IntroductionWhilst the link between physical factors and risk of high altitude (HA)-related illness and acute mountain sickness (AMS) have been extensively explored, the influence of psychological factors has been less well examined. In this study we aimed to investigate the relationship between ‘anxiety and AMS risk during a progressive ascent to very HA.MethodsEighty health adults were assessed at baseline (848m) and over 9 consecutive altitudes during a progressive trek to 5140m. HA-related symptoms (Lake Louise [LLS] and AMS-C Scores) and state anxiety (State-Trait-Anxiety-Score [STAI Y-1]) were examined at each altitude with trait anxiety (STAI Y-2) at baseline.ResultsThe average age was 32.1 ± 8.3 years (67.5% men). STAI Y-1 scores fell from 848m to 3619m, before increasing to above baseline scores (848m) at ≥4072m (p = 0.01). STAI Y-1 scores correlated with LLS (r = 0.31; 0.24–0.3; P<0.0001) and AMS-C Scores (r = 0.29; 0.22–0.35; P<0.0001). There was significant main effect for sex (higher STAI Y-1 scores in women) and altitude with no sex-x-altitude interaction on STAI Y-1 Scores. Independent predictors of significant state anxiety included female sex, lower age, higher heart rate and increasing LLS and AMS-C scores (p<0.0001). A total of 38/80 subjects (47.5%) developed AMS which was mild in 20 (25%) and severe in 18 (22.5%). Baseline STAI Y-2 scores were an independent predictor of future severe AMS (B = 1.13; 1.009–1.28; p = 0.04; r2 = 0.23) and STAI Y-1 scores at HA independently predicted AMS and its severity.ConclusionTrait anxiety at low altitude was an independent predictor of future severe AMS development at HA. State anxiety at HA was independently associated with AMS and its severity.
Bassalto is a newly isolated phage of
Mycobacterium smegmatis
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155 from the campus grounds of Norfolk State University in Norfolk, VA. Bassalto belongs to the cluster B and subcluster B3 mycobacteriophages, based on the nucleotide composition and comparison to known mycobacteriophages.
BackgroundWorking with people with Borderline Personality Disorder (BPD) is often viewed as challenging, especially when there is a high risk of suicide or self-harm. This study aimed to provide insight into the lived experience of clinicians working with these service users within community mental health teams.MethodUnstructured interviews were conducted with four participants from two multidisciplinary teams within the same NHS trust. Transcripts were analysed using Interpretative Phenomenological Analysis.FindingsThree superordinate themes were identified. (1) All participants emphasised the stressful nature of their role, describing its emotional impact and contributory factors, including organisational and relational issues. (2) Coping strategies were evident, which may not always have been within the participants’ awareness. (3) The task of balancing seemingly opposing possibilities was identified, paralleling the need for people with BPD to resolve dichotomous thinking.ConclusionsThere is a role for counselling psychologists in helping clinicians working within multidisciplinary teams to develop a deeper understanding of their responses through training and supervision. This could in turn enhance the care provided.
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