Camp is for Everyone: Intentional Inclusion of Gender-Expansive Teens at Camp

Camp remains a powerful experience for youth of any age, but special care must be taken to ensure camps are supportive of diverse audiences. This article describes the process by which 4-H camp organizers created a welcoming and affirming camp for teen dependents of active duty, retired, or veteran military personnel, especially those campers who identified as non-binary or LGBTQ+. This included careful consideration of language used in recruitment documents, evaluation documents, volunteer and staff training, as well as communication with campers and families. Through careful planning and implementation, the 4-H adventure camps engaged over 90 teens, and survey results showed statistically significant improvements in camper perceptions of self-worth and satisfaction after their camp experience

Nonprofit Data Management: A Stage Model

Managing nonprofit data is both complicated and essential. Nonprofits, while struggling to manage and utilize data to its fullest potential, are increasingly required to do so for funding purposes. Despite the increased pressure on nonprofit managers to report more outcomes to grant funders, little research is available to guide the data management process in nonprofits. Research that does exist is primarily focused on the for-profit or business sector, which is operationally and fundamentally different than nonprofits. For example, for-profit entities typically do not have the same restrictions on how to use funds, such as a percentage cap on spending for non-direct business costs (or overhead), that nonprofits must contend with. Additional funding restrictions, such as funders not allowing infrastructure spending, further constrain how nonprofits manage their technology and their data. As such, the research, and recommendations for data management in the for-profit sector are often not as applicable to the nonprofit sector. This dissertation sought to discover the ways in which nonprofits manage their data, and whether those data management practices are related to nonprofit program outputs and outcomes. Utilizing Stage Theory, the literature review focused on the data collected and used by nonprofits, as well as their data management practices, and that review was used to create a Nonprofit Data Management Stage Model. The model organizes nonprofit data management practices into four separate practice domains and places data management elements in each domain into five distinct stages of data management. Using results from a survey sent to domestic violence shelters across the nation, reported data management practices were placed within the various domains and stages within the Nonprofit Data Management Stage Model. Output and outcome measures collected from the same survey were used to test the relationship between data management practices and program outcomes of nonprofits

IL-4 Signaling Drives a Unique Arginase\u3csup\u3e+\u3c/sup\u3e/IL-1β\u3csup\u3e+\u3c/sup\u3e Microglia Phenotype and Recruits Macrophages to the Inflammatory CNS: Consequences of Age-Related Deficits in IL-4Rα after Traumatic Spinal Cord Injury

Alternative activation of microglia/macrophages (M2a) by interleukin (IL)-4 is purported to support intrinsic growth and repair processes after CNS injury. Nonetheless, alternative activation of microglia is poorly understood in vivo, particularly in the context of inflammation, injury, and aging. Here, we show that aged mice (18-19 months) had reduced functional recovery after spinal cord injury (SCI) associated with impaired induction of IL-4 receptor α (IL-4Rα) on microglia. The failure to successfully promote an IL-4/IL-4Rα response in aged mice resulted in attenuated arginase (M2a associated), IL-1β, and chemokine ligand 2 (CCL2) expression, and diminished recruitment of IL-4Rα+ macrophages to the injured spinal cord. Furthermore, the link between reduced IL-4Rα expression and reduced arginase, IL-1β, and CCL2 expression was confirmed using adult IL-4Rα knock-out (IL-4RαKO) mice. To better understand IL-4Rα-mediated regulation of active microglia, a series of studies was completed in mice that were peripherally injected with lipopolysaccharide and later provided IL-4 by intracerebroventricular infusion. These immune-based studies demonstrate that inflammatory-induced IL-4Rα upregulation on microglia was required for the induction of arginase by IL-4. In addition, IL-4-mediated reprogramming of active microglia enhanced neurite growth ex vivo and increased inflammatory gene expression (i.e., IL-1β and CCL2) and the corresponding recruitment of CCR2+/IL-4Rα+/arginase+ myeloid cells in vivo. IL-4 reprogrammed active microglia to a unique and previously unreported phenotype (arginase+/IL-1β+) that augmented neurite growth and enhanced recruitment of peripheral IL-4Rα+ myeloid cells to the CNS. Moreover, this key signaling cascade was impaired with age corresponding with reduced functional recovery after SCI

