Injuries of the mind, body, and soul : an exploration of moral injury among military service members and veterans

Military service often requires engaging in activities, witnessing acts, or immediate decision-making that may violate the moral codes and personal values to which most individuals ascribe. If unacknowledged, these factors can lead to injuries that can affect the physical, psychological, social, and spiritual health of military men and women. The term moral injury has been assigned to these soul-ceasing experiences. Although researchers have attempted to define moral injury and what leads to such experiences, inconsistencies across definitions exist. In addition, nearly all existing definitions have lacked empirical support. Thus, an in-depth literature review, systematic review, and phenomenological qualitative study were completed to explore how moral injury has been conceptualized and defined across the literature and to respond to the need for an empirically-based, veteran-informed definitional understanding of such injuries. Findings from a qualitative study with United States veterans revealed that moral injuries can be conceptualized by chronic, deep-rooted experiences of (a) betrayal, (b) moral ambivalence, (c) soul injuries, and (d) lack of reconciliation. Recommendations for future research and clinical practice with moral injury must consider the systemic roots and implications for these injuries of the soul. Rather than viewing moral injury as a construct distinct to the field of psychology, trauma, or theology, applying a more systemic framework may be most appropriate for capturing the multi-level implications. For instance, a biopsychosocial-spiritual lens may support the cellular to society and spiritual implications of moral injuries. Additionally, Bronfenbrenner's ecological theory was proposed as a potentially influential theory in grounding future assessments and interventions for the constructs by emphasizing the interplay between context, personal characteristics/values, and multi-level systemic influences on the development of moral injury

Somatotyping of Division I Athletes

Somatotyping has previously examined athletes\u27 genetic morphology. Categorization of somatotyping can be utilized in athletes for specialized, adaptive sports performance. PURPOSE: The purpose of this study was to report somatotyping differences (ectomorph, mesomorph, and endomorph) in selected Division I athletes. METHOD: 39 male football athletes and seven female softball Division I athletes were recruited for this investigation. Height (m), weight (kg), waist-to-hip ratio (cm), and a 4-site skinfold measurement was collected. Skinfold locations were recorded from the triceps (mm), subscapular (mm), supraspinal (mm), and the medial calf (mm). Biepicondylar breadth measures of the humerus (cm), and the femur (cm) were recorded at a respective 90°. Additionally, the girth of the subject’s dominant upper arm (cm) and dominant calf (cm) were recorded. All measurement locations were taken from the Heath-Carter Anthropometric protocol, respectfully. The Heath Carter Somatotype Worksheet consists of a rating scale that is based on a 3-component categorization. All measures are considered when calculating a participant\u27s score. Scores between .5 and 2.5 are low, 3 to 5 are moderate, 5.5 to 7 are high and anything over a 7.5 is considered very high. The first component calculated scores of endomorphy, the second calculated mesomorphy scores, and the last component calculated ectomorph scores. Using these measurements, equations are used to determine a participant’s score to a specific somatotype. The athletes\u27 numbers were then processed and plotted on a 2-D graph plotting the somatotype (X= ectomorph-endomorph, Y=2 x mesomorphy- (endomorphy+ectomorph)). RESULTS: There was a clear indication that somatotyping had variety based on sports and position specialization in football athletes. Football athletes consisted of 6 endomorphs, 30 mesomorphs, and 3 ectomorphs, while softball athletes consisted of 7 meso-endomorphs. CONCLUSION: Due to the anthropometric position differences in male football athletes there was a considerable amount of variety and lack of specificity, while the female softball athletes consisted of a lesser variety in anthropometric measures

Self-assembly of a functional oligo(aniline)-based amphiphile into helical conductive nanowires

A tetra(aniline)-based cationic amphiphile, TANI-NHC(O)C5H10N(CH3)3+Br– (TANI-PTAB) was synthesized, and its emeraldine base (EB) state was found to self-assemble into nanowires in aqueous solution. The observed self-assembly is described by an isodesmic model, as shown by temperature-dependent UV–vis investigations. Linear dichroism (LD) studies, combined with computational modeling using time-dependent density functional theory (TD-DFT), suggests that TANI-PTAB molecules are ordered in an antiparallel arrangement within nanowires, with the long axis of TANI-PTAB arranged perpendicular to the nanowire long axis. Addition of either S- or R- camphorsulfonic acid (CSA) to TANI-PTAB converted TANI to the emeraldine salt (ES), which retained the ability to form nanowires. Acid doping of TANI-PTAB had a profound effect on the nanowire morphology, as the CSA counterions’ chirality translated into helical twisting of the nanowires, as observed by circular dichroism (CD). Finally, the electrical conductivity of CSA-doped helical nanowire thin films processed from aqueous solution was 2.7 mS cm–1. The conductivity, control over self-assembled 1D structure and water-solubility demonstrate these materials’ promise as processable and addressable functional materials for molecular electronics, redox-controlled materials and sensing

