Training Toolkit for Caregivers at Residential Care Centers in Peru

Introduction: Health Bridges International (HBI) is developing a training toolkit for caregivers working with marginalized youth in residential care centers (RCCs) in Peru. The toolkit represents an amalgamation of best practices, evidence informed research, and the results of our QI survey tool. We predicted that current Peruvian caregivers will identify topics of interest that differ from current literature. Methods: Surveys were distributed to over 150 RCCs throughout Peru using email and WhatsApp messages in a snowball format, starting at the administration level. The survey required 20-30 minutes to complete and was completely voluntary. All preliminary data was de-identified and imputed into a REDCap database. Results: We received 113 responses, 108 of which met inclusion criteria for data analysis. Section 1 served to better define our target population and the make-up of each RCC, including location and size of the center. Section 2 used a Likert scale to rank interest in training areas, showing an overwhelming interest in all areas. The final section of the survey allowed participants to write-in any trainings of personal interest. Conclusion: The results of our survey showed that there is a general desire for greater caregiver training. In addition, our survey elicited new training topics, such as challenges of COVID-19, substance abuse, and physical health. These topics will be investigated further by our research team, advisory group, and colleagues at UCSM, so that we can incorporate these topics into our toolkit. Furthermore, the demographic results will inform curriculum implementation during Stage 2 of this project

A Qualitative Exploration of the Use of Service Dogs in Veterans With Post Traumatic Stress Disorder and Traumatic Brain Injury

Objective This qualitative research was conducted to add to the body of knowledge that supports the benefits of service dogs (SDs), as a tertiary treatment modality, to veterans with post‐traumatic stress disorder (PTSD) and/or traumatic brain injury (TBI). Methods This grounded theory research design utilized open‐ended, semi‐structured interviews with veterans (n = 10) who were using SDs as a treatment modality for PTSD and/or TBI. Transcripts were analyzed using NVivo qualitative software until data saturation was achieved. Results Results from the data analysis identified 4 major themes with concurrent subthemes. The most prominent themes were functional status, impact of a SD, recognition of symptoms of PTSD and/or TBI by the SD, and barriers and challenges to the acquisition of a SD. Participants reported that the SD increased socialization and was a positive adjunct to treatment modalities for PTSD and/or TBI. Conclusions Our study highlights the benefits of using a SD as a tertiary treatment for PTSD and/or TBI in veterans. Veterans in our study articulated the benefits of using a SD as a tertiary treatment option, and the need to make this a standard treatment option for all veterans who suffer from PTSD and/or TBI

In Search of a Cure: The Development of Therapeutics to Alter the Progression of Spinal Muscular Atrophy

Until the recent development of disease-modifying therapeutics, spinal muscular atrophy (SMA) was considered a devastating neuromuscular disease with a poor prognosis for most affected individuals. Symptoms generally present during early childhood and manifest as muscle weakness and progressive paralysis, severely compromising the affected individual’s quality of life, independence, and lifespan. SMA is most commonly caused by the inheritance of homozygously deleted SMN1 alleles with retention of one or more copies of a paralog gene, SMN2, which inversely correlates with disease severity. The recent advent and use of genetically targeted therapies have transformed SMA into a prototype for monogenic disease treatment in the era of genetic medicine. Many SMA-affected individuals receiving these therapies achieve traditionally unobtainable motor milestones and survival rates as medicines drastically alter the natural progression of this disease. This review discusses historical SMA progression and underlying disease mechanisms, highlights advances made in therapeutic research, clinical trials, and FDA-approved medicines, and discusses possible second-generation and complementary medicines as well as optimal temporal intervention windows in order to optimize motor function and improve quality of life for all SMA-affected individuals

Implementation and Outcomes of the Trauma Ambassadors Program: A Case Study of Trauma-Informed Youth Leadership Development

Community-based programs serve a critical need for vulnerable youth and families. In recent years, researchers and practitioners have urged programs to adopt a trauma-informed care (TIC) approach to address adversity in young people\u27s lives. The purpose of this article is to describe the implementation and outcomes of the Trauma Ambassador (TA) Program, a pilot youth leadership program guided by a community-university partnership that utilized a TIC approach in an underserved East North Philadelphia neighborhood. Fourteen youth engaged in interactive trainings to build their understanding of trauma and develop practical tools to support encounters with individuals with trauma histories. Focus groups and individual interviews were conducted to better understand program implementation and outcomes. Rich data emerged that identifies a myriad of ways that youth and their community might benefit from a program like the one described. The program successfully impacted participants, as TAs recognized their own trauma and were motivated to help others who may have trauma histories. This program provided quality youth development experiences, particularly with respect to trauma-informed care, and results support taking a holistic, healing-centered approach to foster well-being for youth and adult mentors

Common Gene Variants in the Tumor Necrosis Factor (TNF) and TNF Receptor Superfamilies and NF-kB Transcription Factors and Non-Hodgkin Lymphoma Risk

