Marion Trousselard

Moderate variations of mood/emotional states related to alterations in cochlear otoacoustic emissions and tinnitus onset in young normal hearing subjects exposed to gun impulse noise

This study was designed to test whether under impulse noise exposure mood and emotional states could play a role in the onset of tinnitus and/or could modify cochlear sensitivity objectively measured with distortion product otoacoustic emissions (DPOAEs). The experimental design consisted in a short follow-up study of 54 young military subjects (20+/-2 years old), psychologically normal, with normal hearing, during two consecutive days of target practice rounds. Data collection included an abbreviated version of the profile of mood states (POMSs) inventory [Profile of Mood States, Educational and Industrial Testing Service, San Diego, 1971], questionnaires on tinnitus perception (previous history and after shooting) and DPOAEs measurements before and after shooting. Higher scores of tension-anxiety were found in subjects having previous history of tinnitus. Association between tinnitus previous history and tinnitus after shooting was found significant. Perception of tinnitus after target practice rounds was associated with significantly lower DPOAEs at 3 kHz. The most tense-anxious subjects were found to have DPOAEs decreases of 3.35+/-6 dB at 3 kHz after shooting. This study clearly shows that, in young healthy population, psychologically normal and with normal hearing, moderate variations in mood and emotional states were related to tinnitus onset and DPOAEs alterations. It is possible that stronger variations in mood and/or emotional condition would increase risks of tinnitus and alterations of cochlear sensitivity.

Contribution of somesthetic cues to the perception of body orientation and subjective visual vertical.

Without relevant visual cues, the subjective visual vertical (SVV) is biased in roll-tilted subjects toward the body axis (Aubert or A-effect). This study focused on the role of the somatosensory system with respect to the SVV and on whether somesthetic cues act through the estimated body tilt. The body cast technology was used to obtain a diffuse tactile stimulation. An increased A-effect was expected because of a greater underestimation of the body position in the body cast. Sixteen subjects placed in a tilt chair were rolled sideways from 0° to 105°. They were asked to verbally indicate their subjective body position and then to adjust a luminous line to the vertical under strapped and body cast conditions. Results showed a greater A-effect (p<.001) but an overestimation of the body orientation (p<.01) in the body cast condition for the higher tilt values (beyond 60°). Since the otolith organs produced the same gravity response in both conditions, errors were due to a change in somesthetic cues. Visual and postural errors were not directly related (no correlation). However, the angular distance between the apparent body position and the SVV remained stable, suggesting that the change in somatosensory pattern inputs has a similar impact on the cognitive processes involved in assessing the perception of external space and the sense of self-position.

Validation of a French version of the Freiburg Mindfulness Inventory - short version: relationships between mindfulness and stress in an adult population.

BackgroundWhereas interest in incorporating mindfulness into interventions in medicine is growing, data on the relationships of mindfulness to stress and coping in management is still scarce. This report first presents a French validation of the Freiburg Mindfulness Inventory-short form (FMI) in a middle-aged working population. Secondly, it investigates the relationship between psychological adjustment and mindfulness.MethodsFive hundred and six non-clinical middle-aged working individuals rated themselves on the self-report French version FMI and completed measures of psychological constructs potentially related to mindfulness levels.ResultsResults were comparable to results of the original short version. Internal consistency of the scale based on the one-factor solution was .74, and test-retest reliability was good. The one-dimensional solution as the alternative to the two-factor structure solution yielded suboptimal fit indices. Correlations also indicated that individuals scoring high on mindfulness are prone to stress tolerance, positive affects and higher self-efficacy. Furthermore, subjects with no reports of stressful events were higher on mindfulness.ConclusionThese data showed that mindfulness can be measured validly and reliably with the proposed French version of the FMI. The data also highlighted the relationship between mindfulness and stress in an adult population. Mindfulness appears to reduce negative appraisals of challenging or threatening events.

Role of gravity-based information on the orientation and localization of the perceived body midline

The present study focused on the influence of gravity-based information on the orientation and localization of the perceived body midline. The orientation was investigated by the rolling adjustment of a rod on the subjects’ Z-axis and the localization by the horizontal adjustment of a visual dot as being straight ahead. Experiment 1 investigated the effect of the dissociation between the Z-axis and the direction of gravity by placing subjects in roll tilt and supine postures. In roll tilt, the perception of the body midline orientation was deviated in the direction of body tilt and the perception of its localization was deviated in the opposite direction. In the supine body orientation, estimates of the Z-axis and straight-ahead remained veridical as when the body was upright. Experiment 2 highlighted the relative importance of the otolithic and tactile information using diffuse pressure stimulation. The estimation of body midline orientation was modified contrarily to the estimation of its localization. Thus, subjects had no absolute representation of their egocentric space. The main hypothesis regarding the dissociation between the orientation and localization of the body midline may be related to a difference in the integration of sensory information. It can be suggested that the horizontal component of the vestibulo-ocular reflex (VOR) contributed to the perceived localization of the body midline, whereas its orientation was mainly influenced by tactile information.

