in the electronic environment. For instance, as electronic patient records are linked to bibliographic databases of medical literature, where do the responsibilities of health information managers end and medical librarians begin? The best way to ensure a position on the health care team of the future is to recognize the opportunities provided by this dynamic period in health care.

Health information management in the computer era.

Medical record professionals are confronted with change at practically every front. Technologic advancements are changing the technical aspects of our job responsibilities. These advancements also have implications for the interpersonal aspects of our jobs. The effect of new technology on working relationships is exacerbated by the introduction of TQM, which also encourages a change in organizational relationships through a move away from traditional heirarchical management by fostering teamwork and staff empowerment. The changes that are transforming health care organizations can be viewed in two lights: (1) as unwanted hindrances to accomplishment or (2) as opportunities to enhance accomplishment. Medical record professionals are presented with unprecedented opportunities to enhance our accomplishments and maximize our position in health care facilities. We cannot long for the way things were or be satisfied with the status quo. Such action (or lack thereof) will only ensure that our role on the health care team will be taken over by someone else. To capitalize on the opportunities presented, medical record professionals must hone the knowledge and skills we already possess, gain other knowledge and skills necessary to function in the computerized environment, and, most of all, be proactive rather than reactive. Such action will ensure that we truly become health information managers.

[Lead, cadmium and mercury carry-over to meat products by spices and condiments]. / Blei-, Cadmium- und Quecksilbereintrag durch Gewürze und Gewürzzubereitung in Wurstwaren.

The lead and cadmium contents of 50 species and 19 condiments were investigated by means of flameless atomic absorption spectrophotometry. Mercury contents were determined by cold vapor atomic absorption method including amalgamation. The mean concentrations of lead, cadmium, and mercury were 0.470 mg/kg, 0.080 mg/kg, and 0.005 mg/kg, respectively. By using the detected levels of these three heavy metals in model calculations only a small carry-over of lead, cadmium, and mercury in meat products by species and condiments can be assumed.

Inspiration inhibiting effect of etorphine-derivatives.

The inspiration inhibiting vagal reflex as elicited in rabbits by tracheal occlusion in inspiratory position, is strongly increased by etorphine and its derivatives, the 19-isoamylderivative benig of outstanding activity.

Computer aided assignment of motile Aeromonas strains to genospecies level by standard biochemical tests.

A procedure is given for differentiation of motile Aeromonas spp. Based on nine to 12 biochemical properties it allows an assignment of isolated Aeromonas strains first to phenotypes and, in the second step, to hybridization groups (HGs) 1-13 as well as to the genotypically defined species Aer. allosaccharophila and Aer. encheleia. The computer aided classification is carried out according to the principles of numerical taxonomy. Using this differentiation scheme 23 Aeromonas strains, which were isolated from food, and two reference strains were speciated. A total of 16 strains were assigned to Aer. hydrophila, six strains to Aer. caviae and one strain to Aer. sobria. Of the 16 Aer. hydrophile strains, 11 were attached to HG 1, one to HG 2 and four could not be classified clearly as HG 3 or HG 1. All six Aer. caviae isolated were assigned to HG 5 and the Aer. sobria strain was ranked among HG 8. The reference strains were assigned to the same genotypes by this method than by DNA-DNA hybridization assays.

[Alimentary intake of selected pollutants and nitrate--results of a duplicate study in Bavarian homes for youth and seniors]. / Die alimentäre Aufnahme von ausgewählten Schadstoffen und Nitrat--Ergebnisse einer Duplikatstudie in bayerischen Jugend- und Seniorenheimen.

In a duplicate study during 1987-1991, 478 24-h duplicate samples from 14 homes for elderly people and 10 homes for youth were investigated for their contents of selected harmful substances. The analyses covered 45 active substances of pesticides, 17 PCB-congeners as well as lead, cadmium, and nitrate contents. Pesticides could be detected only in 15% of the investigated samples. The pesticide contents reached max. 8% of the respective FAO/WHO-limits. As the mean intake of the three most important PCB-congeners (sum of the congeners 138, 153, and 180) values of 0.9 and 1.1 micrograms per day and ration or person, respectively, were found. Also in the worst case the daily PCB intake was below the recommended ADI value of the FDA of 1 microgram/kg of body weight. The daily nutritional intake of lead and cadmium via the investigated daily rations reached about 5.6% and 20% of the Provisionally Tolerably Weekly Intake values of the FAO/WHO. The mean nitrate content of the duplicate portions was 101 mg per day and person (median: 79 mg per day and person). Referred to the median value the WHO limit (3.65 mg/kg body weight and day) was exhausted to about 36%.

Space robotics--DLR's telerobotic concepts, lightweight arms and articulated hands.

The paper briefly outlines DLR's experience with real space robot missions (ROTEX and ETS VII). It then discusses forthcoming projects, e.g., free-flying systems in low or geostationary orbit and robot systems around the space station ISS, where the telerobotic system MARCO might represent a common baseline. Finally it describes our efforts in developing a new generation of "mechatronic" ultra-light weight arms with multifingered hands. The third arm generation is operable now (approaching present-day technical limits). In a similar way DLR's four-fingered hand II was a big step towards higher reliability and yet better performance. Artificial robonauts for space are a central goal now for the Europeans as well as for NASA, and the first verification tests of DLR's joint components are supposed to fly already end of 93 on the space station.

Rickettsial relative associated with papaya bunchy top disease.

The phylogeny of a previously unidentified, obligate laticifer-inhabiting bacterium associated with the papaya bunchy top disease was investigated. Portions of genes corresponding to those for 16S rRNA, the flavoprotein subunit of succinate dehydrogenase (SdhA), citrate synthase (GltA), and the 17-kDa rickettsial common antigen were isolated and sequenced from the non-cultivable bacterium from diseased plants. Comparative sequence analyses consistently indicated that the bacterium is a member of the alpha-subdivision of the Proteobacteria and of the genus Rickettsia. The rickettsia was detected by polymerase chain reaction in diseased, but not healthy, papaya tissues and in the leafhopper vector, Empoasca papayae, providing further evidence of the possible etiological role of the bacterium in the disease. Although Rickettsia have been found naturally in arthropods and can be pathogenic to humans and other vertebrates, this is the first evidence of its kind implicating a Rickettsia as a plant pathogen.