Maritime activities have been associated with unique dangers to civilian and military sailors. We performed a retrospective cohort study analyzing injury mechanisms and clinical outcomes of ...casualties onboard US naval ships to determine common injury mechanisms, trends, and outcomes. We hypothesized there would be a downward trend of injuries and fatalities on US naval ships during the study period.
All mishaps recorded by the Naval Safety Command aboard active service US naval ships from 1970 through 2020 were reviewed. Only mishaps resulting in injury or fatality were included. Over time, injury mechanisms and casualty incidence rates were trended and compared based on medical capabilities. Ships without surgical capabilities were categorized as Role 1, and those with surgical capabilities as Role 2.
There were a total of 3,127 casualties identified and analyzed, with 1,048 fatalities and 2,079 injuries. The injury mechanisms associated with the highest mortality included electrocution, blunt head trauma, fall from height, man overboard, and explosion. There was a decrease in the trend of mishaps resulting in casualties, fatalities, and injuries over the 50-year study period. The mortality rate for select severe injury mechanisms was higher on Role 1 capable platforms, compared with Role 2 (0.334 vs. 0.250, p < 0.05).
Casualty incidences decreased over 50 years. However, mortality still remains high for certain mechanisms no matter the operational platform. Furthermore, Role 1 capable vessels have a higher overall mortality rate for severe injuries compared with Role 2. The authors propose training, process improvement, and technology-related solutions to improve outcomes on Role 1 capable naval vessels.
Prognostic and Epidemiological; Level IV.
The arid sagebrush landscape of the Gunnison Basin, Colorado is home to the federally threatened Gunnison sage‐grouse (GUSG; Centrocercus minimus) and is expected to become hotter and drier with a ...changing climate. Wet meadows within the sagebrush ecosystem are a critical lifeline for wildlife and livestock, particularly during drought years, yet they occupy less than 2% of the landscape. Our objective was to enhance wet meadow drought resiliency by slowing the water down, reconnecting floodplains, and increasing wetland vegetation. Indirectly we also aimed to enhance GUSG habitat and improve rangeland condition. Between 2012 and 2020, we constructed nearly 900 low‐tech restoration structures (Zeedyk structures), across seven drainageways with wet meadows. Six of these years were drought years. We used a before‐after‐control‐impact design to assess vegetation response. Vegetation data were collected on 135 randomly selected treated and 30 control transects. We found that 75% of ephemeral units and all of perennial units achieved or surpassed the wetland plant cover management goal of a 4% yearly increase. This led to an average enhancement of 40% in wetland plant cover in the treated drainageways. There was a significant positive difference between treated and control transects in 50% of the drainageways, regardless of hydroperiod status. The low‐tech restoration structures were effective at rewetting perennial and ephemeral wet meadows within the arid landscape, even during a megadrought, and reduced non‐native invasive weeds in all but one of the treated units. Forbs and grasses critical to sage‐grouse and important to livestock operations increased in 67% of the units.
Regulatory T cells (Tregs) play a neuroprotective role by suppressing microglia and macrophage-mediated inflammation and modulating adaptive immune reactions. We previously documented that Treg ...immunomodulatory mechanisms are compromised in Alzheimer's disease (AD). Ex vivo expansion of Tregs restores and amplifies their immunosuppressive functions in vitro. A key question is whether adoptive transfer of ex vivo expanded human Tregs can suppress neuroinflammation and amyloid pathology in a preclinical mouse model.
An immunodeficient mouse model of AD was generated by backcrossing the 5xFAD onto Rag2 knockout mice (5xFAD-Rag2KO). Human Tregs were expanded ex vivo for 24 days and administered to 5xFAD-Rag2KO. Changes in amyloid burden, microglia characteristics and reactive astrocytes were evaluated using ELISA and confocal microscopy. NanoString Mouse AD multiplex gene expression analysis was applied to explore the impact of ex vivo expanded Tregs on the neuroinflammation transcriptome.
Elimination of mature B and T lymphocytes and natural killer cells in 5xFAD-Rag2KO mice was associated with upregulation of 95 inflammation genes and amplified number of reactive microglia within the dentate gyrus. Administration of ex vivo expanded Tregs reduced amyloid burden and reactive glial cells in the dentate gyrus and frontal cortex of 5xFAD-Rag2KO mice. Interrogation of inflammation gene expression documented down-regulation of pro-inflammatory cytokines (IL1A&B, IL6), complement cascade (C1qa, C1qb, C1qc, C4a/b), toll-like receptors (Tlr3, Tlr4 and Tlr7) and microglial activations markers (CD14, Tyrobp,Trem2) following Treg administration.
Ex vivo expanded Tregs with amplified immunomodulatory function, suppressed neuroinflammation and alleviated AD pathology in vivo. Our results provide preclinical evidences for Treg cell therapy as a potential treatment strategy in AD.
Early intervention programs for youth in residential treatment can have a positive impact on numerous outcomes, including health, educational performance, and reduced prevalence of high-risk ...behaviors. Yet, there is currently a limited number of evidenced-based interventions that treat youth in these settings. This paper presents preliminary findings of a new psychosocial treatment for adolescents in residential treatment that can be implemented by front-line youth professionals. A 20-session multimodal group social skill building intervention, called KINNECT, was developed to address numerous health-risk behaviors through movement-based psychosocial skill building. A quasi-experimental post-test only design using non-equivalent groups was used on 63 participants from two residential treatment facilities in the Midwest. The findings of this study found a reduced likelihood of non-emergency medical visits and self-harming behavior in those who participated in the KINNECT intervention. The authors provide a discussion of these findings along with recommendations for future research.
