DCAMM and Capital Stewardship

Created in 1980, the Division of Capital Asset Management and Maintenance (DCAMM) manages some 68 million square feet of building space for the Commonwealth of Massachusetts. This talk focuses on some of the challenges DCAMM faces in managing these facilities at the state\u27s higher education institutions where 74% of the building portfolio were built prior to 1981. After discussing the Commonwealth\u27s priorities in Capital Investment, the talk concludes with a look at DCAMM-funded renovations to the Claire T. Carney Library and Science and Engineering Building at UMass Dartmouth

Severe Back Pain in a Young Patient with Pyoderma Gangrenosum and Crohn’s Disease Controlled with Anti-tumor Necrosis Factor Therapy: Sterile Osteomyelitis

INTRODUCTION: Inflammatory bowel disease has been associated with a number of cutaneous and systemic neutrophilic disorders, including pyoderma gangrenosum. In 1972, the term chronic multi-focal recurrent osteomyelitis was given to a sterile neutrophilic condition which has been associated with inflammatory bowel disease. CASE REPORT: We report a case of a 23-year-old man with long-standing severe Crohn’s disease which necessitated subtotal colectomy. He subsequently developed progressive, intermittent back pain that were limiting his functional movement. Numerous investigations to identify what initially was thought to be an infectious process failed to lead to the diagnosis. Biopsy of the spine identified a sterile neutrophilic infiltrate and the diagnosis of chronic recurrent multi-focal osteomyelitis was made which was successfully treated with immunosuppressive drugs. CONCLUSION: Inflammatory bowel disease can present with cutaneous and systemic neutrophilic disorders and this association is becoming increasingly recognized by gastroenterologists and dermatologists. Chronic recurrent multi-focal osteomyelitis is a sterile neutrophilic disorder which can present with bone pain and responds to immunosuppressive therapy. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s13555-014-0044-3) contains supplementary material, which is available to authorized users

Mixed Mood State Behaviors and Circadian Dysfunction following Homocysteic Acid Treatment: Potential Animal Model for Bipolar Disorder

Bipolar disorder is a neuropsychiatric disease characterized by cyclical fluctuations of mood states between mania and depression. Circadian rhythm abnormalities and inconsistent sleep patterns are two common symptoms of bipolar disorder (Millar, Epsie, & Scott, 2004). Elevated levels of homocysteine, in the blood or cerebrospinal fluid, commonly occurs in patients with neuropsychiatric illnesses, including bipolar disorder (Bell et al., 1992; Boushey, Beresford, Omenn, & Motulsky, 1995). Homocysteic acid (HCA), an endogenous metabolite of homocysteine, has been implicated as a harmful neurotoxin and agonist of NMDA receptors. We have previously shown that postnatal administration of HCA (from postnatal day 3-21) in Sprague Dawley rats results in both mania-like and depressive-like behaviors, suggesting that this may serve as a novel animal model for bipolar disorder. The purpose of the present study was to characterize any circadian abnormalities that may be present in HCA-treated rats, as sleep and circadian dysfunction are common symptoms of bipolar disorder. In addition, we also characterized the developmental onset of the mania-like and depressive-like behaviors in this model. Prior to puberty, we found that HCA-treated rats exhibited no manic-like behaviors and only a trend toward depressive-like behaviors. After puberty, however, HCA-treated rats presented a mixed mood-state of both manic-like and depressive-like behaviors, along with significant dysfunction in the circadian clock. Specifically, both the free-running period and the amplitude of the rhythm were significantly reduced following HCA treatment. We are currently using microarray analyses to determine differences in circadian gene expression levels between HCA treated animals and controls. Additionally, we are examining the therapeutic role of lithium for reversing the circadian disruptions exhibited by the HCA-treated animals. Altogether, the findings of the present study provide strong evidence in support of the HCA model’s face validity for bipolar disorder, allowing us to better understand the mechanisms underlying the development of this disease

