BACKGROUND: Posttraumatic stress injury (PTSI) is a term used to describe a range of psychiatric difficulties which arise following exposure to a psychologically traumatic event. The impact of being diagnosed with multiple psychiatric conditions on the return-to-work (RTW) outcomes of individuals with PTSI has not been adequately researched. OBJECTIVE: The current study examined whether the presence of two or more psychiatric conditions occurring simultaneously is predictive of RTW outcomes in workers with PTSI. METHOD: A population-based cohort design was conducted using archival data from injured workers admitted to a PTSI rehabilitation program. Differences in RTW outcomes and demographic, administrative, and clinical variables were compared between individuals with single and multiple psychiatric diagnoses. A range of variables were entered into a multivariable logistic regression model predicting RTW. RESULTS: The final logistic regression model indicated workers had higher odds of RTW if they had a single psychiatric diagnosis (Adjusted Odds Ratio (AOR) 2.20), non-elevated scores on a measure of traumatic stress (AOR 1.85), and reported higher self-perceived readiness to RTW (AOR 1.24). CONCLUSION: Being diagnosed with multiple psychiatric conditions appears to be associated with more negative RTW outcomes following PTSI rehabilitation.
Back ground Chronic pain is typically described as pain on most days for at least three months. Chronic non-cancer pain (CNCP) is any chronic pain that is not due to a malignancy. Chronic non-cancer pain in adults is a common and complex clinical issue where opioids are routinely used for pain management. There are concerns that the use of high doses of opioids for chronic non-cancer pain lacks evidence of effectiveness and may increase the risk of adverse events. Objectives To describe the evidence from Cochrane Reviews and Overviews regarding the efficacy and safety of high-dose opioids (here defined as 200 mg morphine equivalent or more per day) for chronic non-cancer pain. Methods We identified Cochrane Reviews and Overviews through a search of the Cochrane Database of Systematic Reviews (The Cochrane Library). The date of the last search was 18 April 2017. Two review authors independently assessed the search results. We planned to analyse data on any opioid agent used at high dose for two weeks or more for the treatment of chronic non-cancer pain in adults. Main results We did not identify any reviews or overviews meeting the inclusion criteria. The excluded reviews largely reflected low doses or titrated doses where all doses were analysed as a single group; no data for high dose only could be extracted. Authors' conclusions There is a critical lack of high-quality evidence regarding how well high-dose opioids work for the management of chronic non-cancer pain in adults, and regarding the presence and severity of adverse events. No evidence-based argument can be made on the use of highdose opioids, i.e. 200 mg morphine equivalent or more daily, in clinical practice. Trials typically used doses below our cut-off; we need to know the efficacy and harm of higher doses, which are often used in clinical practice.
This paper discusses engineering options for understanding how extremophile organisms might shed light on the possibilities of life on other planets. The study of extremophiles is responsible for the life that can exist in highly hostile environments on Earth, such as volcanoes, arid deserts, or domains with high salt concentrations. Engineering could be the essential tool to know unexpected life scenarios so that developments in this sense are proposed. The proposed prototype is generated from the analysis of extremophiles so that an engineering development suitable for adaptation to complex environments and valuable for the best human living conditions is possible. The main results show that a design with these characteristics presents more advantages than other technologies.
Two high school English teachers reflect on their experiences teaching Ojibway author Richard Wagamese’s (Indian horse: a novel. Douglas and McIntyre 2012) novel Indian Horse. Both teachers recount moments of shock and discomfort for their students and themselves as the class collectively discovers that the novel’s protagonist, a residential school survivor, had suffered horrific sexual abuse at the hands of a priest who readers had been led to believe was good. While both teachers express the desire to evade discomfort, they recognize the pedagogical potential of such literary encounters. In this chapter, we use our theoretical frame(s) to analyze and describe vignettes from the classroom, articulate our own struggles with teaching such challenging material, and discuss the ethical questions that emerged. Our theorization of students’ responses to the novel draws on notions of difficult knowledge (Britzman 1998) and shock (Felski 2008). Furthermore, we draw on educational scholar Sharon Todd’s (Learning from the other: Levinas, psychoanalysis, and ethical possibilities in education. State University of New York Press, 2003) reading of Levinas to argue that this discomfort can potentially lead to an ethical responsibility for the other. Teaching Indian Horse created the opportunity for us to invite our students to learn from this text-as-other in a way that interrogates and implicates our students’ relational, ontological, and behavioral commitments, past, present, and future.
Information retrieval systems retrieves relevant documents based on a query submitted by the user. The documents are initially indexed and the words in the documents are assigned weights using a weighting technique called TFIDF which is the product of Term Frequency (TF) and Inverse Document Frequency (IDF). TF represents the number of occurrences of a term in a document. IDF measures whether the term is common or rare across all documents. It is computed by dividing the total number of documents in the system by the number of documents containing the term and then computing the logarithm of the quotient. By default, we use base 10 to calculate the logarithm. In this paper, we are going to test this weighting technique by using a range of log bases from 0.1 to 100.0 to calculate the IDF. Testing different log bases for vector model weighting technique is to highlight the importance of understanding the performance of the system at different weighting values. We use the documents of MED, CRAN, NPL, LISA, and CISI test collections that scientists assembled explicitly for experiments in data information retrieval systems.
