Mental Health Status and Perceived Barriers to Seeking Treatment in Rural Reserve Component Veterans

National Guard and Reserve (RC) troops (N=617) primarily from the Appalachian Region in Southwestern Pennsylvania who recently returned from deployment in support of current military conflicts responded to a survey that assessed their demographics, mental health symptoms, help-seeking behaviors, barriers for not seeking treatment, deployment history, and stressors. Veterans were classified as rural (N = 334) or non-rural (N = 283). Rural participants reported a significantly greater number of issues with transportation/access in seeking mental health treatment, were more likely to perceive others as worse off as a reason not to seek treatment, had a more negative attitude toward seeking treatment for mental health problems, and reported fewer concerns about a mental health problem affecting their career. Recommendations for mental health care providers and policymakers are offered based on the results, including the importance of recognizing the distinctive barriers to care that RC Appalachian veterans face when they come back into civilian communities, many of them rural

Longitudinal Predictors of Self-Reliance for Coping with Mental Health Problems in the Military

Military personnel encounter occupational hazards that make them vulnerable to developing mental health symptoms; however, many soldiers who experience a problem do not seek treatment. A major barrier to treatment is self-reliance, a preference to manage problems oneself rather than seek help from a professional. In the present study, we sought a more comprehensive understanding of factors that contribute to self-reliance. Active-duty soldiers (N = 485) were surveyed at two time points. The sample was 93% male, 67% Caucasian, and most were aged 20-24 (49%). The survey included: factors that affect treatment-seeking, deployment experiences, and mental health symptoms. Results indicated that stigmatizing beliefs about those who seek treatment and negative beliefs about treatment at Time 1 were related to higher preferences for self-reliance at Time 2, while positive beliefs about treatment at Time 1 were related to lower self-reliance. Combat exposure, mental health symptoms, social support for treatment-seeking, and stigma from others were not significant predictors. These results demonstrate that self-reliance may not be unique to combat soldiers and may not diminish as symptoms become severe. Instead one’s views of treatment and others who seek treatment may be more impactful, and should be the target of interventions to encourage treatment-seeking

Chronotype, Shift Work, and Sleep Problems Among Emergency Medicine Clinicians

Introduction: Extensive research has demonstrated that shift work can be detrimental to sleep. Chronotype, the preference for time of day to sleep or be active, can influence how we function at different times of day and how shift work impacts us. This study was designed to assess the chronotype of emergency physicians (EPs) and emergency advanced practice providers (EAPPs) and examine how chronotype was related to sleep problems and shifts worked over a three-month period. Methods: A survey assessing chronotype and sleep quality was sent to 225 EPs and EAPPs in a single, large academic Department of Emergency Medicine. An archival database indicated the shifts worked during the prior three months and the percentages of day, evening, and night shifts for each practitioner were calculated. Results: 127 people completed the survey (56.4%). Of the three chronotypes (morning, intermediate, evening), most EM clinicians were categorized as intermediate chronotype (56/127, 44.1%), followed by morning type (39/127, 30.7%) and then evening type (32/127, 25.2%). Those with an evening chronotype were more likely to report daytime dysfunction (a lack of enthusiasm and propensity to fall asleep during activities) (p \u3c 0.01) and worked a greater percentage of night shifts than other chronotypes (p \u3c 0.05). Interestingly, the effect of evening chronotype on daytime dysfunction was no longer significant when controlled for the relatively greater percentage of night shifts worked, suggesting that the observed dysfunction was more likely an artifact of the night shifts worked, rather than purely chronotype driven. Conclusion: This is the first study of a large cohort of EM practitioners investigating chronotype and its influence on shift preference and sleep quality. In this pilot investigation, most of the surveyed clinicians were categorized as an intermediate chronotype. Working night shifts was associated more closely with daytime dysfunction than was chronotype, strengthening the latent literature that working night shift carries with it significant challenges to the EM clinician. Future research should evaluate the relationship between chronotype malalignment to practitioner burnout and well-being

Environment geometry alters subiculum boundary vector cell receptive fields in adulthood and early development

