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Objectives: The aims of this study were to examine the degree of traumatic stress and the coping strategies employed by community residents who lived on both sides of a rail track where a train collision occurred in 1996 in Stafford, UK. The hypothesis was that there would be a high level of traumatic stress and that emotion-focused coping would be the predictor to distress. Method: This was a cross-sectional survey with a retrospective design in which 66 community residents, who lived between 30 and 100 feet away from the crash site, were interviewed. The study began approximately 7 months after the disaster. The Impact of Event Scale (IES), the General Health Questionnaire (GHQ-28) and the Ways of Coping Checklists (WOC) were administered to the residents. Results: On the whole, the results did not entirely support the hypothesis. The residents were found to have experienced some intrusive thoughts and avoidance behaviour but their mean scores were significantly lower than those of standardized samples. Thirty-five per cent scored at 4 or above on the GHQ-28. Traumatic stress was predicted by both emotion-focused and problem-focused coping strategies. Conclusion: Although community residents were not on the train or related to the dead or injured in any way, they could, after being exposed to a train disaster, manifest traumatic stress symptoms which had long-lasting effects. Such traumatic stress was found to be associated with coping strategies of community residents characterized by their efforts to manage or alter the source of stress, and by their efforts to regulate stressful emotions. [ABSTRACT FROM AUTHOR]

In December 1994, an aircraft was returning to Coventry, UK after unloading a cargo of live animals in Amsterdam. The aircraft struck a pylon, subsequently lost control, and started to descend on a large complex of housing estates. It clipped the roofs of two houses and finally crashed into a woodland area close to the edge of a large housing estate. Hundreds of residents on the housing estate had escaped death and were classified as sesternary victims, in that, but by chance, they would have been primary victims. The aims of the study were to examine the traumatic stress of the sesternary victims and the coping strategies that they employed in order to cope with the effects of the trauma. The hypothesis was that the victims would exhibit traumatic distress associated with a specific model of coping characterized by distancing, escape–avoidance, and seeking social support. Eighty-two victims participated in the study and were interviewed using the Impact of Event Scale (IES), the General Health Questionnaire (GHQ) and the Ways of Coping Checklist (WOC). The results showed that the victims experienced more intrusion than avoidance, and that there were no significant differences between the present samples and standardized samples. Fifty-six per cent scored above the cutoff point of 4 in the GHQ. Confrontive coping, distancing, self-controlling, accepting responsibility, escape–avoidance, and positive reappraisal were used by the victims significantly more than the standardized samples. Path analyses showed that avoidance was predicted by the escape–avoidance coping strategy, that intrusion was predicted by distancing and escape–avoidance strategies and that the GHQ total was predicted by distancing and escape–avoidance coping strategies. The conclusion was that the victims exhibited significant traumatic distress which was partially associated with the specific model of coping that we hypothesized. Seeking social support did not seem to account for distress. Copyright © 2001 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: Efficient clinical pathways are needed to meet the growing pressures in dermatology due to the significant rise in the number of suspected skin cancer referrals. Our hospital serves a wide geographical area and receives a large number of 2-week-wait (2WW) suspected skin cancer referrals. In the United Kingdom, approximately 10-12% of 2WW referrals are diagnosed as skin cancers fulfilling the 2WW criteria., Purpose: We sought to assess the role of teledermatology in reducing hospital consultations for patients referred via the dermatology 2WW pathway., Methods: We piloted a teledermatology service and detailed the clinical outcomes of patients with solitary skin lesions of uncertain diagnosis triaged through this pathway. Seventy-six primary care referrals were reviewed by consultant dermatologists and analyzed against the British Association of Dermatologists' teledermatology audit standards., Results: In 52/76 (68%) of patients, confident benign diagnoses were made, avoiding the need for a face-to-face (FTF) consultation., Conclusions: Our results showed that with adequate image quality, teledermatology can be used to accurately diagnose skin lesions., Implications: Teledermatology can significantly reduce the number of urgent referrals necessitating FTF appointments, therefore providing a new solution to streamline care delivery.