Attitudes Toward Evidence-Based Practices for Trauma-Impacted American Indian/Alaska Native Populations: Does the Role of Culture Even Matter?

American Indian and Alaska Native (AI/AN) people experience trauma at disproportional rates compared to the general U.S. population. Despite highly supported evidence-based trauma treatments among majority groups, questions remain regarding whether they address culturally-based attitudes, values, and behaviors necessary to promote change and recovery within AI/AN communities. Minimal data exists on practitioner attitudes towards existing standards of care and areas for continued development. This study details the results of a national online survey of mental health practitioners (N = 103 providers) working with AI/AN trauma-impacted populations from a diverse range of clinical settings, theoretical orientations, and years of training through a mixed methods design. Results indicated that practitioner training characteristics (e.g., level of education, clinical experience, and confidence in using evidence-based practices) and cultural characteristics (e.g., ethnicity, identification with Western values) were significant predictors of evidence-based practice (EBP) attitudes. Additionally, overall attitudes toward EBPs were found to be a significant predictor of perceived need for culturally-informed EBPs, with 88% of practitioners reporting a lack of cultural sensitivity in current standards of care. These findings are presented within the context of efforts to increase the development of culturally-grounded models of healing for AI/AN communities and implications for clinical training, research, and dissemination of findings to help facilitate necessary policy change

Differences in Mnemonic Processing by Neurons in the Human Hippocampus and Parahippocampal Regions

Different structures within the medial-temporal lobe likely make distinct contributions to declarative memory. In particular, several current psychological and computational models of memory predict that the hippocampus and parahippocampal regions play different roles in the formation and retrieval of declarative memories [e.g., Norman, K. A., & O\u27Reilly, R. C. Modeling hippocampal and neocortical contributions to recognition memory: A complementary-learning systems approach. Psychological Review, 110, 611-646, 2003]. Here, we examined the neuronal firing patterns in these two regions during recognition memory. Recording directly from neurons in humans, we find that cells in both regions respond to novel stimuli with an increase in firing (excitation). However, already on the second presentation of a stimulus, neurons in these regions show very different firing patterns. In the parahippocampal region there is dramatic decrease in the number of cells responding to the stimuli, whereas in the hippocampus there is recruitment of a large subset of neurons showing inhibitory (decrease from baseline firing) responses. These results suggest that inhibition is a mechanism used by cells in the human hippocampus to support sparse coding in mnemonic processing. The findings also provide further evidence for the division of labor in the medial-temporal lobe with respect to declarative memory processes

Tropical dead zones and mass mortalities on coral reefs

Degradation of coastal water quality in the form of low dissolved oxygen levels (hypoxia) can harm biodiversity, ecosystem function, and human wellbeing. Extreme hypoxic conditions along the coast, leading to what are often referred to as dead zones, are known primarily from temperate regions. However, little is known about the potential threat of hypoxia in the tropics, even though the known risk factors, including eutrophication and elevated temperatures, are common. Here we document an unprecedented hypoxic event on the Caribbean coast of Panama and assess the risk of dead zones to coral reefs worldwide. The event caused coral bleaching and massive mortality of corals and other reef-associated organisms, but observed shifts in community structure combined with laboratory experiments revealed that not all coral species are equally sensitive to hypoxia. Analyses of global databases showed that coral reefs are associated with more than half of the known tropical dead zones worldwide, with \u3e10% of all coral reefs at elevated risk for hypoxia based on local and global risk factors. Hypoxic events in the tropics and associated mortality events have likely been underreported, perhaps by an order of magnitude, because of the lack of local scientific capacity for their detection. Monitoring and management plans for coral reef resilience should incorporate the growing threat of coastal hypoxia and include support for increased detection and research capacity

Using Intonationally-Marked Presuppositional Information in On-Line Language Processing: Evidence from Eye Movement s to a Visual Model

This study evaluates the effect of presuppositional information associated with contrastive stress on on-line language processing. An eye-tracking methodology was used, in which eye movement latencies to real objects in a visual display are taken as a measure of on-line reference resolution. Results indicate that presupposed contrast sets are being computed on-line, and can be used to speed reference resolution by narrowing the referential domain of an utterance. In addition, presupposed contrast sets appear to play a role in managing attention in the processing of a discourse

