Stress in police officers: a study of the origins, prevalence and severity of stress-related symptoms within a county police force.

BACKGROUND: High levels of stress-related illness are causing concern across industry. Against a background of impending legislative moves to try to improve this situation, there is a need to identify key work-related stressors. Police work tends to be regarded as inherently stressful because of the personal risk of exposure to confrontation and violence and the day-to-day involvement in a variety of traumatic incidents. As a result, high levels of stress-related symptoms might be expected in this population. OBJECTIVE: To examine the sources of stress-related symptoms within police officers and measure the prevalence of significant associated mental ill-health. METHOD: A cross-sectional questionnaire survey of a population of 1206 police officers was performed to assess levels of strain associated with a series of potential home and work related stressors. Participants were then split into low and high scoring groups on the basis of a General Health Questionnaire (GHQ) threshold score in order to identify those stressors most associated with mental ill-health effects. RESULTS: Occupational stressors ranking most highly within the population were not specific to policing, but to organizational issues such as the demands of work impinging upon home life, lack of consultation and communication, lack of control over workload, inadequate support and excess workload in general. The high scoring group constituted 41% of the population and differed significantly from those with low scores in perception of all stressors, ranking both personal and occupational stressors more highly, and from personality constraints appeared significantly more 'stress-prone'. A significant association between gender and mental ill-health was found, with females more likely to score more highly on the GHQ than males. CONCLUSION: This study confirms previous findings of organizational culture and workload as the key issues in officer stress. Given that the degree of symptomatology appears to be worsening, management action is required. Further research is indicated within the police population into a possible increased susceptibility in female officers.

Solution structure of carnobacteriocin B2 and implications for structure-activity relationships among type IIa bacteriocins from lactic acid bacteria.

Carnobacteriocin B2 (CbnB2), a type IIa bacteriocin, is a 48 residue antimicrobial peptide from the lactic acid bacterium Carnobacterium pisicola LV17B. Type IIa bacteriocins have a conserved YGNGVXC sequence near the N-terminus and usually contain a disulfide bridge. CbnB2 seemed to be unique in that its two cysteines (Cys9 and Cys14) could be isolated as free thiols [Quadri et al. (1994) J. Biol. Chem. 26, 12204-12211]. To establish the structural consequences of the presence or absence of a disulfide bridge and to investigate if the YGNGVXC sequence is a receptor-binding motif [Fleury et al. (1996) J. Biol. Chem. 271, 14421-14429], the three-dimensional solution structure of CbnB2 was determined by two-dimensional (1)H nuclear magnetic resonance (NMR) techniques. Mass spectroscopic and thiol modification experiments on CbnB2 and on model peptides, in conjunction with activity measurements, were used to verify the redox status of CbnB2. The results show that CbnB2 readily forms a disulfide bond and that this peptide has full antimicrobial activity. NMR results indicate that CbnB2 in trifluoroethanol (TFE) has a well-defined central helical structure (residues 18-39) but a disordered N terminus. Comparison of the CbnB2 structure with the refined solution structure of leucocin A (LeuA), another type IIa bacteriocin, indicates that the central helical structure is conserved between the two peptides despite differences in sequence but that the N-terminal structure (a proposed receptor binding site) is not. This is unexpected because LeuA and CbnB2 exhibit >66% sequence identity in the first 24 residues. This suggests that the N-terminus, which had been proposed [Fleury et al. (1996) J. Biol. Chem. 271, 14421-14429] to be a receptor binding site of type IIa bacteriocins, may not be directly involved and that recognition of the amphiphilic helical portion is the critical feature.

Sex differences in route learning by children.

Differences between men and women have been reported with respect to route-learning, but sex differences in children on these and related tasks have not been found. In this study, 51 children ages 5 to 12 years were required to learn a route on a map to criterion and then asked to recall landmarks on that route. Boys made significantly fewer errors and took less time and fewer trials to reach criterion in learning the route, and girls recalled more landmarks than boys. Significant main effects for age were also noted on all measures of route learning and landmark recall. These results suggest that the patterns of route learning that have been ascribed to women and men are present in girls and boys.

Flucloxacillin in the treatment of atopic dermatitis.

