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Background Despite the existing knowledge about stress, trauma and pregnancy and maternal stress during natural disasters, little is known about what types of trauma pregnant or preconception women experience during these disasters. In May 2016, the worst natural disaster in modern Canadian history required the evacuation of nearly 90,000 residents of the Fort McMurray Wood Buffalo (FMWB) area of northern Alberta. Among the thousands of evacuees were an estimated 1850 women who were pregnant or soon to conceive. In August 2017, Hurricane Harvey devastated areas of the United States including Texas, with 30,000 people forced to flee their homes due to the intense flooding. Objective To explore immediate and past traumatic experiences of pregnant or preconception women who experienced one of two natural disasters (a wildfire and a hurricane) as captured in their expressive writing. Research questions were: (1) What trauma did pregnant or preconception women experience during the fire and the hurricane? (2) What past traumatic experiences, apart from the disasters, did the women discuss in their expressive writing? Methods A qualitative secondary analysis of expressive writing using thematic content analysis was conducted on the expressive writing of 50 pregnant or preconception women who experienced the 2016 Fort McMurray Wood Buffalo Wildfire (n = 25) and the 2017 Houston Hurricane Harvey (n = 25) Narrative data in the form of expressive writing entries from participants of two primary studies were thematically analyzed. One of the expressive writing questions was used in this analysis: 'What is the most traumatic, upsetting experience of your entire life, especially that you have never discussed in great detail with others?' NVivo 12 supported thematic content analysis. Results For some women, the disasters elicited immense fear and anxiety that surpassed previous traumatic life events. Others, however, disclosed significant past traumas that continue to impact them, including betrayal by a loved one, abuse, maternal health complications, and illness. Conclusion We recommend a strengths-based and trauma-informed care approach in both maternal health and post-disaster relief care., Author(s): Emily Severson [sup.1] , Joanne K. Olson [sup.1] , Ashley Hyde [sup.2] , Suzette Brémault-Phillips [sup.3] , Jude Spiers [sup.1] , Suzanne King [sup.4] , Johanna Bick [sup.5] , [...]

Background: Alcohol use disorder (AUD), the problematic consumption of alcohol, affects 107 million people worldwide. Individuals with AUD experience high morbidity and increased mortality. Nurses practicing in acute care are ideally positioned to deliver quality interventions to patients with AUD, including screening and brief intervention; formal training and assessment of baseline knowledge, attitudes, and perceptions are necessary. Aims and Objectives: The aim of this study was to explore the knowledge, attitudes, and perceptions of acute care nurses caring for patients with AUD. Design: This study used a cross-sectional survey design. Methods: The Survey of Attitudes and Perceptions was completed by 93 nurses working in six acute care centers (seven medicine units) across Alberta. Data were analyzed using descriptive and inferential statistics. Results: Few participants reported receiving any prior structured training on AUD, with the majority reporting limited knowledge of alcohol and the effects of alcohol consumption. Although most participants said that caring for patients with AUD was a part of their professional role, few felt satisfied or motivated to work with this group of patients. Responses to individual questions or subdomains of the survey did not significantly differ by length of time in professional role, employment status, or sex. Conclusion: Our results indicate that nurses need to learn more about caring for patients with AUD. Developing tailored educational interventions that are mindful of the importance of knowledge, support, satisfaction, and motivation is necessary to improve the quality of care for patients with AUD. [ABSTRACT FROM AUTHOR]

Polymer pile products are currently being used in marine environments in pile-supported fender systems due to their superior resistance to this environment over traditional materials. The piles in fender systems are laterally loaded elements, which dissipate energy through flexure. Due to the anisotropic nature of the polymer materials, shear deformations can become significantly large. The goal of this analytical study was to use material properties found in the literature to determine the significance of flexural shear deformations. It was ultimately found that the shear effects in these materials are significant. The significance varies based on the stiffness of the soil. The greater the stiffness, the more influence the shear has on the total deformation. Due to the interdependent nature of the observed results, it is recommended that the shear effects must always be considered when designing with currently available polymer piles. [ABSTRACT FROM AUTHOR]

