Systematic Review and Meta-Analysis on Acute Stress Disorder: Rates Following Different Types of Traumatic Events.

Studies investigating rates of acute stress disorder following exposure to a traumatic event report widely varying results, even when examining the same types of traumatic events. The first purpose of this systematic review and meta-analysis was to describe rates of acute stress disorder following five different types of traumatic events. The second goal was to assess the methodological and trauma-related factors influencing these rates. Between May 2017 and October 2019, studies were identified by searching through the PsychINFO, PubMed/Medline, OVID, CINAHL, Scopus, and PILOTS databases. Records were included if (1) participants were 16 years old and over, (2) the assessment was completed within 30 days of the event, (3) a standardized assessment instrument was utilized, (4) the type of traumatic event was specified, and (5) the acute stress disorder rate was reported. The list of traumatic events used for the search strategy was based on the Diagnostic and Statistical Manual of Mental Disorders and was complemented by those listed in the Life Events Checklist and the National Comorbidity Survey Replication. Seventy-three samples from 70 studies totaling 20,065 participants met inclusion criteria. Results revealed that rates of acute stress disorder ranged from 14.1% for war-related trauma to 36.0% for interpersonal trauma. Interpersonal trauma was significantly more likely to lead to acute stress disorder than other types of events, except for disaster-related trauma. Differing assessment instruments, types of exposure and geographical locations, and the intentional nature of certain events contributed to heterogeneity in rates within each type of traumatic event.

Post-traumatic Reactions and Their Predictors among Workers Who Experienced Serious Violent Acts: Are There Sex Differences?

Background: Serious violent acts (e.g. physical violence, robbery, sexual aggression and death threats) are among the most visible and notable examples of workplace violence. Although women are commonly found to be at higher risk for post-traumatic reactions following workplace violence, little is known as regards sex differences concerning the types of post-traumatic reactions and their predictors. Objective: This study aimed to describe sex differences in the post-traumatic reactions of serious violent acts and the predictors of such reactions. Methods: The study was conducted among a convenience sample of 2889 French-speaking workers from Quebec, Canada by using a self-administrated survey. Linear regression modelings and post-hoc comparisons of coefficients according to the sex of the respondents were used to achieve the objective. Results: Preliminary results confirmed that while men are more exposed to violence at work, women experience a greater number of post-traumatic reactions. Women were more affected by flashbacks, avoidance, and hypervigilance than men. The results also showed that being victimized by a male aggressor was associated with a greater number of post-traumatic reactions for women, whereas being victimized by an insider (e.g. colleague, supervisor, employee) was associated with a greater number of post-traumatic reactions for both sexes. Implications: These findings highlight the necessity to better consider sex as a potential determinant of mental health in studies on workplace violence.

Impact of a Program for the Management of Aggressive Behaviors on Seclusion and Restraint Use in Two High-Risk Units of a Mental Health Institute.

The Omega Program for the Management of Aggressive Behaviors aims to reduce patients' dangerous behaviors, towards themselves or others, and to reduce the use of seclusion and restraint (S/R). A previous study in a Mental Health Institute (Montreal, Canada) showed that implementing this program allowed employees of the intensive care and emergency units to gain confidence in coping with patients' aggressions and to reduce their psychological distress. The present study, conducted in the same high-risk units, assesses the effect of the program on S/R use. We hypothesize that the incidence and duration of S/R should diminish significantly following the implementation of the program in both units. This naturalistic, prospective study covered archival data between April 2010 and July 2014. Pre-training data (April 2010-December 2011) were compared to data during training (January 2012-October 2012) and to post-training data (November 2012-July 2014) for both units. In the intensive care unit, we confirmed an increase of both mean daily number and duration of S/R by admissions in pre-training, followed by a decrease during the training and post-training. In the emergency unit, a decreasing trend is seen during the entire period thus suggesting that the decrease in S/R may be independent of the training. These findings suggest that Omega is a promising intervention program to use in an intensive care unit. However, a more global approach, including institutional changes in culture and attitude, can be important factors to develop to increase the positive outcomes.

Effects of a peer support programme for youth social services employees experiencing potentially traumatic events: a protocol for a prospective cohort study.

INTRODUCTION: The use of peer support programmes to help workers experiencing potentially traumatic events (PTE) has increased in high-risk organisations in the last decades. However, the scientific evidence of its effectiveness is still very limited. This paper aims to describe the protocol of a prospective cohort study that assesses the efficacy of a peer support programme among youth social services employees exposed to a PTE at work on psychological well-being, work functioning and needs of support. METHODS AND ANALYSIS: This is a mixed-methods prospective study that will examine workers' evolution four times over a 12-month period in Canada. This study involves: (1) quantitative data obtained through self-administrated questionnaires among 222 workers, and (2) qualitative in-depth interviews with a subsample of 45 workers. This study will compare findings from a cohort who received the support of a peer following a PTE (peer support-experimental protocol) as part of the experimental protocol of the Montreal Youth Social Services-University Institute (MYSS-UI), the second group of workers did not ask for the peer support (no peer support-experimental protocol) but was part of MYSS-UI, and the third group received standard organisational support from the Monteregie Youth Social Services (MYSS) (standard organisational protocol). ETHICS AND DISSEMINATION: The protocol and informed consent form complied with the ethics guidelines of the MYSS-UI. The Research Ethics Board of MYSS-UI and MYSS reviewed and accepted the protocol as required. The results of the study will be published in peer-reviewed journals, presented at research and general public conferences, disseminated via a public report for the institute that funded the project and for all workers. Results of this study will influence decision making regarding intervention policies following PTE and peer support interventions may be expanded throughout the youth social services in Canada and worldwide.