Although colonization of atopic dermatitis by Staphylococcus aureus is universal and bacterial infection is common, it is not known whether antibiotic therapy is helpful in eczematous children who do not have any signs suggestive of bacterial infection. Fifty children aged 1-16 years with atopic dermatitis took part in a randomized double-blind placebo-controlled study of 4 weeks treatment with oral flucloxacillin, with an 8-week follow-up period. The change in the mean of the log10 of the counts/cm2 of S. aureus after 4 weeks of treatment was significantly different for patients receiving treatment, compared with the change for those receiving the placebo (P = 0.008). However, the difference in the change at 14 days after stopping treatment was not significant (P = 0.32). Methicillin-resistant strains of S. aureus were cultured from five children during or after treatment. Flucloxacillin did not improve the symptoms or clinical appearance of atopic dermatitis and only temporarily changed skin colonization by S. aureus.

Unusual beta-sheet periodicity in small cyclic peptides.

Cyclic peptide homologs of gramicidin S containing 6, 8, 10, 12, 14 and 16 residues were synthesized and characterized using circular dichroism (CD) and 1H NMR spectroscopy. Based on the three-dimensional structures generated from these data we have found strong evidence of a periodic sequence-length dependence on beta-sheet content. In particular, peptides of length 6, 10 and 14 residues exhibit a high beta-sheet content, while peptides of 8, 12 and 16 residues appear to exist as random coils. This unusual beta-sheet periodicity may have important implications in our understanding of beta-sheet formation and in the design of constrained beta-sheet and beta-hairpin mimics.

The possible influence of the menstrual cycle on the adherence of Candida albicans to human buccal epithelial cells in vitro.

Although the influence of the menstrual cycle on both vaginal candidosis and Candida albicans adherence to vaginal epithelial cells in vitro has been shown to be significant, similar studies have not been made on oral candidosis and adherence to buccal epithelial cells. The aim of this study was therefore to use an in vitro adherence assay to investigate the possible influence of the menstrual cycle on the adherence of C. albicans to buccal epithelial cells. Epithelial cells were collected from a single, healthy, female volunteer on days 5, 15, 22 and 28 of six menstrual cycles. Adherence of C. albicans was significantly higher to buccal epithelial cells collected on day 5 of the menstrual cycle when compared with days 15, 22 and 28, both in terms of the percentage of buccal epithelial cells with adherent C. albicans and the number of C. albicans adhering per 200 buccal epithelial cells in four out of six menstrual cycles (p < 0.001). This result indicates that hormonal influences should be considered when buccal epithelial cells are used in vitro to assess candidal adherence and may implicate hormonal factors in the aetiology of oral candidosis.

The influence of post-filtration washing on the in vitro assay of Candida albicans adherence to human buccal epithelial cells.

A simple in vitro assay technique was used to determine the effect of post-filtration washing on the adherence of C. albicans (NCPF 3736) to human buccal epithelial cells (BEC). Washing was carried out with a range of volumes of phosphate buffered saline (PBS), viz. 0, 5, 10 and 20 ml, at a standard flow rate. Both the number of C. albicans adherent to BEC and the percentage of BEC with adherent C. albicans were significantly decreased (p < 0.001 for each of these measures) after washing with 5 ml PBS. Further increases in the volume of PBS did not significantly decrease either measure of adherence. These data indicate that only a small volume of PBS, 5 ml, is required to achieve the removal of non-adherent C. albicans from the surface of BEC. The result of the adherence assay is not significantly affected by increasing the volume of PBS used. It is concluded that considerable savings in time may be made through using only a small (5 ml) volume of washing buffer at a standard flow rate.

The endodontic microflora revisited.

The microbial flora of 35 dental root canals were examined, taking care to maintain the viability of obligate anaerobes which accounted for 45% of total isolations, while streptococcal species accounted for 24% of the total species isolated. Individual root canals yielded a maximum of eight bacterial species. A total of 40 different species was isolated of which the most prevalent were the facultative anaerobe Streptococcus sanguis and the obligate anaerobe, Peptostreptococcus micros (both in 23% of root canals), followed by Eubacterium aerofaciens and the 'Streptococcus milleri group' (both 17%) then Prevotella melaninogenica (formerly Bacteroides melaninogenicus), Enterococcus faecalis and Prevotella oralis (formerly Bacteroides oralis), which were each isolated from 14% of root canals. Highly significant associations were discovered between four pairs of species, viz P. melaninogenica with P. micros, P. melaninogenica with P. oralis, Prevotella corporis with Streptococcus morbillorum and Actinomyces odontolyticus with E. faecalis.

