Disrupting the Intergenerational Transmission of Trauma among Alaska Native People: A Conceptual Model for the Family Wellness Warriors Initiative

Background: Increasing evidence demonstrates the life-long physical, emotional, and social effects of traumatic experiences. In recognition that many health disparities are driven by high rates of traumatic experiences, Alaska Native and American Indian people have created wellness programs that build health by first healing historical and lifetime trauma. Yet, many of these promising community-based interventions are not described in the health sciences literature. Southcentral Foundation’s Family Wellness Warriors Initiative (FWWI) was created by Alaska Native people, addresses traumatic experiences as the root cause of family violence, and builds on cultural strengths. The goal of this study was to build a conceptual model for the program, which has more than 11, 494 participants. Methods: Focus groups were conducted with 27 training graduates and 7 program staff. Transcripts from previous focus groups with 52 total participants were also analyzed. The evaluator and 15 program staff used participatory qualitative analysis and grounded theory to build the conceptual model. Results: Participant responses indicated that change occurred in stages, with healing from the pain and shame of trauma a necessary precursor to building self-esteem, improving family relationships, making positive life changes, and helping others. Activities reported to drive changes included sharing story in group and receiving affirming responses, connecting to others with similar experiences, and actively practicing interpersonal skills, goal setting, and observing and accepting emotions. Additionally, respondents said that participating in a strengths-based Alaska Native-led process was healing and increased self-esteem. Conclusion: As trauma survivors often develop behaviors that disrupt family life and affect the next generation, FWWI heals this trauma to prevent its transmission. The specific techniques utilized and symptoms addressed closely match evidence-based interventions for complex trauma. FWWI differs because it is Alaska Native-led, emphasizes culture and spirituality, and uses peer leaders and modeling rather than clinical hierarchy

Distribution and Ecology of Invasive Ants

This project examines exactly how invasive specific types of ants are, and what effect that has on the ecosystem. To do so, most of the research must be compiled for the first time, as there is a lack of knowledge and research on this subject. Through former research, Tillberg finds that there are invasive pavement ants in Oregon state parks, but due to a lack of research on the species, their impact is unknown. The research will follow a paired design, comparing similar areas with and without pavement ants, to discover what differences this invasive species has on habitats

Distribution and Ecology of Invasive Ants

This project examines exactly how invasive specific types of ants are, and what effect that has on the ecosystem. To do so, most of the research must be compiled for the first time, as there is a lack of knowledge and research on this subject. Through former research, Tillberg finds that there are invasive pavement ants in Oregon state parks, but due to a lack of research on the species, their impact is unknown. The research will follow a paired design, comparing similar areas with and without pavement ants, to discover what differences this invasive species has on habitats

Environmental surveillance as a tool for identifying high-risk settings for typhoid transmission

Enteric fever remains a major cause of morbidity in developing countries with poor sanitation conditions that enable fecal contamination of water distribution systems. Historical evidence has shown that contamination of water systems used for household consumption or agriculture are key transmission routes for Salmonella Typhi and Salmonella Paratyphi A. The World Health Organization now recommends that typhoid conjugate vaccines (TCV) be used in settings with high typhoid incidence; consequently, governments face a challenge regarding how to prioritize typhoid against other emerging diseases. A key issue is the lack of typhoid burden data in many low- and middle-income countries where TCV could be deployed. Here we present an argument for utilizing environmental sampling for the surveillance of enteric fever organisms to provide data on community-level typhoid risk. Such an approach could complement traditional blood culture-based surveillance or even replace it in settings where population-based clinical surveillance is not feasible. We review historical studies characterizing the transmission of enteric fever organisms through sewage and water, discuss recent advances in the molecular detection of typhoidal Salmonella in the environment, and outline challenges and knowledge gaps that need to be addressed to establish environmental sampling as a tool for generating actionable data that can inform public health responses to enteric fever

