Polytrauma Family Needs Assessment

There is a great deal of literature in civilian rehabilitation settings that documents the tremendous impact a brain injury has on both the injured person and the family as a whole. TBI is a leading cause of both death and disability world-wide and is often cited as the signature injury of the ongoing OEF/OIF conflict. In 2005, Congress recognized the severity of injuries that military personnel were encountering in the OEF/OIF conflicts and created the Polytrauma System of Care (PSC). While the PSC has made great efforts to provide innovative and effective treatment for active duty and veteran patients, little is known about the needs of their family members. Given the tremendous impact TBI has on families and the important caregiving role assumed by many, there is an urgent need to better understand their needs. The Family Needs Questionnaire (FNQ) was administered to 44 family members of patients at the Polytrauma Rehabilitation Center (PRC) at McGuire Veterans Affairs Medical Center (VAMC) over a 30 month period. Family members rated 40 needs indicating the importance and extent to which needs were met. Results were compared with findings from similar studies in civilian rehabilitation settings. A review of the rated needs indicated that PRC families rated the needs in the Health Information domain as most important and most frequently met. In addition, PRC family members rated Emotional Support and Instrumental Support as least important and most frequently unmet. Overall results were consistent with findings in civilian rehabilitation research, but subtle differences were examined. Exploratory analyses were conducted to examine a subset of family variables associated with needs indices. Needs were rated differently based on respondents\u27, gender, income, relationship to patient, and time since injury. Results highlight similarities across family needs in rehabilitation settings. However, there remains a need for further research within VAMC PRC\u27s that include a larger more diverse sample and participants utilizing both inpatient and outpatient services

αs from an improved τ vector isovector spectral function

After discussing difficulties in determining αs from tau decay due to the existence of Duality Violations and the associated asymptotic nature of the OPE, we describe a new determination based on an improved vector isovector spectral function, now based solely on experimental input, obtained by (i) combining ALEPH and OPAL results for 2π + 4π and (ii) replacing K−K0 and higher-multiplicity exclusive-mode contributions, both previously estimated using Monte Carlo, with new experimental BaBar results for K−K0 and results implied by e+e− cross sections and CVC for the higher-multiplicity modes. We find αs(mτ) = 0.3077±0.0075, which corresponds to αs(mZ) = 0.1171±0.0010. Finally, we comment on some of the shortcomings in the criticism of our approach by Pich and Rodriguez-Sanchez

Emergence of distinct and heterogeneous strains of amyloid beta with advanced Alzheimer's disease pathology in Down syndrome

Amyloid beta (Aβ) is thought to play a critical role in the pathogenesis of Alzheimer’s disease (AD). Prion-like Aβ polymorphs, or “strains”, can have varying pathogenicity and may underlie the phenotypic heterogeneity of the disease. In order to develop effective AD therapies, it is critical to identify the strains of Aβ that might arise prior to the onset of clinical symptoms and understand how they may change with progressing disease. Down syndrome (DS), as the most common genetic cause of AD, presents promising opportunities to compare such features between early and advanced AD. In this work, we evaluate the neuropathology and Aβ strain profile in the post-mortem brain tissues of 210 DS, AD, and control individuals. We assayed the levels of various Aβ and tau species and used conformation-sensitive fluorescent probes to detect differences in Aβ strains among individuals and populations. We found that these cohorts have some common but also some distinct strains from one another, with the most heterogeneous populations of Aβ emerging in subjects with high levels of AD pathology. The emergence of distinct strains in DS at these later stages of disease suggests that the confluence of aging, pathology, and other DS-linked factors may favor conditions that generate strains that are unique from sporadic AD. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40478-021-01298-0

Psychological wellbeing in survivors of cardiac arrest, and its relationship to neurocognitive function

© 2016 Objective To characterise psychological wellbeing in survivors of out-of-hospital cardiac arrest (OHCA), and examine its relationship to cognitive function. Patients Forty-one highly functioning cardiac arrest survivors were drawn from the follow-up cohort of a randomised controlled trial of initial airway management in OHCA (ISRCTN:18528625). Design Psychological wellbeing was assessed with a self-report questionnaire (the Depression Anxiety and Stress Scale; DASS) and cognitive function was examined using the Delayed Matching to Samples (DMS) test from the Cambridge Neuropsychological Test Automated Battery (CANTAB). Results Mean anxiety levels were significantly higher in this patient group than normative data drawn from the general population (p=0.046). Multiple regression analyses showed that cognitive function, measured by the DMS, did not predict any of the DASS scales. Conclusions Anxiety plays an important role in determining perceived QoL in high functioning survivors, but psychological wellbeing is unrelated to cognitive function in this group. To achieve a comprehensive assessment of wellbeing, resuscitation research should consider outcomes beyond neurological function alone

from an improved

After discussing difficulties in determining αs from tau decay due to the existence of Duality Violations and the associated asymptotic nature of the OPE, we describe a new determination based on an improved vector isovector spectral function, now based solely on experimental input, obtained by (i) combining ALEPH and OPAL results for 2π + 4π and (ii) replacing K−K0 and higher-multiplicity exclusive-mode contributions, both previously estimated using Monte Carlo, with new experimental BaBar results for K−K0 and results implied by e+e− cross sections and CVC for the higher-multiplicity modes. We find αs(mτ) = 0.3077±0.0075, which corresponds to αs(mZ) = 0.1171±0.0010. Finally, we comment on some of the shortcomings in the criticism of our approach by Pich and Rodriguez-Sanchez

The Relationship between Training and Mental Health among Caregivers of Individuals with Polytrauma

This was a hypothesis-generating exploration of relationships between caregiver training during TBI/polytrauma rehabilitation and caregiver mental health. In this cross-sectional study, 507 informal caregivers to US service members with TBI who received inpatient rehabilitation care in a Veterans Affairs’ Polytrauma Rehabilitation Center from 2001 to 2009 completed a retrospective, self-report survey. Embedded in the survey were measures of caregiver mental health, including the National Institutes of Health’s Patient Reported Outcome Measurement Information System (PROMIS) Anxiety and Depression Short Forms, the Rosenberg Self-Esteem scale, and the Zarit Burden Short Form. Though no groups endorsed clinical levels, mental health symptoms varied by caregiver training category (Trained, Not Trained, and Did Not Need Training). Caregivers who did not receive training on how to navigate healthcare systems endorsed higher depression and burden and lower self-esteem than those who did. Caregivers who did not receive training in supporting their care recipients’ emotions endorsed higher anxiety, depression, and burden and lower self-esteem than those who did. Analyses also suggested a different association between training and mental health based on caregivers’ relationship to the care recipient and the intensity of care recipient needs. Potential hypotheses for testing in future studies raised by these findings are discussed