BACKGROUND:A promoter polymorphism in the pro-inflammatory cytokine tumor necrosis factor (TNF) (TNF G-308A) is associated with increased non-Hodgkin lymphoma (NHL) risk. The protein product, TNF-alpha, activates the nuclear factor kappa beta (NF-kappaB) transcription factor, and is critical for inflammatory and apoptotic responses in cancer progression. We hypothesized that the TNF and NF-kappaB pathways are important for NHL and that gene variations across the pathways may alter NHL risk. METHODOLOGY/PRINCIPAL FINDINGS:We genotyped 500 tag single nucleotide polymorphisms (SNPs) from 48 candidate gene regions (defined as 20 kb 5', 10 kb 3') in the TNF and TNF receptor superfamilies and the NF-kappaB and related transcription factors, in 1946 NHL cases and 1808 controls pooled from three independent population-based case-control studies. We obtained a gene region-level summary of association by computing the minimum p-value ("minP test"). We used logistic regression to compute odds ratios and 95% confidence intervals for NHL and four major NHL subtypes in relation to SNP genotypes and haplotypes. For NHL, the tail strength statistic supported an overall relationship between the TNF/NF-kappaB pathway and NHL (p = 0.02). We confirmed the association between TNF/LTA on chromosome 6p21.3 with NHL and found the LTA rs2844484 SNP most significantly and specifically associated with the major subtype, diffuse large B-cell lymphoma (DLBCL) (p-trend = 0.001). We also implicated for the first time, variants in NFKBIL1 on chromosome 6p21.3, associated with NHL. Other gene regions identified as statistically significantly associated with NHL included FAS, IRF4, TNFSF13B, TANK, TNFSF7 and TNFRSF13C. Accordingly, the single most significant SNPs associated with NHL were FAS rs4934436 (p-trend = 0.0024), IRF4 rs12211228 (p-trend = 0.0026), TNFSF13B rs2582869 (p-trend = 0.0055), TANK rs1921310 (p-trend = 0.0025), TNFSF7 rs16994592 (p-trend = 0.0024), and TNFRSF13C rs6002551 (p-trend = 0.0074). All associations were consistent in each study with no apparent specificity for NHL subtype. CONCLUSIONS/SIGNIFICANCE:Our results provide consistent evidence that variation in the TNF superfamily of genes and specifically within chromosome 6p21.3 impacts lymphomagenesis. Further characterization of these susceptibility loci and identification of functional variants are warranted

Molecular mechanisms of cell death: recommendations of the Nomenclature Committee on Cell Death 2018.

Over the past decade, the Nomenclature Committee on Cell Death (NCCD) has formulated guidelines for the definition and interpretation of cell death from morphological, biochemical, and functional perspectives. Since the field continues to expand and novel mechanisms that orchestrate multiple cell death pathways are unveiled, we propose an updated classification of cell death subroutines focusing on mechanistic and essential (as opposed to correlative and dispensable) aspects of the process. As we provide molecularly oriented definitions of terms including intrinsic apoptosis, extrinsic apoptosis, mitochondrial permeability transition (MPT)-driven necrosis, necroptosis, ferroptosis, pyroptosis, parthanatos, entotic cell death, NETotic cell death, lysosome-dependent cell death, autophagy-dependent cell death, immunogenic cell death, cellular senescence, and mitotic catastrophe, we discuss the utility of neologisms that refer to highly specialized instances of these processes. The mission of the NCCD is to provide a widely accepted nomenclature on cell death in support of the continued development of the field

Social Distancing and Mental Health

Learning Objectives Articulate how stress / trauma of social distancing impacts our relational brain Examine how COVID-19 has impacted their individual and cultural well-being Formulate a plan for caring for self during this perio

Storytelling and Advocacy for Physicians

An interactive workshop dedicated to increasing healthcare providers awareness of how storytelling can serve as a strategy to cope with provider stress. The workshop will engage healthcare providers in a storytelling exercise about gun violence, motivating participants to advocate for relevant policy. This workshop will be led by Dr. Valerie Arkoosh, Chair, Montgomery County Board of Commissioners, and members of the Jefferson Eakins Workshop team, Drs. Stanton Miller, Stephen DiDonato, Rachel Brandoff, and Astra Czerny. ----- Dr. Valerie Arkoosh was unanimously elected as Chair of the Montgomery County Board of Commissioners on November 17, 2016 succeeding former Commission Chair Josh Shapiro. First appointed to fill a vacancy on the Commission in January 2015, Arkoosh won election to a full four-year term in November 2015 and served as Commission Vice Chair until her election as Chair. Montgomery County, located in southeastern Pennsylvania, is the third most populous county in Pennsylvania with over 823,000 residents. Dr. Arkoosh is bringing innovative reforms to county government. Rachel Brandoff, Ph.D., ATR-BC, ATCS, LCAT, is an assistant professor and coordinator of the Art Therapy Specialization in Community and Trauma Counseling at Jefferson University in Philadelphia. She has taught at several schools and enjoys training trauma-responsive art therapists and counselors. She is one of the founders of the Expressive Therapies Summit, a NYC-based professional training conference, and served for a decade as the Ethics Chair for the board of the New York Art Therapy Association (NYATA). Rachel has experience with a wide array of clinical populations in both inpatient and outpatient settings, and has specialized with individuals and families coming out of crisis situations and facing major life transition. Rachel has maintained a private practice for 12 years and provides supervision and consultation to practicing art therapists. Dr. Stephen DiDonato holds his Ph.D. in International Psychology from The Chicago School of Professional Psychology. Stephen is a Licensed Professional Counselor (LPC) in the State of Pennsylvania and holds his National Certified Counselor (NCC) credential. Stephen has clinical expertise working with children, families, and communities who have been exposed to potentially traumatic events. Specifically, Stephen’s clinical focus has been on enhancing the adaption to the inherently complex traumatic environments that children and families face in underserved communities. Stephen is a co-founder of the Jefferson Eakins Writers’ Workshop - a literary workshop at Jefferson Center for Injury Research & Prevention dedicated to the stories of injury and all its victims