Dynamic association between perfusion and white matter integrity across time since injury in Veterans with history of TBI.

ObjectiveCerebral blood flow (CBF) plays a critical role in the maintenance of neuronal integrity, and CBF alterations have been linked to deleterious white matter changes. Although both CBF and white matter microstructural alterations have been observed within the context of traumatic brain injury (TBI), the degree to which these pathological changes relate to one another and whether this association is altered by time since injury have not been examined. The current study therefore sought to clarify associations between resting CBF and white matter microstructure post-TBI.Methods37 veterans with history of mild or moderate TBI (mmTBI) underwent neuroimaging and completed health and psychiatric symptom questionnaires. Resting CBF was measured with multiphase pseudocontinuous arterial spin labeling (MPPCASL), and white matter microstructural integrity was measured with diffusion tensor imaging (DTI). The cingulate cortex and cingulum bundle were selected as a priori regions of interest for the ASL and DTI data, respectively, given the known vulnerability of these regions to TBI.ResultsRegression analyses controlling for age, sex, and posttraumatic stress disorder (PTSD) symptoms revealed a significant time since injury × resting CBF interaction for the left cingulum (p < 0.005). Decreased CBF was significantly associated with reduced cingulum fractional anisotropy (FA) in the chronic phase; however, no such association was observed for participants with less remote TBI.ConclusionsOur results showed that reduced CBF was associated with poorer white matter integrity in those who were further removed from their brain injury. Findings provide preliminary evidence of a possible dynamic association between CBF and white matter microstructure that warrants additional consideration within the context of the negative long-term clinical outcomes frequently observed in those with history of TBI. Additional cross-disciplinary studies integrating multiple imaging modalities (e.g., DTI, ASL) and refined neuropsychiatric assessment are needed to better understand the nature, temporal course, and dynamic association between brain changes and clinical outcomes post-injury

Analysis of Care Coordination for Children with Special Health Care Needs: A Parent\u27s Perspective

Introduction. Care coordination involves organizing patient care activities and sharing information among all of the participants concerned with a patient\u27s care to achieve improved outcomes, a recent national focus. Compared to the national average, a higher percentage of Vermont children are cared for in an office that meets medical home criteria. However, there is limited research on medical home and care coordination for children with special health care needs (CSHCN) in the state of Vermont. Objectives. The goal of this study was to assess family perceptions, knowledge, and attitudes about how well care coordination is working for Vermont families with CSHCN. Methods. A paper and an electronic anonymous survey was developed for Vermont families with CSHCN. The surveys were then distributed by Vermont Family Network and the UVMMC Department of Pediatrics. Focus group interviews were also conducted at Vermont Family Network to provide family insight to explain the quantitative data. Results. 30 participants responded to the survey; only 20 completed it. The overall composite satisfaction score is 54%. This score takes into account 4 questions regarding care coordination satisfaction. Each question was formatted into a numerical value ranging from zero to five, with an overall score of 20 equating to 100% satisfaction. Discussion. Findings indicate that families with CSHCN are not satisfied with the level of care coordination currently provided. Respondents reported many barriers regarding care coordination, including lack of communication among health care providers, insurance coverage, and lack of support during transitional periods in care. Recommended improvements were identified.https://scholarworks.uvm.edu/comphp_gallery/1251/thumbnail.jp

Gulf of Maine seals - fisheries interactions and integrated research : final report

