Recognizing Suicide Lethality Factors: Who is Competent?

Not all of those likely to counsel potential suicide victims are equally qualified to do so. How do the competency levels of various professional groups rate

The Price of Slavery: An Analysis of Human Trafficking Policy and Spending in Department of Defense Procurement

Excerpt from the Proceedings of the Nineteenth Annual Acquisition Research SymposiumThe Department of Defense (DoD) is charged with upholding the U.S. zero tolerance human trafficking policy in a world of complex, opaque supply chains and constrained human and capital resources. This study explores how the DoD can better leverage its acquisition workforce, sourcing expertise, and data to rigorously uphold the U.S. policy of zero tolerance for human trafficking in such an environment. As part of this analysis a program evaluation of the DoD’s Combating Trafficking in Persons training was conducted for the acquisition workforce. This evaluation categorized the training related to prevention, monitoring, and response to human trafficking. A quantitative analysis of DoD spending was conducted to illuminate the amount of tax dollars spent in categories, based on product and service codes, where trafficking is most prevalent to help the DoD focus its efforts for program improvement. The spend analysis revealed areas that are most at risk. Globally, an estimated 24.9 million people are subjected to human trafficking, which generates an estimated $150 billion annually in illicit profits (White House, 2020, p. 8). Specifically, the DoD spent$13.1 billion (2018–2020) in countries that are not making significant efforts to combat human trafficking according to the Department of State. The research provides insight and recommendations on where the DoD should focus attention to address human trafficking in contracts constrained of prevention, monitoring, and response resources. Finally, we provided recommended courses of action to increase participation and enhance the mandatory training for the acquisition workforce.Approved for public release; distribution is unlimited

Vascular Dysfunction and Posttraumatic Stress Disorder: Examining the Role of Oxidative Stress and Sympathetic Activity

Purpose: The physiological manifestations of posttraumatic stress disorder (PTSD) have been associated with an increase in risk of cardiovascular disease (CVD) independent of negative lifestyle factors. The goal of the study was to better elucidate the mechanisms behind the increased CVD risk by examining peripheral vascular function, a precursor to CVD. Moreover, this study sought to determine the role of oxidative stress and sympathetic nervous system (SNS) activity in PTSD-induced vascular dysfunction. Methods: Sixteen individuals with PTSD (10 women, 6 men; age 24 ± 4 years), and twenty-four healthy controls (CTRL; 15 women, 9 men, 24 ± 4 years), participated in the study. The PTSD group participated in two visits, consuming either a placebo or antioxidant cocktail (AO - vitamins C and E and alpha lipoic acid) prior to their visits, in a randomized order. Arm vascular function was assessed via the reactive hyperemia- induced flow mediated dilation of the brachial artery (BAFMD) technique and evaluated with Doppler ultrasonography. Brachial artery and arm microvascular function were determined by percent change of diameter from baseline normalized for BA shear rate (BAD/Shear), and blood flow area under the curve (BF AUC), respectively. Heart rate variability (HRV) was used to assess autonomic nervous system activity. Results: BF AUC was significantly lower (p = 0.02) and SNS activity was significantly higher (p = 0.02) in the PTSD group when compared to the CTRL group. BAD/Shear was not different between groups. Following the acute AO supplementation, BF AUC was augmented to which it was no longer significantly different (p = 0.16) when compared to the CTRL group. SNS activity within the PTSD group was significantly reduced (p=.007) following the AO supplementation when compared to the PL condition, and the difference between PTSD and CTRL was no longer significant (p=.41). Conclusion: Young individuals with PTSD demonstrated lower arm microvascular, but not brachial artery, function as well as higher sympathetic activity when compared to healthy controls matched for age, sex, and physical activity level. Furthermore, this microvascular dysfunction and SNS activity was attenuated by an acute AO supplementation to the level of the healthy controls. Taken together, this study revealed that the modulation of oxidative stress, via an acute AO supplementation, improved vascular dysfunction in individuals with PTSD, potentially by reducing the substantial SNS activity associated with this disorder.https://scholarscompass.vcu.edu/gradposters/1084/thumbnail.jp

THE PRICE OF SLAVERY: AN ANALYSIS OF HUMAN TRAFFICKING POLICY AND SPENDING IN DEPARTMENT OF DEFENSE PROCUREMENT

The Department of Defense (DOD) is charged with upholding the U.S. zero-tolerance human trafficking policy in a world of complex, opaque supply chains and constrained human and capital resources. This study explores how the DOD can better leverage its acquisition workforce, sourcing expertise, and data to rigorously uphold U.S. policy of zero-tolerance for human trafficking in such an environment. As part of this analysis a program evaluation of the DOD’s Combating Trafficking in Persons training was conducted for the acquisition workforce. This evaluation categorized the training related to prevention, monitoring, and response to human trafficking. A quantitative analysis of DOD spend was conducted to illuminate the amount of tax dollars spent in categories, based on product and service codes, where trafficking is most prevalent to help the DOD focus its efforts for program improvement. The spend analysis revealed areas that are most at risk. Specifically, the DOD spent $13.1 billion (2018–2020) in countries that are not making significant efforts to combat human trafficking according to the Department of State. The research provides insight and recommendations on where the DOD should focus attention to address human trafficking in contracts constrained of prevention, monitoring, and response resources. Finally, we provided recommended courses of action to increase participation and enhance the mandatory training for the acquisition workforce.Outstanding ThesisFirst Lieutenant, United States Air ForceCaptain, United States Air ForceFirst Lieutenant, United States Air ForceApproved for public release. Distribution is unlimited