Boundaries to movement form a specific class of landmark information used for navigation: Boundary Vector Cells (BVCs) are neurons which encode an animal's location as a vector displacement from boundaries. Here we characterise the prevalence and spatial tuning of subiculum BVCs in adult and developing male rats, and investigate the relationship between BVC spatial firing and boundary geometry. BVC directional tunings align with environment walls in squares, but are uniformly distributed in circles, demonstrating that environmental geometry alters BVC receptive fields. Inserted barriers uncover both excitatory and inhibitory components to BVC receptive fields, demonstrating that inhibitory inputs contribute to BVC field formation. During post-natal development, subiculum BVCs mature slowly, contrasting with the earlier maturation of boundary-responsive cells in upstream Entorhinal Cortex. However, Subiculum and Entorhinal BVC receptive fields are altered by boundary geometry as early as tested, suggesting this is an inherent feature of the hippocampal representation of space

X-ray Spectroscopic Study of the Electronic Structure of a Trigonal High-Spin Fe(IV)═O Complex Modeling Non-Heme Enzyme Intermediates and Their Reactivity

Fe K-edge X-ray absorption spectroscopy (XAS) has long been used for the study of high-valent iron intermediates in biological and artificial catalysts. 4p-mixing into the 3d orbitals complicates the pre-edge analysis but when correctly understood via 1s2p resonant inelastic X-ray scattering and Fe L-edge XAS, it enables deeper insight into the geometric structure and correlates with the electronic structure and reactivity. This study shows that in addition to the 4p-mixing into the 3dz2 orbital due to the short iron-oxo bond, the loss of inversion in the equatorial plane leads to 4p mixing into the 3dx2-y2,xy, providing structural insight and allowing the distinction of 6- vs 5-coordinate active sites as shown through application to the Fe(IV)═O intermediate of taurine dioxygenase. Combined with O K-edge XAS, this study gives an unprecedented experimental insight into the electronic structure of Fe(IV)═O active sites and their selectivity for reactivity enabled by the π-pathway involving the 3dxz/yz orbitals. Finally, the large effect of spin polarization is experimentally assigned in the pre-edge (i.e., the α/β splitting) and found to be better modeled by multiplet simulations rather than by commonly used time-dependent density functional theory

Metalloprotein entatic control of ligand-metal bonds quantified by ultrafast x-ray spectroscopy

The multifunctional protein cytochrome c (cyt c) plays key roles in electron transport and apoptosis, switching function by modulating bonding between a heme iron and the sulfur in a methionine residue. This Fe-S(Met) bond is too weak to persist in the absence of protein constraints. We ruptured the bond in ferrous cyt c using an optical laser pulse and monitored the bond reformation within the protein active site using ultrafast x-ray pulses from an x-ray free-electron laser, determining that the Fe-S(Met) bond enthalpy is ~4 kcal/mol stronger than in the absence of protein constraints. The 4 kcal/mol is comparable with calculations of stabilization effects in other systems, demonstrating how biological systems use an entatic state for modest yet accessible energetics to modulate chemical function

Au+Au Reactions at the AGS: Experiments E866 and E917

Particle production and correlation functions from Au+Au reactions have been measured as a function of both beam energy (2-10.7AGeV) and impact parameter. These results are used to probe the dynamics of heavy-ion reactions, confront hadronic models over a wide range of conditions and to search for the onset of new phenomena.Comment: 12 pages, 14 figures, Talk presented at Quark Matter '9

Participatory Process for Implementing a Colorectal Cancer Screening Intervention: an Action Plan for Local Sustainability

Background: Rigid protocols can hamper translation of evidence-based interventions from research to real-world settings. This investigation aimed to develop procedures for modifying the study protocol of a community-based participatory research (CBPR) project and to analyze the theoretical constructs that underlie this process. Methods: The research project is a dissemination and implementation study of the Educational Program to Increase Colorectal Cancer Screening (EPICS), an evidence-based intervention targeting African Americans in the United States. The study is being conducted in a partnership with community coalitions in 15 different cities. Each site initially presented unique issues that required modification of the study protocol. Results: In order to honor underlying CBPR theory, it was necessary to negotiate protocol changes with the community coalition at each site, while insuring preservation of the core elements of the intervention. Conclusions: We discuss the ways in which this represents a narrowing of the gap between CBPR and traditional research approaches