Art therapy for PTSD and TBI: A senior active duty military service member’s therapeutic journey

AbstractArt therapy is increasingly being accepted as a form of complementary and integrative care for military veterans affected by trauma and injuries in the line of duty. Less is known, however, about the applications of art therapy for co-morbid traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD). In addition, most studies to date have focused on art therapy with veterans (former military service members) rather than with active duty service members; furthermore, there are no studies that have examined the unique context of PTSD in senior military personnel. This case study presents the therapeutic process through art therapy in the case of a senior active duty military service member (with chronic PTSD and TBI), in the context of an integrated model of care that included medical and complementary therapies

Long-term sac behavior after endovascular abdominal aortic aneurysm repair with the Excluder low-permeability endoprosthesis

PurposeSac regression is a surrogate marker for clinical success in endovascular aneurysm repair (EVAR) and has been shown to be device-specific. The low porosity Excluder endograft (Excluder low-permeability endoprosthesis [ELPE]; W. L. Gore & Associates Inc, Flagstaff, Ariz) introduced in 2004 was reported in early follow-up to be associated with sac regression rates similar to other endografts, unlike the original Excluder which suffered from sac growth secondary to fluid accumulation in the sac. The purpose of this study was to determine whether this behavior is durable in mid-term to long-term follow-up.MethodsBetween July 2004 and December 2007, 301 patients underwent EVAR of an abdominal aortic aneurysm (AAA) with the ELPE at two institutions. Baseline sac size was measured by computed tomography (CT) scan at 1 month after repair. Follow-up beyond 1 year was either with a CT or ultrasound scan. Changes in sac size ≥5 mm from baseline were determined to be significant. Endoleak history was assessed with respect to sac behavior using χ2 and logistic regression analysis.ResultsTwo hundred sixteen patients (mean age 73.6 years and 76% men) had at least 1-year follow-up imaging available for analysis. Mean follow-up was 2.6 years (range, 1-5 years). The average minor-axis diameter was 52 mm at baseline. The proportion of patients with sac regression was similar during the study period: 58%, 66%, 60%, 59%, and 63% at 1 to 5 years, respectively. The proportion of patients with sac growth increased over time to 14.8% at 4-year follow-up. The probability of freedom from sac growth at 4 years was 82.4%. Eighty patients (37.7%) had an endoleak detected at some time during follow-up with 29.6% (16 of 54) residual endoleak rate at 4 years; 13 of the residual 16 endoleaks were type II. All patients with sac growth had endoleaks at some time during the study compared with only 18% of patients with sac regression (P < .0001).ConclusionA sustained sac regression after AAA exclusion with ELPE is noted up to 5-year follow-up. Sac enlargement was observed only in the setting of a current or previous endoleak, with no cases of suspected hygroma formation noted

Active-duty military service members’ visual representations of PTSD and TBI in masks

Active-dutymilitary service members have a significant risk of sustaining physical and psychological trauma resulting in traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD). Within an interdisciplinary treatment approach at the National Intrepid Center of Excellence, servicemembers participated in mask making during art therapy sessions. This study presents an analysis of the mask-making experiences of service members (n = 370) with persistent symptoms from combatand mission-related TBI, PTSD, and other concurrent mood issues. Data sources included mask images and therapist notes collected over a five-year period. The data were coded and analyzed using grounded theory methods. Findings indicated that mask making offered visual representations of the self related to individual personhood, relationships, community, and society. Imagery themes referenced the injury, relational supports/losses, identity transitions/questions, cultural metaphors, existential reflections, and conflicted sense of self. These visual insights provided an increased understanding of the experiences of service members, facilitating their recovery

New Measure to Screen Deaf Women for Perinatal Depression

Approximately 1 million women in the U.S. have profound hearing loss and use American Sign Language (ASL) as their primary language. Many providers are unfamiliar with the unique linguistic and cultural needs of the Deaf community, therefore Deaf women experience major obstacles to receiving effective physical and mental healthcare. For example, failure to provide ASL interpreters or translations from written English is a common communication barrier that prevents Deaf women from receiving health-related treatment and information. In 2017, Drs. Melissa Anderson, Kelly Wolf Craig, and Nancy Byatt were awarded a 1-year pilot project grant for their Creating the Capacity to Screen Deaf Women for Perinatal Depression project. The primary goal of this project was to translate the Edinburgh Postnatal Depression Scale (EPDS) from written English to American Sign Language (ASL). Using the new ASL EPDS, the team aimed to recruit 50 Deaf perinatal women from across the United States to conduct depression screening interviews. This brief describes the study, its results and future plans