Stress among nurses working in emergency, anesthesiology and intensive care units depends on qualification: a Job Demand‑Control survey

BackgroundThe nurse stress literature reports an overwhelming culture of acceptance and expectation of work stressors, ironically linked to the control of the workplace to effectively and proactively manage stress. The stressors involved in delivering “stress management” have been well studied in nursing-related workplaces, especially in acute care settings in accordance with the Karasek Job Demand-Control-Support (JDCS) model. However, little is known about the effects of specificity of an acute care unit and the level of qualifications on stress experienced by nurses.MethodsA survey using the JDCS model was conducted among 385 nurses working in three different acute care units (anesthesiology, emergency and intensive care unit) from a university hospital. Specific questions explored variables such as gender, acute care units, level of qualification and working experience.ResultsTwo hundred questionnaires were returned. A high level of job strain was highlighted without a gender effect and in the absence of isostrain. Nurses from acute care units were located in the high stress quadrant of the JDCS model. Conversely, other nurses were commonly located in the “active” quadrant. Independent of acute care settings, the highest level of education was associated with the highest job strain and the lowest level of control.ConclusionsIn an acute care setting, a high level of education was a key factor for high job stress and was associated with a perception of a low control in the workplace, both of which may be predictors of adverse mental health. In particular, the lack of control has been associated with moral distress, a frequently reported characteristic of acute care settings. To enhance the personal and professional outcomes of the advanced registered nurses, strategies for supporting nurses manage daily stressors in acute care are urgently required.

The long-term effects of occupational exposure to vinyl chloride monomer on microcirculation : a cross-sectional study 15 years after retirement

Objectives To assess residual long-term microcirculation abnormalities by capillaroscopy, 15 years after retiring from occupational exposure to vinyl chloride monomer (VCM). Design Cross-sectional study. Setting Allier, one of the major areas of polyvinyl chloride production in France. Participants We screened 761 (97% men) retired workers exposed to chemical toxics. Exposure to chemicals other than VCM excluded potential participants. Primary and secondary outcome measures These participants underwent a medical examination including a capillaroscopy, symptoms of Raynaud and comorbidities, as well as a survey to determine exposure time, direct or indirect contact, type of occupation, smoking status and time after exposure. A double blind analysis of capillaroscopic images was carried out. A control group was matched in age, sex, type of occupation. Results 179/761 retired workers were only exposed to VCM at their work, with 21 meeting the inclusion criteria and included. Exposure time was 29.8±1.9 years and time after exposure was 15.9±2.4 years. Retired workers previously exposed to VCM had significantly higher capillaroscopic modifications than the 35 controls: enlarged capillaries (19% vs 0%, p<0.001), dystrophy (28.6% vs 0%, p=0.0012) and augmented length (33% vs 0%, p<0.001). Time exposure was linked (p<0.001) with enlarged capillaries (R2=0.63), dystrophy (R2=0.51) and capillary length (R2=0.36). They also had higher symptoms of Raynaud (19% vs 0%, p=0.007) without correlation with capillaroscopic modifications. Conclusions Although VCM exposure was already known to affect microcirculation, our study demonstrates residual long-term abnormalities following an average of 15 years’ retirement, with a time-related exposure response. Symptoms of Raynaud, although statistically associated with exposure, were not related to capillaroscopic modifications; its origin remains to be determined.

Urinary Interleukin-8 Is a Biomarker of Stress in Emergency Physicians, Especially with Advancing Age — The JOBSTRESS* Randomized Trial

