Monitoring and modelling the effects of ecosystem engineers on ecosystem functioning

Biodiversity is crucial for supporting ecosystem functioning, yet some species play a disproportionate role in maintaining complex ecological processes. Ecosystem engineers are species that directly influence ecosystems by modifying biophysical environments, creating novel habitats, altering biogeochemical cycles, increasing biodiversity and/or modulating ecological processes. Although these species may substantially influence ecosystem functioning, their role is often overlooked and difficult to quantify. Understanding the status, dynamics and trends of ecosystem engineers is essential for mitigating biodiversity loss and maintaining healthy ecosystems. This review reveals the common but underappreciated roles that ecosystem engineers play in ecosystem functioning across many different taxa, biomes and ecological processes. We first synthesise how knowledge of ecosystem engineering improves our understanding of species interactions and the ecological processes underlying both ecosystem functioning and BEF relationships. We provide a conceptual model for addressing the effects of ecosystem engineers in BEF research and ecological dynamics. We provide a ‘how to’ analytical framework for monitoring and quantifying changes in ecosystem engineers and their effects on ecosystem functioning. This framework includes (i) what variables to measure, how and at which scale; (ii) experiments involving species exclusion or removal, introduction and comparative designs when experimental manipulation is not feasible and (iii) statistical, data-driven and theory-driven models. We discuss how to leverage ecosystem engineering in the context of current global change and ecosystem restoration efforts. Including ecosystem engineers in conservation and restoration programs, when implemented in the appropriate context and supported by an understanding of ecological mechanisms and processes, may be crucial for sustaining biological diversity and functional ecosystems

Downeast Maine MAT Expansion Project: Year 3 Final Data Summary

This report summarizes the collaborative effort of Healthy Acadia, its providers, the Downeast Substance Treatment Network, and Downeast Substance Use Response Coalition, to combat opioid use disorder (OUD) in Downeast Maine through multiple evidence-based strategies. Project goals included the reduction of barriers to accessing medication-assisted treatment (MAT) and the enhancement of MAT services by improving provider capacity through training and implementation of best practice treatment. For more information, please contact M. Lindsey Smith, PhD, [email protected]

Traumatic Bladder Ruptures: A Ten-Year Review at a Level 1 Trauma Center

Abstract Bladder rupture occurs in only 1.6% of blunt abdominopelvic trauma cases. Although rare, bladder rupture can result in significant morbidity if undiagnosed or inappropriately managed. AUA Urotrauma Guidelines suggest that urethral catheter drainage is a standard of care for both extraperitoneal and intraperitoneal bladder rupture regardless of the need for surgical repair. However, no specific guidance is given regarding the length of catheterization. The present study seeks to summarize contemporary management of bladder trauma at our tertiary care center, assess the impact of length of catheterization on bladder injuries and complications, and develop a protocol for management of bladder injuries from time of injury to catheter removal. A retrospective review was performed on 34,413 blunt trauma cases to identify traumatic bladder ruptures over the past 10 years (January 2008–January 2018) at our tertiary care facility. Patient data were collected including age, gender, BMI, mechanism of injury, and type of injury. The primary treatment modality (surgical repair vs. catheter drainage only), length of catheterization, and post-injury complications were also assessed. Review of our institutional trauma database identified 44 patients with bladder trauma. Mean age was 41 years, mean BMI was 24.8 kg/m2, 95% were Caucasian, and 55% were female. Motor vehicle collision (MVC) was the most common mechanism, representing 45% of total injuries. Other mechanisms included falls (20%) and all-terrain vehicle (ATV) accidents (13.6%). 31 patients had extraperitoneal injury, and 13 were intraperitoneal. Pelvic fractures were present in 93%, and 39% had additional solid organ injuries. Formal cystogram was performed in 59% on presentation, and mean time to cystogram was 4 hours. Gross hematuria was noted in 95% of cases. Operative management was performed for all intraperitoneal injuries and 35.5% of extraperitoneal cases. Bladder closure in operative cases was typically performed in 2 layers with absorbable suture in a running fashion. The intraperitoneal and extraperitoneal injuries managed operatively were compared, and length of catheterization (28 d vs. 22 d, ), time from injury to normal fluorocystogram (19.8 d vs. 20.7 d, ), and time from injury to repair (4.3 vs. 60.5 h, ) were not statistically different between cohorts. Patients whose catheter remained in place for greater than 14 days had prolonged time to initial cystogram (26.6 d vs. 11.5 d) compared with those whose foley catheter was removed within 14 days. The complication rate was 21% for catheters left more than 14 days while patients whose catheter remained less than 14 days experienced no complications. The present study provides a 10-year retrospective review characterizing the presentation, management, and follow-up of bladder trauma patients at our level 1 trauma center. Based on our findings, we have developed an institutional protocol which now includes recommendations regarding length of catheterization after traumatic bladder rupture. By providing specific guidelines for initial follow-up cystogram and foley removal, we hope to decrease patient morbidity from prolonged catheterization. Further study will seek to allow multidisciplinary trauma teams to standardize management, streamline care, and minimize complications for patients presenting with traumatic bladder injuries

Medication Assisted Treatment: Prescription Drug and Opioid Addiction Expansion Project