Experiential Learning: Voices of Librarians-to-Be

Academic libraries, and particularly specialized ones, often can provide a broad range of career-building opportunities to those thinking about or in the process of becoming librarians. Participants in a variety of experiences at one of UNC’s specialized libraries have ranged from teens to graduate students to recent graduates transitioning to new careers in libraries. Hear several current and recent librarians-to-be discuss their efforts to acquire hands-on practical skills, learn more about the field of librarianship, receive mentoring and career planning assistance, and participate in library meetings, events and other professional activities inside and outside of the library. Challenges include matching potential candidates with appropriate experiential opportunities tailored to their needs, while meeting Human Resources requirements and ensuring students enrolled for credit satisfy the expectations of their specific institutions and programs. To further aid in making career resources more accessible to fledgling professionals, the library also created an online guide

Synthesis and activity of a novel Autotaxin inhibitor-Icodextrin conjugate

© Copyright 2018 American Chemical Society. Autotaxin is an extracellular phospholipase D that catalyses the hydrolysis of lysophosphatidyl choline (LPC) to generate the bioactive lipid lysophosphatidic acid (LPA). Autotaxin has been implicated in many pathological processes relevant to cancer. Intraperitoneal administration of an autotaxin inhibitor may benefit patients with ovarian cancer, however low molecular mass compounds are known to be rapidly cleared from the peritoneal cavity. Icodextrin is a polymer that is already in clinical use because it is slowly eliminated from the peritoneal cavity. Herein we report conjugation of the autotaxin inhibitor HA-155 to icodextrin. The conjugate inhibits autotaxin activity (IC50 = 0.86 ± 0.13 μg mL-1) and reduces cell migration. Conjugation of the inhibitor increased its solubility, decreased its membrane permeability and improved its intraperitoneal retention in mice. These observations demonstrate the first application of icodextrin as a covalently-bonded drug delivery platform with potential use in the treatment of ovarian cancer

Pathways through which higher neighborhood crime is longitudinally associated with greater body mass index

Abstract Background Although crime and perceived safety are associated with obesity and body mass index (BMI), the pathways are less clear. Two likely pathways by which crime and perceived safety may impact obesity are through distress and physical activity. Methods We examined data from 2013 to 2014 for 644 predominantly African-American adults (mean age 57 years; 77% female) living in low-income Pittsburgh, PA neighborhoods, including self-reported perceptions of safety and emotional distress, interviewer-measured height/weight, and physical activity measured via accelerometry. We used secondary data on neighborhood crime from 2011 to 2013. We built a structural equation model to examine the longitudinal direct and indirect pathways from crime to BMI through perceived safety, distress and physical activity. Results Long-term exposure to crime was positively associated with lack of perceived safety (β = 0.11, p = 0.005) and lack of perceived safety was positively associated with BMI (β = 0.08, p = 0.03). The beneficial association between physical activity and BMI (β = −0.15, p < 0.001) was attenuated by a negative association between crime and physical activity (β = −0.09, p = 0.01). Although crime was associated with distress we found no evidence of a path from crime to BMI via distress. Conclusions Our findings suggest decrements in perceived safety and physical activity are important processes that might explain why neighborhood crime is associated with greater BMI.https://deepblue.lib.umich.edu/bitstream/2027.42/139054/1/12966_2017_Article_611.pd

A cluster randomized controlled trial of the effectiveness and cost-effectiveness of Intermediate Care Clinics for Diabetes (ICCD) : study protocol for a randomized controlled trial

Background World-wide healthcare systems are faced with an epidemic of type 2 diabetes. In the United Kingdom, clinical care is primarily provided by general practitioners (GPs) rather than hospital specialists. Intermediate care clinics for diabetes (ICCD) potentially provide a model for supporting GPs in their care of people with poorly controlled type 2 diabetes and in their management of cardiovascular risk factors. This study aims to (1) compare patients with type 2 diabetes registered with practices that have access to an ICCD service with those that have access only to usual hospital care; (2) assess the cost-effectiveness of the intervention; and (3) explore the views and experiences of patients, health professionals and other stakeholders. Methods/Design This two-arm cluster randomized controlled trial (with integral economic evaluation and qualitative study) is set in general practices in three UK Primary Care Trusts. Practices are randomized to one of two groups with patients referred to either an ICCD (intervention) or to hospital care (control). Intervention group: GP practices in the intervention arm have the opportunity to refer patients to an ICCD - a multidisciplinary team led by a specialist nurse and a diabetologist. Patients are reviewed and managed in the ICCD for a short period with a goal of improving diabetes and cardiovascular risk factor control and are then referred back to practice. or Control group: Standard GP care, with referral to secondary care as required, but no access to ICCD. Participants are adults aged 18 years or older who have type 2 diabetes that is difficult for their GPs to control. The primary outcome is the proportion of participants reaching three risk factor targets: HbA1c (≤7.0%); blood pressure (<140/80); and cholesterol (<4 mmol/l), at the end of the 18-month intervention period. The main secondary outcomes are the proportion of participants reaching individual risk factor targets and the overall 10-year risks for coronary heart disease(CHD) and stroke assessed by the United Kingdom Prospective Diabetes Study (UKPDS) risk engine. Other secondary outcomes include body mass index and waist circumference, use of medication, reported smoking, emotional adjustment, patient satisfaction and views on continuity, costs and health related quality of life. We aimed to randomize 50 practices and recruit 2,555 patients