Children diagnosed with reactive attachment disorder (RAD) have been reported to exhibit a multitude of symptoms and behaviors that are not captured by the Diagnostic and Statistical Manual of Mental ...Disorders criteria. One behavior in particular that has been the source of much argument and controversy is aggression. Although limited research on this topic does support an association between aggression and RAD behaviors, the exact nature of this link remains unclear. This study aims to fill this gap by reporting data from a study that examined the behavioral processes that occur in adopted children with RAD. Guided by the principles of grounded theory, this study employed a multi-stage semi-structured interview design. The sample consisted of 5 adoptive families, and included both adult and child participants, including the adopted children with RAD. The findings revealed 5 prominent themes: The adopted children are reported to engage in extreme and prolonged tantrums, known as rages; children were often inconsolable during these rages; these rages are perceived as uncontrollable by children with RAD; these rages are directed toward a discriminate caregiver; and the impetus for these rages appears to be associated with difficulties in adapting to environmental demands. An in-depth discussion that draws a theoretical connection between these rages and possible deficits in brain-based processes responsible for emotional regulation is presented.
Over the past decade, there has been substantial growth in empirical evidence supporting that proper assessment and treatment of trauma using evidence-based practices can effectively reduce a wide ...range of symptoms in both children and adults. Given the complex nature of trauma treatment, trauma-based educational programming in social work is most commonly found at the graduate level. Yet, to date, there has been little discussion calling for the inclusion of trauma content in BSW education. In this paper, we examine the current state of trauma-content inclusion in social work education, and offer a guiding framework for integrating core trauma content into the BSW curriculum that is based on the core principles of trauma-informed care.
Children with histories of early childhood neglect can exhibit a multitude of problematic behaviors, along with the potential for numerous physical and cognitive deficits. In some cases, these ...children can exhibit behaviors reflective of a diagnosis of reactive attachment disorder (RAD). Families who adopt children with RAD may face unique issues when it comes to addressing problem behavior and providing the child adequate care. This article discusses the results of a study that examined the processes that occur in families who adopt children with RAD. Guided by the principles of grounded theory, this study employed a multi-stage semi-structured interview design. The sample consisted of five adoptive families from the Midwest, and included both adult and child participants. The findings revealed six prominent themes: Parents report difficulty educating others about RAD; obtaining the needed care and services was a constant fight; RAD behavior is socially isolating; and raising a child with RAD is continuously stressful. Older siblings felt compelled to intervene in the care of the child with RAD; and felt increased autonomy from their parents. Implications for social work and clinical practice are discussed.
In the past 2 decades, social work education has increasingly advocated for inclusion of trauma-related content in educational programming. Yet, to date, little is known about the current state of ...trauma education and training in social work programs. The aim of this study is to describe trauma education and training in accredited, North American social work programs. The data are from an online survey of 192 social work educators from 165 universities with accredited social work programs in the United States (n=151) and Canada (n=14). Participants were asked whether trauma-specific education is offered, and if so, to provide the formats used to deliver the content, the type of curriculum used, and evaluation efforts. Most programs (67.9%) reported integrating trauma education into existing courses, with 61.4% of BSW programs and 65.4% of MSW programs offering some form of trauma education. Results suggest that social work educators are recognizing the importance of including trauma education in their programming. However, more evaluation is needed to identify specific trauma content being presented.
Deep Brain Stimulation in a Case of Mitochondrial Disease Martinez-Ramirez, Daniel; Hack, Nawaz; Vasquez, Matthew L. ...
Movement disorders clinical practice (Hoboken, N.J.),
March/April 2016, Volume:
3, Issue:
2
Journal Article
Peer reviewed
Open access
Background
DBS has proven to be an effective therapy for Parkinson's disease, essential tremor, and primary dystonia. Mixed results have been reported in case series for other hyperkinetic disorders, ...and sparse data are available regarding secondary movement disorders. We report on the clinical effects of bilateral globus pallidus internus (GPi) DBS, a progressive mitochondrial cytopathy.
Methods
A single patient with myoclonus and dystonia syndrome secondary to a mitochondrial cytopathy with history of perinatal hypoxia was identified from our University of Florida DBS database. Demographics, clinical, surgical, and DBS data were documented.
Results
At 6 months post‐DBS, we observed a 32% (361 to 527) improvement on quality of life (36‐item Medical Outcome Study Short‐Form Health Survey; SF‐36). Objective clinical scales revealed a 33% (143 to 96) improvement in the Unified Myoclonus Rating Scale (UMRS) total score. The UMRS action myoclonus subsection revealed a 29% (69 to 46) improvement. No significant changes were observed in the Burke‐Fahn‐Mardsen Dystonia Rating Scale (BFMDRS). After 1‐year follow‐up, a worsening of 59% (527 to 215) was observed in the SF‐36 scale, of 19% (28.5 to 35) in the BFMDRS, and of 23% (96 to 124) in the UMRS. However, the frequency and intensity of action myoclonus scores remained lower when compared to baseline scores.
Conclusions
Although we observed a loss of benefit in the long term for most quality‐of‐life and clinical outcomes, the DBS effects on action myoclonus seemed to remain stable. Longer follow‐up studies are necessary to confirm our short‐term and unblinded findings.
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