The Effects of Trivialization of Workplace Violence on Its Victims: Profession and Sex Differences in a Cross-Sectional Study among Healthcare and Law Enforcement Workers.

BACKGROUND: Workers from the law enforcement and healthcare sectors tend to normalize or mute their victimization from workplace violence (WPV). OBJECTIVES: This study aims to assess the impact of the trivialization of WPV on psychological consequences for workers who have been affected by a WPV incident. The second aim is to assess the moderating effect of sex on the trivialization of WPV. The third and overarching aim is to assess the moderating effect of professional identity on the relations between individual and organizational factors and psychological consequences following a WPV incident. METHODS: The findings are based on a convenience sample of 377 (204 female and 173 male) workers from the law enforcement and healthcare sectors. Individual factors (sex, age, professional identity, prior victimization, witnessing WPV, injuries, and trivialization of violence) and perceived support factors (colleagues' support and employer's support) were used as predictor variables of psychological consequences in hierarchical linear regression models. Sex was used as a moderator of trivialization while professional identity was used as a moderator of all predictors. FINDINGS: When individual and social support factors were controlled for, normalizing violence was negatively associated with psychological consequences while perceiving a taboo associated with complaining about WPV was positively associated for all participants. When these relations were moderated by the sex of the participants and then by their professional identity, normalization was found to decrease psychological consequences only for male healthcare workers. IMPLICATIONS: To help employees cope with WPV, organizations should promote strategies adapted to profession and sex differences. For male healthcare workers, normalization as a cognitive coping strategy should be formally recognized. For both professions and sexes, organizational strategies that counter the perceived taboo of complaining about violence should be reinforced.

Evaluation of an Education and Training Program to Prevent and Manage Patients' Violence in a Mental Health Setting: A Pretest-Posttest Intervention Study.

Workplace violence can lead to serious consequences for victims, organizations, and society. Most workplace violence prevention programs aim to train staff to better recognize and safely manage at-risk situations. The Omega education and training program was developed in Canada in 1999, and has since been used to teach healthcare and mental health workers the skills needed to effectively intervene in situations of aggression. The present study was designed to assess the impact of Omega on employee psychological distress, confidence in coping, and perceived exposure to violence. This program was offered to 105 employees in a psychiatric hospital in Montreal, Canada. Eighty-nine of them accepted to participate. Questionnaires were completed before the training, after a short period of time (M = 109 days) and at follow-up (M = 441 days). Repeated-measures ANOVAs and Cohen's d effect sizes were calculated. Results demonstrated statistically significant improvements in short-term and follow-up posttest scores of psychological distress, confidence in coping, and in levels of exposure to violence. This study is one of very few to demonstrate the positive impact of this training program. Further research is needed to understand how to improve the effectiveness of the program, especially among participants resistant to change.

Enzima e simbiótico para frangos criados nos sistemas convencional e alternativo / Enzyme and symbiotic for broilers bred in conventional and alternative systems

O objetivo deste trabalho foi estudar os efeitos da inclusão de enzima e simbiótico nas rações de frangos de corte criados nos sistemas convencional e alternativo sobre o desempenho, rendimento de carcaça, cortes e gordura abdominal e também avaliar economicamente o uso destes aditivos em ambos os sistemas de criação. Foram utilizados 720 pintos machos Cobb, com um dia de idade, distribuídos em um delineamento em blocos casualizados no esquema fatorial 2x3, com dois sistemas de criação: convencional (com promotor de crescimento) e alternativo (sem promotor de crescimento) e três aditivos: sem outro aditivo (SA), com simbiótico (SI) e com enzima + simbiótico (SIE), com 4 repetições de 30 aves cada. Aos 42 dias de idade, o fator de produção (FP) foi menor (P<0,05) para aves SA (324), quando comparadas às tratadas com SI (334) e SIE (337). Aves criadas no sistema convencional apresentaram maior (P<0,05) FP (338), quando comparadas às do sistema de criação alternativo (325). No sistema alternativo, a conversão alimentar foi melhor (P<0,05) para aves SI (1,77), quando comparadas às SIE (1,82) e SA (1,85). O uso de SI e SIE favorece o desempenho dos frangos aos 42 dias de idade e não influencia o rendimento de carcaça, cortes e gordura abdominal, tanto no sistema convencional como no alternativo, sendo que estes aditivos aumentam os custos de produção em ambos os sistemas. O sistema alternativo de criação proporciona maior retorno econômico, apesar do menor fator de produção.

This research was aimed at evaluating the effects of enzyme and symbiotic inclusion in broilers diets bred in conventional and alternative systems on performance, carcass yield, cuts, abdominal fat and economic return these additives in both breeding systems. 720 one-day old male Cobb chicks were distributed in randomized blocks design according to a 2x3 factorial, two breeding systems: conventional (with growth promoter) and alternative (no growth promoter) and three additives: no additive (NA), symbiotic (SY) and symbiotic + enzyme (SYE), with four replicates of 30 broilers each. At 42 days old, the production factor (PF) was lower in NA broiler chickens (324) as broiler chickens supplemented with SY (334) and SYE (337). Broiler bred in conventional system showed higher PF (338) as broilers bred in alternative system (325). In alternative breeding system, the feed conversion was better in SY broilers (1.77) as SYE (1.82) and NA (1.85) broilers. The SY and SYE use improve the performance of broiler chickens at 42 days old and it doesnÆt affect carcass yield, cuts, and abdominal fat, in conventional or alternative system; moreover these additives increase production costs in both systems. Alternative system provide higher economic return, despite of lower production factor.