Four decades of military posttraumatic stress:Protocol for a meta-analysis and systematic review of treatment approaches and efficacy

Background: Over 85% of active members of the Canadian Armed Forces have been exposed to potentially traumatic events linked to the development of posttraumatic stress disorder (PTSD). At the time of transition to civilian life, as high as 1 in 8 veterans may be diagnosed with PTSD. Given the high prevalence of PTSD in military and veteran populations, the provision of effective treatment considering their unique challenges and experiences is critical for mental health support and the well-being of these populations. Objective: This paper presents the protocol for a meta-analysis and systematic review that will examine the effectiveness of treatment approaches for military-related PTSD. Methods: This PROSPERO-preregistered meta-analysis is being conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and Cochrane guidelines. A comprehensive search of the literature wasconducted using the databases PsycInfo, Medline, Embase, CINAHL, and ProQuest Dissertation &amp; Theses. Effect sizes will be computed based on changes in PTSD symptom scores over time across studies using validated PTSD scales. A multilevel meta-analysis will examine the overall effects, between-study effects, and within-study effects of available evidence for PTSD treatments in military populations. Effect sizes will be compared between pharmacotherapeutic, psychotherapeutic, and alternative/emerging treatment interventions. Finally, meta-regression and subgroup analyses will explore the moderating roles of clinical characteristics (eg, PTSD symptom clusters), treatment approaches (eg, therapeutic orientations in psychotherapy and alternative therapies and classifications of drugs in pharmacotherapy), as well as treatment characteristics (eg, length of intervention) on treatment outcomes. Results: The literature search was completed on April 14, 2021. After the removal of duplicates, a total of 12, 002 studies were screened for inclusion. As of July 2021, title and abstract screening has been completed, with 1469 out of 12, 002 (12.23%) studies included for full-text review. Full review is expected to be completed in the summer of 2021, with initial results expected for publication by early winter of 2021. Conclusions: This meta-analysis will provide information on the current state of evidence on the efficacy and effectiveness of various treatment approaches for military-related PTSD and identify factors that may influence treatment outcomes. The results will inform clinical decision-making for service providers and service users. Finally, the findings will provide insights into future treatment development and practice recommendations to better support the well-being of military and veteran populations.</p

Four decades of military posttraumatic stress:Protocol for a meta-analysis and systematic review of treatment approaches and efficacy

Background: Over 85% of active members of the Canadian Armed Forces have been exposed to potentially traumatic events linked to the development of posttraumatic stress disorder (PTSD). At the time of transition to civilian life, as high as 1 in 8 veterans may be diagnosed with PTSD. Given the high prevalence of PTSD in military and veteran populations, the provision of effective treatment considering their unique challenges and experiences is critical for mental health support and the well-being of these populations. Objective: This paper presents the protocol for a meta-analysis and systematic review that will examine the effectiveness of treatment approaches for military-related PTSD. Methods: This PROSPERO-preregistered meta-analysis is being conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and Cochrane guidelines. A comprehensive search of the literature wasconducted using the databases PsycInfo, Medline, Embase, CINAHL, and ProQuest Dissertation &amp; Theses. Effect sizes will be computed based on changes in PTSD symptom scores over time across studies using validated PTSD scales. A multilevel meta-analysis will examine the overall effects, between-study effects, and within-study effects of available evidence for PTSD treatments in military populations. Effect sizes will be compared between pharmacotherapeutic, psychotherapeutic, and alternative/emerging treatment interventions. Finally, meta-regression and subgroup analyses will explore the moderating roles of clinical characteristics (eg, PTSD symptom clusters), treatment approaches (eg, therapeutic orientations in psychotherapy and alternative therapies and classifications of drugs in pharmacotherapy), as well as treatment characteristics (eg, length of intervention) on treatment outcomes. Results: The literature search was completed on April 14, 2021. After the removal of duplicates, a total of 12, 002 studies were screened for inclusion. As of July 2021, title and abstract screening has been completed, with 1469 out of 12, 002 (12.23%) studies included for full-text review. Full review is expected to be completed in the summer of 2021, with initial results expected for publication by early winter of 2021. Conclusions: This meta-analysis will provide information on the current state of evidence on the efficacy and effectiveness of various treatment approaches for military-related PTSD and identify factors that may influence treatment outcomes. The results will inform clinical decision-making for service providers and service users. Finally, the findings will provide insights into future treatment development and practice recommendations to better support the well-being of military and veteran populations.</p