The Trajectory of Coping with Trauma: Meaning Making as a Factor in Determining the Trauma Outcome for Combat Veterans

Specific ways in which an individual makes meaning following a stressful life event have been conceptualized as contributing to the emergence of Posttraumatic Stress Disorder (PTSD). However, little is known about how meaning making impacts the trauma trajectory and how that transition affects the outcomes of PTSD, Posttraumatic Growth (PTG), or resiliency. In this study, 166 combat veterans nationwide completed self-report surveys that were analyzed using a multivariate Structural Equation Modeling (SEM) method to create a model of how PTSD, PTG, and resiliency are impacted based upon meaning making. The results suggest that following a stressful life event, individuals who maintain intact world beliefs are more likely to be resilient. Individuals who experience a shattering of their world beliefs are hypothesized to report symptoms of PTSD. Likewise, individuals who experience a shattering of world beliefs and engage in avoidance coping are more likely to experience PTSD. However, individuals who experience a shattering of world beliefs but then make meaning from their experience are more likely to report an experience of PTG. Limitations and future directions of this research are also discussed in relation to the field\u27s movement toward outlining factors that positively impact PTG following deployment

Use of Checklists Teaches Communication Skills Utilized by Specialties

Abstract Objectives: The purpose of the current study was to implement the use of communication checklists and determine whether medical students were able to attend to and distinguish differences in communication skills between various physician specialties. Methods: As part of a newly-revised medical education curriculum, all first-year medical students at a mid-Atlantic medical school were required to complete a communication skills checklist while observing 10 clinical encounters performed by attending physicians. The checklists were collected and analyzed for trends found within the reporting. Results: Even novice learners distinguished complex medical communication skills when structured observation checklists were used as a teaching tool. Significant differences were noted in demonstrations of targeted communication skills when analyzed by physician specialty and gender. Conclusions: Structured observation checklists can be used as an instructional tool for exposing medical students to advanced physician-patient communication skills, providing students with guidance on what skills to observe and identify, and highlighting the differences in implementation of these skills across specialties. Practice implications: This study provides implications for faculty development as well as medical communication curriculum. Communication checklists can assist in providing structured observations and normative feedback for learners and faculty desiring to improve their physician-patient communication skills

Model Systems to Study the Chronic, Polymicrobial Infections in Cystic Fibrosis: Current Approaches and Exploring Future Directions.

A recent workshop titled "Developing Models to Study Polymicrobial Infections," sponsored by the Dartmouth Cystic Fibrosis Center (DartCF), explored the development of new models to study the polymicrobial infections associated with the airways of persons with cystic fibrosis (CF). The workshop gathered 35+ investigators over two virtual sessions. Here, we present the findings of this workshop, summarize some of the challenges involved with developing such models, and suggest three frameworks to tackle this complex problem. The frameworks proposed here, we believe, could be generally useful in developing new model systems for other infectious diseases. Developing and validating new approaches to study the complex polymicrobial communities in the CF airway could open windows to new therapeutics to treat these recalcitrant infections, as well as uncovering organizing principles applicable to chronic polymicrobial infections more generally

Accelerating Medicines Partnership® Schizophrenia (AMP® SCZ):Rationale and Study Design of the Largest Global Prospective Cohort Study of Clinical High Risk for Psychosis

This article describes the rationale, aims, and methodology of the Accelerating Medicines Partnership® Schizophrenia (AMP® SCZ). This is the largest international collaboration to date that will develop algorithms to predict trajectories and outcomes of individuals at clinical high risk (CHR) for psychosis and to advance the development and use of novel pharmacological interventions for CHR individuals. We present a description of the participating research networks and the data processing analysis and coordination center, their processes for data harmonization across 43 sites from 13 participating countries (recruitment across North America, Australia, Europe, Asia, and South America), data flow and quality assessment processes, data analyses, and the transfer of data to the National Institute of Mental Health (NIMH) Data Archive (NDA) for use by the research community. In an expected sample of approximately 2000 CHR individuals and 640 matched healthy controls, AMP SCZ will collect clinical, environmental, and cognitive data along with multimodal biomarkers, including neuroimaging, electrophysiology, fluid biospecimens, speech and facial expression samples, novel measures derived from digital health technologies including smartphone-based daily surveys, and passive sensing as well as actigraphy. The study will investigate a range of clinical outcomes over a 2-year period, including transition to psychosis, remission or persistence of CHR status, attenuated positive symptoms, persistent negative symptoms, mood and anxiety symptoms, and psychosocial functioning. The global reach of AMP SCZ and its harmonized innovative methods promise to catalyze the development of new treatments to address critical unmet clinical and public health needs in CHR individuals.</p