Stress and burnout in psychiatric professionals when starting to use dialectical behavioural therapy in the work with young self-harming women showing borderline personality symptoms.

The aim of the study was to investigate how starting to use dialectical behavioural therapy (DBT) in the work with young self-harming women showing symptoms of borderline personality disorder affected the psychiatric professionals (n = 22) experience of occupational stress and levels of professional burnout. The study was carried out in relation to an 18-month clinical psychiatric development project, and used a mix of quantitative and qualitative research methods [a burnout inventory, the Maslach burnout inventory-General Survey (MBI-GS), free format questionnaires and group interviews]. The result confirms previous reports that psychiatric health professionals experience treatment of self-harming patients as very stressful. DBT was seen as stressful in terms of learning demands, but decreased the experience of stress in the actual treatment of the patients. The teamwork and supervision were felt to be supportive, as was one particular facet of DBT, namely mindfulness training which some therapists felt also improved their handling of other work stressors not related to DBT. The inventory for professional burnout, the MBI-GS, showed no significant changes over the 18-month period, although there was a tendency for increased burnout levels at the 6-month assessment, which had returned to baseline levels at 18 months.

Monotherapy with amlodipine or atenolol versus their combination in stable angina pectoris.

BACKGROUND: The basic cause of angina pectoris is imbalance between the metabolic needs of the myocardium and the capacity of the coronary circulation to deliver sufficient oxygenated blood to satisfy these needs. HYPOTHESIS: The study was undertaken to evaluate whether the effect of combined amlodipine and atenolol therapy on patients with stable angina pectoris and with ST-depression during exercise testing and 48-h ambulatory electrocardiographic monitoring is superior to that of either agent given alone. METHODS: Patients with stable angina pectoris and ST depression during exercise and ambulatory monitoring were randomized to receive amlodipine (n = 116) or atenolol (n = 116), or both (n = 119). All patients were also treated with short- and long-acting nitrates. The design was a double-blind, randomized, triple-arm parallel group study with 10 weeks of administration of the test medication. RESULTS: In terms of time to onset of ST depression > 1 mm, time to onset of angina, total exercise time, maximum achieved workload, and peak intensity of angina, amlodipine and atenolol alone were as effective as their combination. During ambulatory monitoring, atenolol was more effective than amlodipine regarding total time and number of ST-depression episodes, and as effective as the combined drugs. CONCLUSION: For individual patients with stable angina pectoris, combination of a beta blocker with a calcium antagonist is not necessarily more effective than either drug given alone.

Preventive oral health behaviors among Detroit-area residents.

PURPOSE: It has been recommended that adults brush and floss their teeth daily and have periodic oral health checkups. A study was conducted to determine if those recommendations are followed. METHODS: Data were collected during face-to-face interviews with a probability sample of 662 dentate adults residing in the Detroit metropolitan area from August to November 1989. Participants were asked how frequently they brushed, flossed, and had checkups. They were also asked about the thoroughness with which they brushed and flossed, and about the advantages and disadvantages of all three behaviors. Descriptive statistics were calculated. RESULTS: The response rate was 72%. While 97% of subjects reported brushing at least once a day and 32% reported flossing at least once a day, 13% indicated they did not brush all teeth or all parts of teeth, and one-third of those who said they flossed daily did not floss all teeth. Seventy-three percent of respondents reported getting dental checkups at least once a year. For brushing, insufficient thoroughness was more commonly a problem than insufficient frequency. CONCLUSIONS: Patient education efforts related to brushing will probably be more effective if they focus on thoroughness rather than frequency. Interventions to increase flossing should probably focus on overcoming skill deficits.