THE FEASIBILITY AND ACCEPTABILITY OF BEHAVIORAL ACTIVATION IN AN ADOLESCENT CLINICAL SETTING

Purpose: During the COVID-19 pandemic, estimates of adolescent depression prevalence have significantly increased. Although 80% of youth with mental health problems do not access mental health (MH) services, most interact regularly with pediatricians, suggesting primary care is a promising setting for youth MH service delivery. Behavioral activation (BA) is a straightforward intervention focusing on increasing engagement in meaningful activities and has been shown to be effective in adolescent populations. This study examines the feasibility and acceptability of implementing BA delivered by nurses to adolescents with mild to moderate depressive symptoms in an ambulatory setting. Methods: We examined the feasibility and acceptability of BA to a sociodemographic-diverse adolescent population. To examine feasibility, we retrospectively analyzed the percentage of patients presenting with mild to moderate depressive symptoms on the patient health questionnaire-9 during a random four week period. We then conducted qualitative interviews with four parent-adolescent dyads, and two additional adolescents. A semi-structured interview guide was iteratively developed to assess perceived acceptability of BA and barriers and facilitators to engaging in the intervention. Interviews were recorded, transcribed, and coded by authors JDT and JF. A thematic analysis was completed to identify whether the program as designed was acceptable to the targeted population. Results: A records review found that out of 122 unique patients presenting for any clinic visit during the four week period, 44 (35%) met criteria for mild to moderate depressive symptoms. Of those who met criteria, youth were 17.45 years old (range = 12-22) with 61% identified as female. Results of the qualitative interviews suggest that participants perceived BA to be appropriate; themes emerged suggesting that both parents and youth noted nurse-delivered BA was similar to other types of therapies they had engaged with in other settings and that participants experienced nurses’ as able to protect confidentiality and someone they could be “vulnerable” with. Participants were mixed in how feasible they felt regular visits to the pediatrician’s office was, with some noting that transportation and time were major barriers for engaging in treatment. All participants noted that telehealth options (including meeting with a nurse provider over the phone or through web conferencing) were appropriate and would facilitate treatment access. Participants also noted that time, transportation and cost were significant barriers to engaging in valued activities (a central mechanism of BA), and several parents and youth noted that these barriers were exacerbated during the pandemic. Conclusion: Our data highlights the implementation potential for delivering BA by nurses in an adolescent ambulatory setting. Qualitative themes suggest this approach (especially delivered via telehealth) is feasible and acceptable for youth with mild to moderate depressive symptoms

Pain assessment for individuals with advanced dementia in care homes: A systematic review

Pain is prevalent in older people, especially in those with advanced dementia who have communication impairments. Although pain is recognised to be present in this population, it is often under-assessed and ineffectively managed. The assessment of pain in advanced dementia is extremely challenging and complex, particularly in institutional settings such as care homes. This study systematically reviews the literature to examine and characterise the evidence for the use of pain assessment tools in care homes with individuals living with advanced dementia. Relevant publications were sourced from electronic bibliometric medical databases including AMED, CINAHL Plus, Medline, PsycINFO, EMBASE, TRIP Pro, Google Scholar, and HINARI. The database search was supplemented by screening citations and reference lists, in addition to a grey literature searches. The search identified 2221 studies, among which 26 were included in the review. The majority of the studies were observational, which created a rich source of data to create four major themes. The findings were informed and shaped by working with key stakeholders to develop a conceptual model that can contribute to developing evidence-based practice. This highlights the importance of a comprehensive, multi-disciplinary approach to pain assessment in this population, which is beyond the use of tools

Longitudinal study of local authority child and family social workers (Wave 1) Research report August 2019

In 2018, the Department for Education (DfE) commissioned a consortium led by IFF Research, working with social work academics at Manchester Metropolitan University and the University of Salford, to conduct a major new longitudinal study tracking the careers of local authority child and family social workers in England over five years. The aim of this landmark new study is to collect robust evidence on recruitment, retention and progression in child and family social work. In particular it aims to establish a much stronger understanding of child and family social work recruitment issues, career pathways, choices and decisions and how these differ across different individual, job and employer characteristics