Background: Traditionally, outpatient visits for those with chronic liver disease (CLD) have been delivered in-person with the patient traveling to a centralized location to see the health care provider. The use of virtual care in health care delivery has been gaining popularity across a variety of patient populations, especially within the COVID-19 context. Performed before COVID-19, the aim of the present study was to explore the perspectives of patients with CLD toward the use of virtual care with their liver specialists. Methods: A cross-sectional, mixed methods study was used to conduct this work. Results: A total of 101 patients with CLD participated in this study. Participants had a mean age of 54.5 years (range 19–87 years). Quantitative analysis revealed that 86% were willing to attend a virtual visit with their liver specialist in the future. There was a significant relationship between both age and income level and acceptance of virtual care. The themes emerging from the qualitative analysis included: (1) past experiences attending in-person visits, (2) perspectives on the use of virtual visits, and (3) perceived challenges of virtual visits. Conclusions: Although there are many potential benefits of virtual care to both the patient and the health care system, there are instances (older age, low income level) when in-person care may be preferred by patients. A tailored approach that is mindful of the individual patient's health status, ease of access to technology, and preferences must be considered when offering virtual care. These findings are of particular relevance during COVID-19, an era that has forced us into the virtual space. [ABSTRACT FROM AUTHOR]

Objective: Following disasters, perinatal women are vulnerable to developing post-traumatic stress disorder (PTSD)-like symptoms. Little is known about protective factors. We hypothesized that peritraumatic stress would predict PTSD-like symptoms in pregnant and postpartum women and would be moderated by social support and resilience. Method: Women (n = 200) who experienced the 2016 Fort McMurray Wood Buffalo wildfire during or shortly before pregnancy completed the Peritraumatic Distress Inventory (PDI), Peritraumatic Dissociative Experiences Questionnaire, and the Impact of Event Scale-Revised for current PTSD-like symptoms. They also completed scales of social support (Social Support Questionnaire-Short Form) and resilience (Connor-Davidson Resilience Scale). Results: Greater peritraumatic distress (r = 0.56) and dissociative experiences (r = 0.56) correlated with more severe PTSD-like symptoms. Greater social support satisfaction was associated with less severe post-traumatic stress symptoms but only when peritraumatic distress was below average; at more severe levels of PDI, this psychosocial variable was not protective. Conclusions: Maternal PTSD-like symptoms after a wildfire depend on peritraumatic distress and dissociation. Higher social support satisfaction buffers the association with peritraumatic distress, although not when peritraumatic reactions are severe. Early psychosocial interventions may protect perinatal women from PTSD-like symptoms after a wildfire. [ABSTRACT FROM AUTHOR]

Striking similarities have been seen between accretion signatures of Galactic X-ray binary (XRB) systems and active galactic nuclei (AGNs). XRB spectral states show a V-shaped correlation between X-ray spectral hardness and Eddington ratio as they vary, and some AGN samples reveal a similar trend, implying analogous processes at vastly larger masses and timescales. To further investigate the analogies, we have matched 617 sources from the Chandra Source Catalog to Sloan Digital Sky Survey spectroscopy, and uniformly measured both X-ray and optical spectral characteristics across a broad range of AGN and galaxy types. We provide useful tabulations of X-ray spectral slope for broad- and narrow-line AGNs, star-forming and passive galaxies, and composite systems, also updating relationships between optical (Hα and [O III]) line emission and X-ray luminosity. We further fit broadband spectral energy distributions with a variety of templates to estimate bolometric luminosity. Our results confirm a significant trend in AGNs between X-ray spectral hardness and Eddington ratio expressed in X-ray luminosity, albeit with significant dispersion. The trend is not significant when expressed in the full bolometric or template-estimated AGN luminosity. We also confirm a relationship between the X-ray/optical spectral slope αox and Eddington ratio, but it may not follow the trend predicted by analogy with XRB accretion states. [ABSTRACT FROM AUTHOR]