Meeting held: October 28, 2011, Provincetown Center for Coastal Studies, Provincetown, MA. Sponsored by the Marine Mammal Center at the Woods Hole Oceanographic Institution and the Provincetown Center for Coastal StudiesThe 2011 meeting, “Gulf of Maine Seals: Fisheries Interactions and Integrated Research”, held at the Provincetown Center for Coastal Studies (PCCS), featured posters and oral presentations as well as a series of discussion groups. This meeting was a follow up to the 2009 meeting, “Gulf of Maine Seals - Populations, Problems and Priorities”, held at the Woods Hole Oceanographic Institution (WHOI) (Bogomolni et al. 2010). At the conclusion of the 2009 meeting, attendees emphasized the need to improve communication, to obtain funding for long term research, to continue meeting on a regular basis, to increase data and data sharing, and to support cross cutting research between the meeting’s three primary topic areas: disease and health; human and fishery interactions; and population biology. The overarching goals of the 2011 meeting were to discuss and share work to date, present some of the tools developed since the 2009 meeting, and outline goals for future integrated research. One of the tools presented within the framework of cross-cutting research areas and integrative research was the development of a sightings database and website for uniquely identifiable (unique pelage, scars, lesions, tagged, branded, marked, etc.) animals. The practicality of this tool as a means to increase communication was discussed. Additionally, seal/fisheries interactions throughout the Gulf of Maine, Cape Cod and waters off of the northeast U.S. have continued to concern stakeholders since the 2009 meeting. The urgency of documenting, understanding and mitigating these interactions has become more apparent. Therefore, the focus of the 2011 Provincetown meeting was on fisheries interaction and related topics raised at the last 2009 workshop and in the meetings with Cape Cod fishermen described below. For the purposes of this report, 'fisheries interaction' can be direct/operational (e.g. depredation, when seals remove fish from gear; or entanglement/bycatch, when seals are unintentionally captured), or indirect/ecological (competition, displacement or other large-scale interactions between seals and fisheries). Stakeholder concerns about fisheries interactions and recent increases in local seal abundance were rising prior to the 2009 meeting. In December of 2006, the Chatham-based Cape Cod Commercial Hook Fishermen’s Association (CCCHFA) took the lead in organizing a meeting entitled, “Structuring a Novel Research Team to Define and Assess the Impact of Human/Seal Interactions on Cape Cod/Gulf of Maine through Ecosystem-Based Analysis”. Participants included fishermen, policy makers, environmental organizations and researchers aiming to develop a unique partnership to study the New England seal population. The goal of this meeting was to create a research team that would define the ecological role of seals in Cape Cod waters by studying population dynamics, behavior, and health. This meeting resulted in a successful partnership, financially aided by the International Fund for Animal Welfare (IFAW), between fishermen and seal researchers. A cost-effective cooperative research agreement was reached whereby seal researchers were provided boat transport around the Chatham and Monomoy areas by local fishermen. This agreement allowed students and researchers to gain access to areas off of Chatham that would otherwise not have been accessible. It also supported a collaborative effort to increase understanding and communication between stakeholders. In addition to the CCCHFA-led meeting in 2006, a series of informal meetings have been held on Cape Cod between commercial and recreational fishermen and marine scientists. This work was initially funded by the Cape Cod Five Cents Savings Bank Charitable Foundation. Owen Nichols and Lisa Sette (PCCS) have held individual meetings with commercial fishermen in Chatham, Orleans, and Provincetown, and recreational fishermen, outfitters, and associations throughout the Outer Cape. These individual meetings were followed by larger group meetings in Eastham and Chatham in 2010 and 2011, and more are planned for 2012. Attendees included commercial and recreational fishermen and scientists, and discussion topics included observed seal/fishery interactions and potential collaborative research projects. The goal of the meetings is to develop a working group composed of members of the fishing and scientific communities with expertise in marine mammal and fisheries ecology. The above meetings laid the foundation for the 2011 meeting, during which members of the scientific and fishing communities gathered to focus on fisheries interactions and integrated research techniques to quantify and mitigate interactions. Several invited presentations were given, some of which were scheduled (Appendix A) with selected abstracts provided (Appendix B), and some of which were delivered on an ad hoc basis upon request from organizers or attendees (see Appendix F for edited transcripts of presentations). In order to ensure that the fishing community had a distinct voice, a forum was included in the agenda, during which fishermen were encouraged to share their observations, experiences and concerns. Separately, moderated discussion groups focused specifically on fisheries interactions, tagging and tracking, and management issues. All four sessions, despite their specific foci, shared common themes such as the need for collaborative research involving both the scientific and fishing communities. Recommendations from the discussion groups and summaries from each session are listed on the following pages.Funding was provided by the Woods Hole Oceanographic Institution Marine Mammal Center and the Provincetown Center for Coastal Studie

Interactive effects of vascular risk burden and advanced age on cerebral blood flow.