Experimental and Computational Sonic Boom Assessment of Boeing N+2 Low Boom Models

Near-field pressure signatures were measured and computational predictions made for several sonic boom models representing Boeing's Quiet Experimental Validation Concept (QEVC) supersonic transport, as well as three axisymmetric calibration models. Boeing developed the QEVC under a NASA Research Announcement (NRA) contract for Experimental Systems Validations for N+2 Supersonic Commercial Transport Aircraft, which was led by the NASA High Speed Project under the Fundamental Aeronautics Program. The concept was designed to address environmental and performance goals given in the NRA, specifically for low sonic boom loudness levels and high cruise efficiency, for an aircraft anticipated to enter service in the 2020 timeframe. Wind tunnel tests were conducted on the aircraft and calibration models during Phases I and II of the NRA contract from 2011 to 2013 in the NASA Ames 9- by 7-Foot and NASA Glenn 8- by 6-Foot Supersonic Wind Tunnels. Sonic boom pressure signatures were acquired primarily at Mach 1.6 and 1.8, and force and moment data were acquired from Mach 0.8 to 1.8. The sonic boom test data were obtained using a 2-in. flat-top pressure rail and a 14-in. round-top tapered "reflection factor 1" (RF1) pressure rail. Both rails capture an entire pressure signature in one data point, and successive signatures at varying positions along or above the rail were used to improve data quality through spatial averaging. The sonic boom data obtained by the rails were validated with high-fidelity numerical simulations of off-body pressures using the CFD codes USM3D, Cart3D, and OVERFLOW. The test results from the RF1 rail showed good agreement between the computational and experimental data when a variety of testing techniques including spatial averaging of a series of pressure signatures were employed, however, reflections off the 2-in. flat-top rail caused distortions in the signatures that did not agree with the CFD predictions. The 9 x 7 and 8 x 6 wind tunnels generally produced comparable data

Variety is the spice of life : flying-foxes exploit a variety of native and exotic food plants in an urban landscape mosaic

Generally, urbanization is a major threat to biodiversity; however, urban areas also provide habitats that some species can exploit. Flying-foxes (Pteropus spp.) are becoming increasingly urbanized; which is thought to be a result of increased availability and temporal stability of urban food resources, diminished natural food resources, or both. Previous research has shown that urban-roosting grey-headed flying-foxes (Pteropus poliocephalus) preferentially forage in human-modified landscapes. However, which land-use areas and food plants support its presence in urban areas is unknown. We tracked nine P. poliocephalus roosting in Adelaide, South Australia, between December 2019 and May 2020, using global positioning systems (GPS), to investigate how individuals used the urban landscape mosaic for feeding. The most frequently visited land-use category was “residential” (40% of fixes) followed by “road-side,” “reserves” and “primary production” (13–14% each). However, “reserves” were visited four times more frequently than expected from their areal availability, followed by the “residential” and “road-side” categories that were visited approximately twice more than expected each; in contrast, the “primary production” category was visited approximately five times less than expected. These results suggest that while residential areas provide most foraging resources supporting Adelaide’s flying-fox population, reserves contain foraging resources that are particularly attractive to P. poliocephalus. Primary production land was relatively less utilized, presumably because it contains few food resources. Throughout, flying-foxes visited an eclectic mixture of diet plants (49 unique species), with a majority of feeding fixes (63%) to locally indigenous Australian native species; however, in residential areas 53% of feeding visits were to non-locally indigenous species, vs only 13% in reserves. Flowering and fruiting phenology records of the food plants visited further indicated that non-locally indigenous species increase the temporal availability of foraging resources for P. poliocephalus in urban Adelaide. Our findings demonstrate the importance of residential areas for urban-roosting P. poliocephalus, and suggest that the anthropogenic mixture of food resources available in the urban landscape mosaic supports the species’ year-round presence in urban areas. Our results further highlight the importance of conserving natural habitats within the urban landscape mosaic, and stress the need for accounting for wildlife responses to urban greening initiatives