Emergent productivity regimes of river networks

High-resolution data are improving our ability to resolve temporal patterns and controls on river productivity, but we still know little about the emergent patterns of primary production at river-network scales. Here, we estimate daily and annual river-network gross primary production (GPP) by applying characteristic temporal patterns of GPP (i.e., regimes) representing distinct river functional types to simulated river networks. A defined envelope of possible productivity regimes emerges at the network-scale, but the amount and timing of network GPP can vary widely within this range depending on watershed size, productivity in larger rivers, and reach-scale variation in light within headwater streams. Larger rivers become more influential on network-scale GPP as watershed size increases, but small streams with relatively low productivity disproportionately influence network GPP due to their large collective surface area. Our initial predictions of network-scale productivity provide mechanistic understanding of the factors that shape aquatic ecosystem function at broad scales

Physician Intervention to Positive Depression Screens Among Adolescents in Primary Care

Purpose The objective of this study was to determine the effectiveness of computer-based screening and physician feedback to guide adolescent depression management within primary care. Methods We conducted a prospective cohort study within two clinics of the computer-based depression screening and physician feedback algorithm among youth aged 12–20 years between October 2014 and October 2015 in Marion County (Indianapolis), Indiana. Results Our sample included 2,038 youth (51% female; 60% black; mean age = 14.6 years [standard deviation = 2.1]). Over 20% of youth screened positive for depression on the Patient Health Questionnaire-2 and 303 youth (14.8%) screened positive on the Patient Health Questionnaire-9 (PHQ-9). The most common follow-up action by physicians was a referral to mental health services (34.2% mild, 46.8% moderate, and 72.2% severe range). Almost 11% of youth in the moderate range and 22.7% of youth in the severe range were already prescribed a selective serotonin reuptake inhibitor. When predicting mental health service referral, significant predictors in the multivariate analysis included clinic site (40.2% vs. 73.9%; p < .0001) and PHQ-9 score (severe range 77.8% vs. mild range 47.5%; p < .01). Similarly, when predicting initiation of selective serotonin reuptake inhibitors, only clinic site (28.6% vs. 6.9%; p < .01) and PHQ-9 score (severe range 46.7% vs. moderate range 10.6%; p < .001) were significant. Conclusions When a computer-based decision support system algorithm focused on adolescent depression was implemented in two primary care clinics, a majority of physicians utilized screening results to guide clinical care

Cognitive dysfunction after analgesia and sedation: Out of the operating room and into the pediatric intensive care unit

In the midst of concerns for potential neurodevelopmental effects after surgical anesthesia, there is a growing awareness that children who require sedation during critical illness are susceptible to neurologic dysfunctions collectively termed pediatric post-intensive care syndrome, or PICS-p. In contrast to healthy children undergoing elective surgery, critically ill children are subject to inordinate neurologic stress or injury and need to be considered separately. Despite recognition of PICS-p, inconsistency in techniques and timing of post-discharge assessments continues to be a significant barrier to understanding the specific role of sedation in later cognitive dysfunction. Nonetheless, available pediatric studies that account for analgesia and sedation consistently identify sedative and opioid analgesic exposures as risk factors for both in-hospital delirium and post-discharge neurologic sequelae. Clinical observations are supported by animal models showing neuroinflammation, increased neuronal death, dysmyelination, and altered synaptic plasticity and neurotransmission. Additionally, intensive care sedation also contributes to sleep disruption, an important and overlooked variable during acute illness and post-discharge recovery. Because analgesia and sedation are potentially modifiable, understanding the underlying mechanisms could transform sedation strategies to improve outcomes. To move the needle on this, prospective clinical studies would benefit from cohesion with regard to datasets and core outcome assessments, including sleep quality. Analyses should also account for the wide range of diagnoses, heterogeneity of this population, and the dynamic nature of neurodevelopment in age cohorts. Much of the related preclinical evidence has been studied in comparatively brief anesthetic exposures in healthy animals during infancy and is not generalizable to critically ill children. Thus, complementary animal models that more accurately reverse translate critical illness paradigms and the effect of analgesia and sedation on neuropathology and functional outcomes are needed. This review explores the interactive role of sedatives and the neurologic vulnerability of critically ill children as it pertains to survivorship and functional outcomes, which is the next frontier in pediatric intensive care