Mental Health Status and Perceived Barriers to Seeking Treatment in Rural Reserve Component Veterans

National Guard and Reserve (RC) troops (N=617) primarily from the Appalachian Region in Southwestern Pennsylvania who recently returned from deployment in support of current military conflicts responded to a survey that assessed their demographics, mental health symptoms, help-seeking behaviors, barriers for not seeking treatment, deployment history, and stressors. Veterans were classified as rural (N = 334) or non-rural (N = 283). Rural participants reported a significantly greater number of issues with transportation/access in seeking mental health treatment, were more likely to perceive others as worse off as a reason not to seek treatment, had a more negative attitude toward seeking treatment for mental health problems, and reported fewer concerns about a mental health problem affecting their career. Recommendations for mental health care providers and policymakers are offered based on the results, including the importance of recognizing the distinctive barriers to care that RC Appalachian veterans face when they come back into civilian communities, many of them rural

Longitudinal Predictors of Self-Reliance for Coping with Mental Health Problems in the Military

Military personnel encounter occupational hazards that make them vulnerable to developing mental health symptoms; however, many soldiers who experience a problem do not seek treatment. A major barrier to treatment is self-reliance, a preference to manage problems oneself rather than seek help from a professional. In the present study, we sought a more comprehensive understanding of factors that contribute to self-reliance. Active-duty soldiers (N = 485) were surveyed at two time points. The sample was 93% male, 67% Caucasian, and most were aged 20-24 (49%). The survey included: factors that affect treatment-seeking, deployment experiences, and mental health symptoms. Results indicated that stigmatizing beliefs about those who seek treatment and negative beliefs about treatment at Time 1 were related to higher preferences for self-reliance at Time 2, while positive beliefs about treatment at Time 1 were related to lower self-reliance. Combat exposure, mental health symptoms, social support for treatment-seeking, and stigma from others were not significant predictors. These results demonstrate that self-reliance may not be unique to combat soldiers and may not diminish as symptoms become severe. Instead one’s views of treatment and others who seek treatment may be more impactful, and should be the target of interventions to encourage treatment-seeking

Chronotype, Shift Work, and Sleep Problems Among Emergency Medicine Clinicians

Introduction: Extensive research has demonstrated that shift work can be detrimental to sleep. Chronotype, the preference for time of day to sleep or be active, can influence how we function at different times of day and how shift work impacts us. This study was designed to assess the chronotype of emergency physicians (EPs) and emergency advanced practice providers (EAPPs) and examine how chronotype was related to sleep problems and shifts worked over a three-month period. Methods: A survey assessing chronotype and sleep quality was sent to 225 EPs and EAPPs in a single, large academic Department of Emergency Medicine. An archival database indicated the shifts worked during the prior three months and the percentages of day, evening, and night shifts for each practitioner were calculated. Results: 127 people completed the survey (56.4%). Of the three chronotypes (morning, intermediate, evening), most EM clinicians were categorized as intermediate chronotype (56/127, 44.1%), followed by morning type (39/127, 30.7%) and then evening type (32/127, 25.2%). Those with an evening chronotype were more likely to report daytime dysfunction (a lack of enthusiasm and propensity to fall asleep during activities) (p \u3c 0.01) and worked a greater percentage of night shifts than other chronotypes (p \u3c 0.05). Interestingly, the effect of evening chronotype on daytime dysfunction was no longer significant when controlled for the relatively greater percentage of night shifts worked, suggesting that the observed dysfunction was more likely an artifact of the night shifts worked, rather than purely chronotype driven. Conclusion: This is the first study of a large cohort of EM practitioners investigating chronotype and its influence on shift preference and sleep quality. In this pilot investigation, most of the surveyed clinicians were categorized as an intermediate chronotype. Working night shifts was associated more closely with daytime dysfunction than was chronotype, strengthening the latent literature that working night shift carries with it significant challenges to the EM clinician. Future research should evaluate the relationship between chronotype malalignment to practitioner burnout and well-being

Metalloprotein entatic control of ligand-metal bonds quantified by ultrafast x-ray spectroscopy

The multifunctional protein cytochrome c (cyt c) plays key roles in electron transport and apoptosis, switching function by modulating bonding between a heme iron and the sulfur in a methionine residue. This Fe-S(Met) bond is too weak to persist in the absence of protein constraints. We ruptured the bond in ferrous cyt c using an optical laser pulse and monitored the bond reformation within the protein active site using ultrafast x-ray pulses from an x-ray free-electron laser, determining that the Fe-S(Met) bond enthalpy is ~4 kcal/mol stronger than in the absence of protein constraints. The 4 kcal/mol is comparable with calculations of stabilization effects in other systems, demonstrating how biological systems use an entatic state for modest yet accessible energetics to modulate chemical function

Au+Au Reactions at the AGS: Experiments E866 and E917

Particle production and correlation functions from Au+Au reactions have been measured as a function of both beam energy (2-10.7AGeV) and impact parameter. These results are used to probe the dynamics of heavy-ion reactions, confront hadronic models over a wide range of conditions and to search for the onset of new phenomena.Comment: 12 pages, 14 figures, Talk presented at Quark Matter '9

Participatory Process for Implementing a Colorectal Cancer Screening Intervention: an Action Plan for Local Sustainability

Background: Rigid protocols can hamper translation of evidence-based interventions from research to real-world settings. This investigation aimed to develop procedures for modifying the study protocol of a community-based participatory research (CBPR) project and to analyze the theoretical constructs that underlie this process. Methods: The research project is a dissemination and implementation study of the Educational Program to Increase Colorectal Cancer Screening (EPICS), an evidence-based intervention targeting African Americans in the United States. The study is being conducted in a partnership with community coalitions in 15 different cities. Each site initially presented unique issues that required modification of the study protocol. Results: In order to honor underlying CBPR theory, it was necessary to negotiate protocol changes with the community coalition at each site, while insuring preservation of the core elements of the intervention. Conclusions: We discuss the ways in which this represents a narrowing of the gap between CBPR and traditional research approaches

Monoubiquitination of syntaxin 3 leads to retrieval from the basolateral plasma membrane and facilitates cargo recruitment to exosomes

Syntaxin 3 (Stx3), a SNARE protein located and functioning at the apical plasma membrane of epithelial cells, is required for epithelial polarity. A fraction of Stx3 is localized to late endosomes/lysosomes, although how it traffics there and its function in these organelles is unknown. Here we report that Stx3 undergoes monoubiquitination in a conserved polybasic domain. Stx3 present at the basolateral—but not the apical—plasma membrane is rapidly endocytosed, targeted to endosomes, internalized into intraluminal vesicles (ILVs), and excreted in exosomes. A nonubiquitinatable mutant of Stx3 (Stx3-5R) fails to enter this pathway and leads to the inability of the apical exosomal cargo protein GPRC5B to enter the ILV/exosomal pathway. This suggests that ubiquitination of Stx3 leads to removal from the basolateral membrane to achieve apical polarity, that Stx3 plays a role in the recruitment of cargo to exosomes, and that the Stx3-5R mutant acts as a dominant-negative inhibitor. Human cytomegalovirus (HCMV) acquires its membrane in an intracellular compartment and we show that Stx3-5R strongly reduces the number of excreted infectious viral particles. Altogether these results suggest that Stx3 functions in the transport of specific proteins to apical exosomes and that HCMV exploits this pathway for virion excretion