Building resilience with the Stress Resilience Training System: Design validation and applications.

Background: Resilience to stress is critical in today's military service. Past work has shown that experts handle stress in more productive ways compared to novices. Training that specifically addresses stress regulation, such as the Graduated Stress Exposure paradigm, can build individual and unit resilience as well as adaptability so that stressors trigger effective stress coping skills rather than stress injury.

Police department personnel stress resilience training: an institutional case study.

The objective of this case study was to test the impact in law enforcement personnel of an innovative self-regulation and resilience building program delivered via an iPad (Apple Inc, Cupertino, California) app and personal mentoring. The Stress Resilience Training System (SRTS) app includes training on stress and its effects, HRV coherence biofeedback, a series of HeartMath self-regulation techniques (The Institute of HeartMath, Boulder Creek, California), and HRV-controlled games. The stressful nature of law enforcement work is well established, and the need for meaningful and effective stress resilience training programs is becoming better understood, as it has been in the military.

Flaw strength distributions and statistical parameters for ceramic fibers: the normal distribution.

The present paper investigates large sets of ceramic fibre failure strengths (500 to 1000 data) produced using tensile tests on tows that contained either 500 or 1000 filaments. The probability density function was determined through acoustic emission monitoring which allowed detection and counting of filament fractures. The statistical distribution of filament strengths was described using the normal distribution.

Leadership 99. Interview by Terese Hudson.

Cost control, customer service and collaboration among health care sectors rank as top concerns with panelists in H&HN's annual Leadership Report. Efforts to improve community health are a priority, too, but are often frustrated by financial and other constraints. The 16 panelists represent managed care, physicians, and hospitals and health systems.

Life-threatening, antiglobulin test-negative, acute autoimmune hemolytic anemia due to a non-complement-activating IgG1 kappa cold antibody with Pra specificity.

A 21-year-old man with fulminant cold autoantibody hemolytic anemia (CAHA) was hospitalized with hemoglobinemia, hemoglobinuria, hemoglobin concentration of 3.3 gm per dL, a negative direct antiglobulin test (DAT) with polyspecific and anti-C3d reagents, a negative Donath-Landsteiner test, and a cold agglutinin titer of 80. He failed to respond to corticosteroids, multiple plasma exchanges, and cyclophosphamide; he required 54 transfusions in 10 days to maintain a hemoglobin concentration of 6.

Cancer surveillance. Who stands to benefit?

Currently, surveillance or risk-oriented follow-up of patients in the individual practice setting may be the most efficacious means of reducing the morbidity and mortality associated with selected types of cancer. Intervention into carcinogenesis or alteration of the natural history of cancer requires a clear understanding of the pathogenesis of the disease and patient acceptance of interval surveillance. Because etiologic information and patient compliance are frequently limited, careful scrutiny of recommendations for cancer screening or prevention is essential.

Effects of altered porphyrin synthesis on brain neurochemistry.

Lead is one of several environmentally significant substances which alter porphyrin synthesis in several organs. Biochemically, the consequences of both acute and chronic lead exposure, at relatively low dose, are increases in tissue and plasma levels of the porphyrin precursor aminolevulinic acid (ALA) and inhibition of the enzyme ALA dehydrase. These effects are considered for their possible role in the neurotoxicity associated with lead exposure.

Clinical trial of desferrioxamine entrapped in red cell ghosts.

Ten patients with excess body iron stores of different levels and with different diagnoses were given desferrioxamine inside osmotically lysed and resealed red blood cells (red cell ghosts). Red cell ghost entrapped desferrioxamine was given intravenously and, ten days later, an equal dose of desferrioxamine was administered via slow subcutaneous infusion over 10 h. Differences were apparent for these single dose challenges with respect to the pattern of urine iron excretion and the efficiency of iron chelation.

Hepatic protoporphyrin production in human protoporphyria. Effects of intravenous hematin and analysis of erythrocyte protoporphyrin distribution.

Human protoporphyria with atypical features suggesting increased hepatic protoporphyrin synthesis was investigated in 2 patients. Analysis of the distribution of protoporphyrin among circulating erythrocytes of increasing age indicated that the erythrocyte porphyrin burden derived predominantly from erythroid sources in case 1, and from hepatic sources in case 2. Intravenous hematin was administered to both patients to assess any negative feedback effect on protoporphyrin synthesis.

Hematin therapy for acute porphyria.

1. A therapeutic trial of intravenous hematin is presented. Eleven cases of AIP and one of VP who did not improve with conventional treatment (high carbohydrate intake) received this new agent.

Hematin administration to an adult with lead intoxication.

Lead poisoning and acute intermittent porphyria (AIP) may exhibit similar neurologic manifestations, and they have in common elevated excretion of urinary aminolevulinic acid (ALA). Despite their similarities, the possible pathophysiologic connection between AIP and lead poisoning in not known. Because intravenous hematin administration has produced biochemical improvement in AIP, a hematin trial in lead intoxication was of interest with respect to some of the heme metabolism abnormalities observed in the condition.

Family evaluations in acute intermittent porphyria using red cell uroporphyrinogen I synthetase.

Acute intermittent porphyria (AIP) is a primary disorder of haem biosynthesis that is chemically characterised by raised urinary porphobilinogen (PBG). A defect in the biochemical pathway at the step of PBG conversion to uroporphyrinogen has been shown to be a result of a partial deficiency of the enzyme uroporphyrinogen I synthetase (uro I syn). The ascertainment rate of latent AIP (that is, chemically manifest but clinically asymptomatic) was examined in 185 individuals from 12 AIP kindreds using three parameters: red cell uro I syn, quantitative urinary PBG, and pedigree analysis with respect to uro I syn.

Idiopathic hemochromatosis in a young female. A case study and review of the syndrome in young people.

Idiopathic hemochromatosis (iH) is typically a disease of older males. The case presented here describes a 26-yr-old woman with problems presenting heart failure, insulin-dependent diabetes, hepatomegaly, and secondary amenorrhea. The diagnosis was established by serum iron and transferrin saturation measurements, liver biopsy, and bone marrow examination for iron.

Danazol administration to females with menses-associated exacerbations of acute intermittent porphyria.

Acute intermittent porphyria (AIP) is a disorder of porphyrin metabolism in which the basic defect is a partial deficiency of uroporphyrinogen I synthase. The clinical disorder is more common in women, and some experience acute attacks before menstrual periods. Oral contraceptives have prevented menstrual-associated attacks in some cases, but exogenous estrogens and progestins are otherwise contraindicated in this disease.

Prevention of acute porphyric attacks by intravenous haematin.

A thirty-three-year-old female with acute intermittent porphyria (A.I.P.

Screening tests in acute porphyria.

Two recognized screening procedures for rapid evaluation of urinary porphobilinogen (PBG) concentrations are compared with quantitative PBG determinations (expressed as mg/24 hours and as a concentration in urine, mg/liter). One hundred ninety-one 24-hour urine specimens from 74 patients with suspected or documented acute type porphyria are included in this investigation. The two screening tests are compared with regard to sensitivity and method of performance.