Background Emergency physicians are exposed to greater stress during a 24-hour shift (24 hS) than a 14-hour night shift (14 hS), with an impact lasting several days. Interleukin-8 (IL-8) is postulated to be a chronic stress biomarker. However, no studies have tracked IL-8 over several shifts or used it for monitoring short-term residual stress. The IL-8 response to the shifts may also increase with age. Conveniently, IL-8 can be measured non-intrusively from urine. Methods We conducted a shifts-randomized trial comparing 17 emergency physicians’ urinary IL-8 levels during a 24 hS, a 14 hS, and a control day (clerical work on return from leave). Mean levels of IL-8 were compared using a Wilcoxon matched-pairs test. Independent associations of key factors including shifts, stress, and age with IL-8 levels were further assessed in a multivariable generalized estimating equations model. Results Mean urinary IL-8 levels almost doubled during and after a 24 hS compared with a 14 hS or a control day. Furthermore, IL-8 levels failed to return to control values at the end of the third day after the shift despite a rest day following the 24 hS. In the multivariable model, engaging in a 24 hS, self-reported stress, and age were independently associated with higher IL-8 levels. A 24 hS significantly increased IL-8 levels by 1.9 ng (p = .007). Similarly, for every unit increase in self-reported stress, there was a 0.11 ng increase in IL-8 levels (p = .003); and for every one year advance in age of physicians, IL-8 levels also increased by 0.11 ng (p = .018). Conclusion The 24 hS generated a prolonged response of the immune system. Urinary IL-8 was a strong biomarker of stress under intensive and prolonged demands, both acutely and over time. Because elevated IL-8 levels are associated with cardiovascular disease and negative psychological consequences, we suggest that emergency physicians limit their exposure to 24 hS, especially with advancing age.

Relationship between emotional experience and resilience: An fMRI study in fire-fighters

Resilience refers to the capacity to cope effectively in stressful situations or adversity. It may involve the ability to experience emotions matching the demands of environmental circumstances. The brain mechanisms underlying resilience remain unclear. In this study, we aim to investigate the relationship between the neural basis of emotional experience and resilience. Thirty-six fire-fighters were included. They performed an fMRI script-driven paradigm comprising relaxing and trauma-related scripts to evaluate the cerebral substrate of emotional experience (p<0.05, FDR-corrected). Correlations were examined between fMRI activations and the resilience DRS15 scale (p<0.05). Resilience was positively correlated with the right amygdala and left orbitofrontal activations when performing the contrast of trauma vs. relaxing script. The present study provides neural data on the mechanisms underlying resilience and their relationship with emotional reactivity, suggesting that appropriate emotional response in stressful situations is essential for coping with aversive events in daily life.

Acute stress disorder modifies cerebral activity of amygdala and prefrontal cortex.

The diagnosis constraint of acute stress disorder (ASD), consisting of testing individuals in the month following trauma exposure, limits research on the very early and initial stage of the disease. In this regard, this work aims to explore the cerebral mechanism of ASD in a population of fire-fighters before and after trauma exposure. Thirty-six healthy non-traumatized male fire-fighters were explored by an fMRI emotional face-matching task to evaluate the cerebral substrate of emotional recognition. During the two years of the follow-up, two subjects were traumatized, and thus retested, as were 10 non-traumatized subjects among the initial non-exposed ones. In comparison to non-exposed subjects, fire-fighters with ASD had enhanced amygdala, orbitofrontal, and dorsolateral prefrontal BOLD responses to fearful and angry faces (p < .05, FDR-corrected). These results shed new light on the cerebral mechanism associated with ASD. We observed for the first time the existence of an altered fear processing pathway in ASD that is mediated by amygdala and prefrontal cortex hyperactivity, which might be at the core of the disorder.

Validation of the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) in French psychiatric and general populations

The Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) has been validated in general population samples in many countries. Interest in using this measure in clinical populations is growing, particularly for tertiary prevention and mental health promotion. This paper reports validation of the French WEMWBS in healthy and chronic remitted schizophrenia populations. The French WEMWBS was administered to 319 workers, 75 students and 121 patients. For non-patients, self-reported Trait- and State-Anxiety, Mindfulness, Positive and Negative Affect and the General Health Questionnaire were completed. For patients, the Positive and Negative Syndrome Scale, Clinical Global Impression Severity Scale, Birchwood Insight Scale, Social Adjustment Scale, and Global Assessment of Functioning scale were completed. Test-retest reliability and responsiveness to intervention was assessed at 6 months. Whatever the sample, response frequencies showed normal distributions, and internal consistency was good (Cronbachs α). Scree plots of eigenvalues suggested a single factor in the samples. The one-dimensional solution yielded suboptimal fit indices. Construct validity was confirmed. Significant improvement in scores was observed before and after intervention. Test-retest variation was non-significant. Impairment of insight and cognition in the assessed patients implies that attention must be paid before applying WEMWBS to all patients. Nevertheless, WEMWBS proved valid and reliable in a further European population, suggesting transcultural validity for both monitoring and evaluation of interventions in healthy as well as chronic remitted schizophrenia populations.