Greater Portland Health (GPH) in collaboration with Preble Street Resource Center was awarded a Medication Assisted Treatment: Prescription Drug & Opioid Addiction (MOUD-PDOA) grant from SAMHSA. The GPH MOUD-PDOA project will include a mixed-methods evaluation led by Catherine E. Cutler Institute. The evaluation team will build knowledge and provide feedback to inform the implementation and refinement of the GPH MOUD-PDOA Program. Evaluation Goals: Document program strategies and identify barriers and facilitators to implementation Examine the efficacy of using a continuum of treatment services to increase access to MOUD among vulnerable populations in underserved communities Assess the impact of the intervention strategies on patient engagement and outcomes This report highlights the process and outcome evaluation data collected during Year 1. For more information, please contact M.Lindsey Smith or Kat Knight

Long-term Monitoring of Active Galactic Nuclei with Swift

https://scholarworks.moreheadstate.edu/student_scholarship_posters/1197/thumbnail.jp

HOUSE: Homeless Opioid User Service Engagement Program. Year 1 Report

Homelessness and lack of stable housing is often a barrier to achieving stability for individuals who are experiencing homelessness (IWAEH) with an OUD. In order to meet the complex needs of IWAEH with OUD, the Department of Health and Human Services funded a pilot program in 2021, the Homeless Opioid Users Service Engagement (HOUSE) Program; clinicians at Greater Portland Health provide clients with low-barrier Medication Assisted Treatment (MAT), while staff at Preble Street provide casework support and rapid housing assistance to individuals who have been identified as being at high risk of overdose, are experiencing homelessness, and are diagnosed with an OUD. . The services resulting from this pilot are intended to provide comprehensive treatment, case management, housing services and peer support in an effort to support long-term recovery and reduced opioid related morbidity and mortality among IWAEH with OUD. The primary goals of the HOUSE Program evaluation are to: (1) document implementation strategies and identify barriers and facilitators to implementation; (2) evaluate the efficacy of the intervention strategies at increasing access to prevention, treatment and recovery supports for IWAEH with OUD; (3) examine the impact of housing liaison services and Assistance Funds on housing stability among IWAEH with OUD; (4) assess the cost effectiveness and return on investment of the intervention strategies and (5) examine the impact of the intervention strategies on participant engagement and outcomes. Early learnings from the mixed methods approach indicate that the first year of the initiative demonstrate that while there remain challenges to engaging this population, the use of evidence-based treatments in combination with intensive case management and peer supports can be an effective way to maintain stabilize patients and address both their medical and housing needs

SUPPORT for ME Needs Assessment Summary.

Maine Department of Health and Human Services contracted with the Catherine Cutler Institute at the University of Southern Maine to conduct a baseline needs assessment. The overall goal was to better understand the current capacity to address substance use in Maine; find barriers to receiving and utilizing SUD treatment and recovery services; and identify any gaps in SUD-related services in the state. The Cutler team conducted interviews, surveys, community listening sessions and focus groups with healthcare key informants (leadership from health systems, residential care, recovery housing, behavioral health agencies), providers (medical, behavioral health, first responders, residential treatment, law enforcement, opioid treatment), youth ages 12-21, and community members across Maine. The team also analyzed health claims data to identify how common substance misuse is among MaineCare (Medicaid) members and what types of substance use disorder (SUD) treatment and support services MaineCare members use. For more information, please contact the principal investigator, M. Lindsey Smith, PhD, at [email protected]

Feasibility randomised controlled trial of Recovery-focused Cognitive Behavioural Therapy for Older Adults with bipolar disorder (RfCBT-OA): study protocol

Introduction: Bipolar disorder is a severe and chronic mental health problem that persists into older adulthood. The number of people living with this condition is set to rise as the UK experiences a rapid ageing of its population. To date, there has been very little research or service development with respect to psychological therapies for this group of people. Methods and analysis: A parallel two-arm randomised controlled trial comparing a 14-session, 6-month Recovery-focused Cognitive-Behavioural Therapy for Older Adults with bipolar disorder (RfCBT-OA) plus treatment as usual (TAU) versus TAU alone. Participants will be recruited in the North-West of England via primary and secondary mental health services and through self-referral. The primary objective of the study is to evaluate the feasibility and acceptability of RfCBT-OA; therefore, a formal power calculation is not appropriate. It has been estimated that randomising 25 participants per group will be sufficient to be able to reliably determine the primary feasibility outcomes (eg, recruitment and retention rates), in line with recommendations for sample sizes for feasibility/pilot trials. Participants in both arms will complete assessments at baseline and then every 3 months, over the 12-month follow-up period. We will gain an estimate of the likely effect size of RfCBTOA on a range of clinical outcomes and estimate parameters needed to determine the appropriate sample size for a definitive, larger trial to evaluate the effectiveness and cost-effectiveness of RfCBT-OA. Data analysis is discussed further in the Analysis section in the main paper. Ethics and dissemination: This protocol was approved by the UK National Health Service (NHS) Ethics Committee process (REC ref: 15/NW/0330). The findings of the trial will be disseminated through peerreviewed journals, national and international conference presentations and local, participating NHS trusts. Trial registration number: ISRCTN13875321; Preresults