Effects of a Cognitive Behavioral Therapy Intervention Trial to Improve Disease Outcomes in Children with Inflammatory Bowel Disease:

Studies testing the efficacy of behavioral interventions to modify psychosocial sequelae of IBD in children are limited. This report presents outcomes through a six month follow up from a large RCT testing the efficacy of a cognitive-behavioral intervention for children with IBD and their parents

Experimental and Computational Sonic Boom Assessment of Boeing N+2 Low Boom Models

Near-field pressure signatures were measured and computational predictions made for several sonic boom models representing Boeings Quiet Experimental Validation Concept (QEVC) supersonic transport, as well as for three axisymmetric calibration models. The concept was designed under a NASA Research Announcement (NRA) contract to address environmental and performance goals, specifically for low sonic boom loudness levels and high cruise efficiency, for an aircraft anticipated to enter service in the 2020-timeframe. Wind tunnel tests were conducted on the aircraft and calibration models during Phases I and II of the NRA contract from 2011 to 2013 in the NASA Ames 9- by 7-Foot and NASA Glenn 8- by 6-Foot Supersonic Wind Tunnels. Sonic boom pressure signatures were acquired primarily at Mach 1.6 and 1.8, and force and moment data were acquired from Mach 0.8 to 1.8. The sonic boom test data were obtained using a 2-in. flat-top pressure rail and a 14-in. tapered reflection factor 1 (RF1) pressure rail. Both rails capture an entire pressure signature in one data point, and successive signatures at varying positions along or above the rail were used to improve data quality through spatial averaging. The sonic boom data obtained by the rails were validated with high-fidelity numerical simulations of offbody pressures. The test results showed good agreement between the computational and experimental data when a variety of testing techniques including spatial averaging of a series of pressure signatures were employed. The two wind tunnels generally produced comparable data

Cognitive-Behavioral Therapy for Children With Functional Abdominal Pain and Their Parents Decreases Pain and Other Symptoms

Unexplained abdominal pain in children has been shown to be related to parental responses to symptoms. This randomized controlled trial tested the efficacy of an intervention designed to improve outcomes in idiopathic childhood abdominal pain by altering parental responses to pain and children's ways of coping and thinking about their symptoms

Sociality predicts individual variation in the immunity of free-ranging rhesus macaques

This work was supported by CONICYT-Chilean scholarship [number 72190290], NIH grant [number R01AG060931] to N.S-M., L.J.N.B. and J.P.H., NIH grant [number R00AG051764] to N.S-M., NIH grant [number MH118203] to L.J.N.B.. and M.L.P, and NSF grant [number 1800558] to J.P.H. and Susan Anton. The CPRC is supported by the National Institutes of Health. An Animal and Biological Material Resource Center Grant [P40OD012217] was awarded to UPR from the Office of Research Infrastructure Programs (ORIP), and a Research Facilities Construction Grant [C06OD026690] was awarded for the renovation of CPRC facilities after Hurricane Maria.Social integration and social status can substantially affect an individual's health and survival. One route through which this occurs is by altering immune function, which can be highly sensitive to changes in the social environment. However, we currently have limited understanding of how sociality influences markers of immunity in naturalistic populations where social dynamics can be fully realized. To address this gap, we asked if social integration and social status in free-ranging rhesus macaques (Macaca mulatta) predict anatomical and physiological markers of immunity. We used data on agonistic interactions to determine social status, and social network analysis of grooming interactions to generate measures of individual variation in social integration. As measures of immunity, we included the size of two of the major organs involved in the immune response, the spleen and liver, and counts of three types of blood cells (red blood cells, platelets, and white blood cells). Controlling for body mass and age, we found that neither social status nor social integration predicted the size of anatomical markers of immunity. However, individuals that were more socially connected, i.e., with more grooming partners, had lower numbers of white blood cells than their socially isolated counterparts, indicating lower levels of inflammation with increasing levels of integration. These results build upon and extend our knowledge of the relationship between sociality and the immune system in humans and captive animals to free-ranging primates, demonstrating generalizability of the beneficial role of social integration on health.Publisher PDFPeer reviewe