Links between traumatic brain injury and ballistic pressure waves originating in the thoracic cavity and extremities

Identifying patients at risk of traumatic brain injury (TBI) is important because research suggests prophylactic treatments to reduce risk of long-term sequelae. Blast pressure waves can cause TBI without penetrating wounds or blunt force trauma. Similarly, bullet impacts distant from the brain can produce pressure waves sufficient to cause mild to moderate TBI. The fluid percussion model of TBI shows that pressure impulses of 15-30 psi cause mild to moderate TBI in laboratory animals. In pigs and dogs, bullet impacts to the thigh produce pressure waves in the brain of 18-45 psi and measurable injury to neurons and neuroglia. Analyses of research in goats and epidemiological data from shooting events involving humans show high correlations (r > 0.9) between rapid incapacitation and pressure wave magnitude in the thoracic cavity. A case study has documented epilepsy resulting from a pressure wave without the bullet directly hitting the brain. Taken together, these results support the hypothesis that bullet impacts distant from the brain produce pressure waves that travel to the brain and can retain sufficient magnitude to induce brain injury. The link to long-term sequelae could be investigated via epidemiological studies of patients who were gunshot in the chest to determine whether they experience elevated rates of epilepsy and other neurological sequelae

Conversations with Gatekeepers: An Exploratory Study of Agricultural Publication Editors\u27 Decisions to Publish Risk Coverage

The United States’ agriculture industry is impacted by numerous financial, human, legal, and production risks. These risks are frequently reported in mass media and agricultural publications. Farmers often use agricultural magazines to help them make production decisions and learn about new technology, which both involve some element of risk. Gatekeeping is the process of determining what information is included in media coverage in which editors serve as gatekeepers and make decisions regarding what topics to report. The purpose of this study was to discover how agricultural publication editors, in their role as gatekeepers, make decisions regarding coverage of risk related to agriculture and to explore the forces that influence this coverage. Researchers interviewed seven purposively selected editors of national or regional agricultural magazines. The findings indicated that the editors conceptualize risk in agriculture differently from how agricultural risks are reported in the mainstream media for the more general public; many emphasized the issues in terms of marketing or financial risk. Editors emphasized that they report on risk from an action angle, providing advice or information on how to mitigate the risk. The public’s perception of agriculture, advertisers, and personal topic preferences were cited as influencers of their risk coverage. When covering risk stories, agricultural publication editors prefer journalists who can write well and have an agricultural background or knowledge of the industry. Future research should be conducted to expand on the results from this exploratory study

Predicting Patriarchy: Using Individual and Contextual Factors to Examine Patriarchal Endorsement in Communities

In much feminist literature, patriarchy has often been studied as a predictive variable for attitudes toward or acts of violence against women. However, rarely has patriarchy been examined as an outcome across studies. The current study works toward filling this gap by examining several individual-and neighborhood-level factors that might influence patriarchy. Specifically, this research seeks to determine if neighborhood-level attributes related to socioeconomic status, family composition, and demographic information affect patriarchal views after individual-level correlates of patriarchy were controlled. Findings suggest that factors at both the individual- and neighborhood levels, particularly familial characteristics and dynamics, do influence the endorsement of patriarchal views

Coming in Warm: Qualitative Study and Concept Map to Cultivate Patient‐Centered Empathy in Emergency Care

Background Increased empathy may improve patient perceptions and outcomes. No training tool has been derived to teach empathy to emergency care providers. Accordingly, we engaged patients to assist in creating a concept map to teach empathy to emergency care providers. Methods We recruited patients, patient caretakers and patient advocates with emergency department experience to participate in three separate focus groups (n = 18 participants). Facilitators guided discussion about behaviors that physicians should demonstrate in order to rapidly create trust, enhance patient perception that the physician understood the patient's point of view, needs, concerns, fears, and optimize patient/caregiver understanding of their experience. Verbatim transcripts from the three focus groups were read by the authors and by consensus, 5 major themes with 10 minor themes were identified. After creating a codebook with thematic definitions, one author reviewed all transcripts to a library of verbatim excerpts coded by theme. To test for inter‐rater reliability, two other authors similarly coded a random sample of 40% of the transcripts. Authors independently chose excerpts that represented consensus and strong emotional responses from participants. Results Approximately 90% of opinions and preferences fell within 15 themes, with five central themes: Provider transparency, Acknowledgement of patient's emotions, Provider disposition, Trust in physician, and Listening. Participants also highlighted the need for authenticity, context and individuality to enhance empathic communication. For empathy map content, patients offered example behaviors that promote perceptions of physician warmth, respect, physical touch, knowledge of medical history, explanation of tests, transparency, and treating patients as partners. The resulting concept map was named the “Empathy Circle”. Conclusions Focus group participants emphasized themes and tangible behaviors to improve empathy in emergency care. These were incorporated into the “Empathy Circle”, a novel concept map that can serve as the framework to teach empathy to emergency care providers

Testing Multi-Field Inflation: A Geometric Approach

We develop an approach for linking the power spectra, bispectrum, and trispectrum to the geometric and kinematical features of multifield inflationary Lagrangians. Our geometric approach can also be useful in determining when a complicated multifield model can be well approximated by a model with one, two, or a handful of fields. To arrive at these results, we focus on the mode interactions in the kinematical basis, starting with the case of no sourcing and showing that there is a series of mode conservation laws analogous to the conservation law for the adiabatic mode in single-field inflation. We then treat the special case of a quadratic potential with canonical kinetic terms, showing that it produces a series of mode sourcing relations identical in form to that for the adiabatic mode. We build on this result to show that the mode sourcing relations for general multifield inflation are extension of this special case but contain higher-order covariant derivatives of the potential and corrections from the field metric. In parallel, we show how these interactions depend on the geometry of the inflationary Lagrangian and on the kinematics of the associated field trajectory. Finally, we consider how the mode interactions and effective number of fields active during inflation are reflected in the spectra and introduce a multifield consistency relation, as well as a multifield observable that can potentially distinguish two-field scenarios from scenarios involving three or more effective fields.Comment: 21 pages, 4 figures + tables. Revised to clarify several points and reorganized Section III for pedagogical reasons. Error in one equation and typos were corrected, as well as additional references adde