Integrating Through-Wafer Interconnects with Active Devices and Circuits

Through wafer interconnects (TWIs) enable vertical stacking of integrated circuit chips in a single package. A complete process to fabricate TWIs has been developed and demonstrated using blank test wafers. The next step in integrating this technology into 3D microelectronic packaging is the demonstration of TWIs on wafers with preexisting microcircuitry. The circuitry must be electrically accessible from the backside of the wafer utilizing the TWIs; the electrical performance of the circuitry must be unchanged as a result of the TWI processing; and the processing must be as cost effective as possible. With these three goals in mind, several options for creating TWIs were considered. This paper explores the various processing options and describes in detail, the final process flow that was selected for testing, the accompanying masks that were designed, the actual processing of the wafers, and the electrical test results

Enskog Theory for Polydisperse Granular Mixtures. I. Navier-Stokes order Transport

A hydrodynamic description for an $s$-component mixture of inelastic, smooth hard disks (two dimensions) or spheres (three dimensions) is derived based on the revised Enskog theory for the single-particle velocity distribution functions. In this first portion of the two-part series, the macroscopic balance equations for mass, momentum, and energy are derived. Constitutive equations are calculated from exact expressions for the fluxes by a Chapman-Enskog expansion carried out to first order in spatial gradients, thereby resulting in a Navier-Stokes order theory. Within this context of small gradients, the theory is applicable to a wide range of restitution coefficients and densities. The resulting integral-differential equations for the zeroth- and first-order approximations of the distribution functions are given in exact form. An approximate solution to these equations is required for practical purposes in order to cast the constitutive quantities as algebraic functions of the macroscopic variables; this task is described in the companion paper.Comment: 36 pages, to be published in Phys. Rev.

Trauma Surveillance in Cape Town, South Africa: An Analysis of 9236 Consecutive Trauma Center Admissions.

PublishedJournal ArticleResearch Support, Non-U.S. Gov'tThis is the final version of the article. Available from American Medical Association via the DOI in this record.IMPORTANCE: Trauma is a leading cause of death and disability worldwide. In many low- and middle-income countries, formal trauma surveillance strategies have not yet been widely implemented. OBJECTIVE: To formalize injury data collection at Groote Schuur Hospital, the chief academic hospital of the University of Cape Town, a level I trauma center, and one of the largest trauma referral hospitals in the world. DESIGN, SETTING, AND PARTICIPANTS: This was a prospective study of all trauma admissions from October 1, 2010, through September 30, 2011, at Groote Schuur Hospital. A standard admission form was developed with multidisciplinary input and was used for both clinical and data abstraction purposes. Analysis of data was performed in 3 parts: demographics of injury, injury risk by location, and access to and maturity of trauma services. Geographic information science was then used to create satellite imaging of injury "hot spots" and to track referral patterns. Finally, the World Health Organization trauma system maturity index was used to evaluate the current breadth of the trauma system in place. MAIN OUTCOMES AND MEASURES: The demographics of trauma patients, the distribution of injury in a large metropolitan catchment, and the patterns of injury referral and patient movement within the trauma system. RESULTS: The minimum 34-point data set captured relevant demographic, geographic, incident, and clinical data for 9236 patients. Data field completion rates were highly variable. An analysis of demographics of injury (age, sex, and mechanism of injury) was performed. Most violence occurred toward males (71.3%) who were younger than 40 years of age (74.6%). We demonstrated high rates of violent interpersonal injury (71.6% of intentional injury) and motor vehicle injury (18.8% of all injuries). There was a strong association between injury and alcohol use, with alcohol implicated in at least 30.1% of trauma admissions. From a systems standpoint, the data suggest a mature pattern of referral consistent with the presence of an inclusive trauma system. CONCLUSIONS AND RELEVANCE: The implementation of injury surveillance at Groote Schuur Hospital improved insights about injury risk based on demographics and neighborhood as well as access to service based on patterns of referral. This information will guide further development of South Africa's already advanced trauma system.This work was supported by the Canadian Institute for Health Research and the Social Sciences and Humanities Research Council