Failure of oral zinc supplementation in atopic eczema.

An eight week double-blind placebo-controlled trial of oral zinc sulphate 185.4 mg per day was undertaken in 50 children with atopic eczema aged 1-16 years. In those receiving zinc there was no significant improvement in disease severity as assessed by surface area affected and degree of erythema, symptom scores of itch, sleep disturbance and redness of skin, or weight of emollient or topical steroid use.

Serum levels of trace metals in children with atopic eczema.

The hypothesis that atopic eczema is associated with a non-specific decrease in the serum concentration of trace metals was examined by measurement of the levels of zinc, copper and iron in 134 children with atopic eczema and 112 controls. The results failed to confirm the hypothesis. There was no significant difference between patients and controls for the concentrations of serum zinc, iron, iron-binding capacity and albumin. Patients with eczema had a significantly higher copper concentration (median 21.0 mumol/l) than controls (median 17.0 mumol/l), and a significantly lower concentration of ferritin (median 11.9 ng/ml for patients and 16.5 ng/ml for controls). There was a highly significant correlation between the surface area of skin affected by eczema and the concentrations of albumin and orosomucoid.

Collagen in dissecting aneurysms of the human thoracic aorta. Increased collagen content and decreased collagen concentration may be predisposing factors in dissecting aneurysms.

Biochemical investigations were made into dissecting aneurysms of the thoracic aorta by taking samples at 12 specific sites from aortas of 10 patients who had dissected with fatal results in comparison with samples from 10 matched controls. When sites actually involved in dissection were compared with corresponding sites in controls, there were highly significant increases in dry weight, amount of collagen, and total protein (all p less than 0.001) and a significant decrease in collagen concentration (p = 0.016). In contrast, when samples from sites within dissected aortas, but not involved in dissection, were compared with corresponding sites in controls, there were no significant differences. We therefore conclude that in dissecting aneurysms of the thoracic aorta, there is localized expansion of the aortic matrix, due to deposition of collagen and other proteins, which decreases the concentration of matrix constituents, including collagen. Clearly, the deposition of collagen could be a cause but not a consequence of dissection. The altered composition means that the aortic wall becomes weaker and less able to withstand the mechanical stresses constantly imposed upon it.

The improved recovery of Candida albicans from fluid culture media.

This study compares the mean generation time (MGT) and lag period of the growth of Candida albicans in four blood culture media, under a variety of conditions of incubation. The media compared were Bactec 6B, brain-heart infusion, malt extract broth and Sabourauds liquid medium. All four media were incubated under the eight possible permutations of the following conditions: 37 degrees C or 30 degrees C, vented or unvented, unshaken or constantly shaken. Then, using the incubation conditions found to be most favourable, minimum detection times for C. albicans were compared in the four media. The combination of incubation of the cultures at 37 degrees C, venting and constant-shaking, produced the fastest generation time with the minimum lag period. Of the media, Bactec 6B medium had the shortest lag period under these conditions while brain-heart infusion had the lowest MGT overall. Sabourauds liquid medium, which resulted in the most favourable combination of generation time and lag period, proved superior to the other media for the recovery of C. albicans.

Proximal femoral fractures: some determinants of outcome.

We identified 226 proximal femoral fractures prospectively in people aged over 60 years during one year in Stockport (population approximately 289,000). Our objective was to examine the association between primary treatment and outcome 6 months after the fracture using multivariate regression models. Higher haemoglobin concentrations and mental test scores on admission to hospital were associated with lower fatality within 6 months, whereas a high blood calcium-phosphate product, greater age, and an active medical problem at the time of the fracture were all associated with increased fatality. An intracapsular fracture, greater age, and a greater degree of dependency before the fracture all reduced the likelihood of regaining previous walking ability by 6 months. Good walking ability before the fracture increased the likelihood of walking well by 6 months. After adjusting for the effects of these extraneous variables there was no statistically significant association between treatment and outcome.