Prioritizing Investment in Residential Energy Efficiency and Renewable Energy: A Case Study for the U.S. Midwest

Residential building energy use is an important contributor to greenhouse gas emissions and in the United States represents about 20% of total energy consumption. A number of previous macro-scale studies of residential energy consumption and energy-efficiency improvements are mainly concerned with national or international aggregate potential savings. In this paper we look into the details of how a collection of specific homes in one region might reduce energy consumption and carbon emissions, with particular attention given to some practical limits to what can be achieved by upgrading the existing residential building stock. Using a simple model of residential, single-family home construction characteristics, estimates are made for the efficacy of (i) changes to behavioral patterns that do not involve building shell modifications; (ii) straightforward air-infiltration mitigation measures, and (iii) insulation measures. We derive estimates of net lifetime savings resulting from these measures, in terms of energy, carbon emissions and dollars. This study points out explicitly the importance of local and regional patterns in decision-making about what fraction of necessary regional or national emissions reduction might be accomplished through energy-efficiency measures and how much might need to concentrate more heavily on renewable or other carbon-free sources of energy

Targeting Residential Energy Reduction for City Utilities Using Historical Electrical Utility Data and Readily Available Building Data

Energy use data for the eight-year period 2003–2010 was analyzed for over 1200 single family residences in Village of Yellow Springs, Ohio. Electricity, natural gas, residential building, and weather databases are merged to permit determination of the energy intensity of each home in the village. The energy use intensity for each home is disaggregated into weather independent and weather dependent electric and natural gas use. This use is compared to typical baseline, cooling, and heating energy use for the region. From this comparison, priority homes are identified for energy reduction investment. Collective potential low cost energy reduction is estimated for the community. Energy reduction of greater than 41% is determined to be easily achievable. Finally, a process is established, beginning with individual home energy report cards, for turning the analysis and predictions into energy reduction action

Effects of Dietary Sodium Intake on Blood Flow Regulation During Exercise in Salt Resistant Individuals

PURPOSE: Dietary sodium intake guidelines is ≤2,300 mg/day, yet is exceeded by 90% of Americans. This study examined the impact of a high sodium diet on blood flow regulation during exercise. METHODS: Six males (25 ± 2 years) consumed dietary sodium intake guidelines for two weeks, with one week salt-capsule supplemented (HS: 6,900 mg/day of sodium) and the other week placebo-capsule supplemented (LS: 2,300 mg/day of sodium). At the end of each week, peripheral hemodynamic measurements [blood flow (BF), shear rate (SR), and flow mediated dilation (FMD)/SR)] of the brachial and superficial femoral artery were taken during handgrip (HG) and plantar flexion (PF) exercise, respectively. Each exercise workload was 3 minutes and progressed by 8 kilograms until exhaustion. RESULTS: There were no differences between LS and HS in blood pressure (82 ± 4 v 80 ± 5 mmHg; p = 0.3) or heart rate (56 ± 6 v 59 ± 10 bpm; p = 0.4). HG and PF exercise increased BF, SR, and FMD/SR across workload (p \u3c 0.03 for all), but no difference between diets (p \u3e 0.05 for all). CONCLUSION: Despite previous reports that HS impairs resting vascular function, this study revealed that peripheral vascular function and blood flow regulation during exercise is not impacted by a HS diet.https://scholarscompass.vcu.edu/gradposters/1082/thumbnail.jp

Collaboration in the Semantic Grid: a Basis for e-Learning

The CoAKTinG project aims to advance the state of the art in collaborative mediated spaces for the Semantic Grid. This paper presents an overview of the hypertext and knowledge based tools which have been deployed to augment existing collaborative environments, and the ontology which is used to exchange structure, promote enhanced process tracking, and aid navigation of resources before, after, and while a collaboration occurs. While the primary focus of the project has been supporting e-Science, this paper also explores the similarities and application of CoAKTinG technologies as part of a human-centred design approach to e-Learning

Use of Social Media Across US Hospitals: Descriptive Analysis of Adoption and Utilization

Background: Use of social media has become widespread across the United States. Although businesses have invested in social media to engage consumers and promote products, less is known about the extent to which hospitals are using social media to interact with patients and promote health. Objective: The aim was to investigate the relationship between hospital social media extent of adoption and utilization relative to hospital characteristics. Methods: We conducted a cross-sectional review of hospital-related activity on 4 social media platforms: Facebook, Twitter, Yelp, and Foursquare. All US hospitals were included that reported complete data for the Centers for Medicare and Medicaid Services Hospital Consumer Assessment of Healthcare Providers and Systems survey and the American Hospital Association Annual Survey. We reviewed hospital social media webpages to determine the extent of adoption relative to hospital characteristics, including geographic region, urban designation, bed size, ownership type, and teaching status. Social media utilization was estimated from user activity specific to each social media platform, including number of Facebook likes, Twitter followers, Foursquare check-ins, and Yelp reviews. Results: Adoption of social media varied across hospitals with 94.41% (3351/3371) having a Facebook page and 50.82% (1713/3371) having a Twitter account. A majority of hospitals had a Yelp page (99.14%, 3342/3371) and almost all hospitals had check-ins on Foursquare (99.41%, 3351/3371). Large, urban, private nonprofit, and teaching hospitals were more likely to have higher utilization of these accounts. Conclusions: Although most hospitals adopted at least one social media platform, utilization of social media varied according to several hospital characteristics. This preliminary investigation of social media adoption and utilization among US hospitals provides the framework for future studies investigating the effect of social media on patient outcomes, including links between social media use and the quality of hospital care and services