Scaling up evidence-based approaches to tuberculosis screening in prisons

People deprived of liberty have among the highest rates of tuberculosis globally. The incidence of tuberculosis is ten times greater than the incidence of tuberculosis in the general population. In 2021, WHO updated its guidance to strongly recommend systematic screening for tuberculosis in prisons and penitentiary systems. Which case-finding strategies should be adopted, and how to effectively implement these strategies in these settings, will be crucial questions facing ministries of health and justice. In this Viewpoint, we review the evidence base for tuberculosis screening and diagnostic strategies in prisons, highlighting promising approaches and knowledge gaps. Drawing upon past experiences of implementing active case-finding and care programmes in settings with a high tuberculosis burden, we discuss challenges and opportunities for improving the tuberculosis diagnosis and treatment cascade in these settings. We argue that improved transparency in reporting of tuberculosis notifications and outcomes in prisons and renewed focus and resourcing from WHO and other stakeholders will be crucial for building the commitment and investments needed from countries to address the continued crisis of tuberculosis in prisons

Diverse Applications of Nanomedicine

The design and use of materials in the nanoscale size range for addressing medical and health-related issues continues to receive increasing interest. Research in nanomedicine spans a multitude of areas, including drug delivery, vaccine development, antibacterial, diagnosis and imaging tools, wearable devices, implants, high-throughput screening platforms, etc. using biological, nonbiological, biomimetic, or hybrid materials. Many of these developments are starting to be translated into viable clinical products. Here, we provide an overview of recent developments in nanomedicine and highlight the current challenges and upcoming opportunities for the field and translation to the clinic. \ua9 2017 American Chemical Society

Mechanism of KMT5B haploinsufficiency in neurodevelopment in humans and mice.

Pathogenic variants in KMT5B, a lysine methyltransferase, are associated with global developmental delay, macrocephaly, autism, and congenital anomalies (OMIM# 617788). Given the relatively recent discovery of this disorder, it has not been fully characterized. Deep phenotyping of the largest (n = 43) patient cohort to date identified that hypotonia and congenital heart defects are prominent features that were previously not associated with this syndrome. Both missense variants and putative loss-of-function variants resulted in slow growth in patient-derived cell lines. KMT5B homozygous knockout mice were smaller in size than their wild-type littermates but did not have significantly smaller brains, suggesting relative macrocephaly, also noted as a prominent clinical feature. RNA sequencing of patient lymphoblasts and Kmt5b haploinsufficient mouse brains identified differentially expressed pathways associated with nervous system development and function including axon guidance signaling. Overall, we identified additional pathogenic variants and clinical features in KMT5B-related neurodevelopmental disorder and provide insights into the molecular mechanisms of the disorder using multiple model systems

Clinical Sequencing Exploratory Research Consortium: Accelerating Evidence-Based Practice of Genomic Medicine

Despite rapid technical progress and demonstrable effectiveness for some types of diagnosis and therapy, much remains to be learned about clinical genome and exome sequencing (CGES) and its role within the practice of medicine. The Clinical Sequencing Exploratory Research (CSER) consortium includes 18 extramural research projects, one National Human Genome Research Institute (NHGRI) intramural project, and a coordinating center funded by the NHGRI and National Cancer Institute. The consortium is exploring analytic and clinical validity and utility, as well as the ethical, legal, and social implications of sequencing via multidisciplinary approaches; it has thus far recruited 5,577 participants across a spectrum of symptomatic and healthy children and adults by utilizing both germline and cancer sequencing. The CSER consortium is analyzing data and creating publically available procedures and tools related to participant preferences and consent, variant classification, disclosure and management of primary and secondary findings, health outcomes, and integration with electronic health records. Future research directions will refine measures of clinical utility of CGES in both germline and somatic testing, evaluate the use of CGES for screening in healthy individuals, explore the penetrance of pathogenic variants through extensive phenotyping, reduce discordances in public databases of genes and variants, examine social and ethnic disparities in the provision of genomics services, explore regulatory issues, and estimate the value and downstream costs of sequencing. The CSER consortium has established a shared community of research sites by using diverse approaches to pursue the evidence-based development of best practices in genomic medicine