Vascular risk factors and cerebral blood flow (CBF) reduction have been linked to increased risk of cognitive impairment and Alzheimer's disease (AD); however the possible moderating effects of age and vascular risk burden on CBF in late life remain understudied. We examined the relationships among elevated vascular risk burden, age, CBF, and cognition. Seventy-one non-demented older adults completed an arterial spin labeling MR scan, neuropsychological assessment, and medical history interview. Relationships among vascular risk burden, age, and CBF were examined in a priori regions of interest (ROIs) previously implicated in aging and AD. Interaction effects indicated that, among older adults with elevated vascular risk burden (i.e., multiple vascular risk factors), advancing age was significantly associated with reduced cortical CBF whereas there was no such relationship for those with low vascular risk burden (i.e., no or one vascular risk factor). This pattern was observed in cortical ROIs including medial temporal (hippocampus, parahippocampal gyrus, uncus), inferior parietal (supramarginal gyrus, inferior parietal lobule, angular gyrus), and frontal (anterior cingulate, middle frontal gyrus, medial frontal gyrus) cortices. Furthermore, among those with elevated vascular risk, reduced CBF was associated with poorer cognitive performance. Such findings suggest that older adults with elevated vascular risk burden may be particularly vulnerable to cognitive change as a function of CBF reductions. Findings support the use of CBF as a potential biomarker in preclinical AD and suggest that vascular risk burden and regionally-specific CBF changes may contribute to differential age-related cognitive declines

Saturated Fat Intake Is Associated with Lung Function in Individuals with Airflow Obstruction: Results from NHANES 2007⁻2012

Nutritional status is a well-recognized prognostic indicator in chronic obstructive pulmonary disease (COPD); however, very little is known about the relationship between lung function and saturated fat intake. We used data from the cross-sectional National Health and Nutrition Examination Surveys (NHANES) to assess the relationship between saturated fatty acid (SFA) intake and lung function in the general US adult population. Adults in NHANES (2007⁻2012) with pre-bronchodilator spirometry measurements and dietary SFA intake were included. Primary outcomes were lung function including forced expiratory volume in one second (FEV₁

Relationship between body composition, inflammation and lung function in overweight and obese asthma

Background: The obese-asthma phenotype is not well defined. The aim of this study was to examine both mechanical and inflammatory influences, by comparing lung function with body composition and airway inflammation in overweight and obese asthma. Methods: Overweight and obese (BMI 28-40 kg/m2) adults with asthma (n = 44) completed lung function assessment and underwent full-body dual energy x-ray absorptiometry. Venous blood samples and induced sputum were analysed for inflammatory markers. Results: In females, android and thoracic fat tissue and total body lean tissue were inversely correlated with expiratory reserve volume (ERV). Conversely in males, fat tissue was not correlated with lung function, however there was a positive association between android and thoracic lean tissue and ERV. Lower body (gynoid and leg) lean tissue was positively associated with sputum %neutrophils in females, while leptin was positively associated with android and thoracic fat tissue in males. Conclusions: This study suggests that both body composition and inflammation independently affect lung function, with distinct differences between males and females. Lean tissue exacerbates the obese-asthma phenotype in females and the mechanism responsible for this finding warrants further investigation

Exposure fluctuations of astronauts due to orientation

The dose incurred in an anisotropic environment depends on the orientation of the astronaut's body relative to the direction of the radiation field. The fluctuations in exposure of specific organs due to astronaut orientation are found to be a factor of 2 or more in a typical space habitation module and typical space radiations. An approximation function is found that overestimates astronaut exposure in most cases studied and is recommended as a shield design guide for future space missions

Feasibility of omega-3 fatty acid supplementation as an adjunct therapy for people with chronic obstructive pulmonary disease: study protocol for a randomized controlled trial

There is evidence to support the use of supplementation with long-chain omega-3 polyunsaturated fatty acids (LCn-3PUFA) from oily fish or fish oil for the treatment of various inflammatory diseases such as rheumatoid arthritis. Chronic obstructive pulmonary disease (COPD) is a progressive, terminal disease characterized by persistent airflow limitation, lung and systemic inflammation. To date, one randomized controlled trial has been published that assessed the efficacy of LCn-3PUFA in people with this condition. The aim of this article is to discuss the feasibility of conducting a trial to evaluate fish oil supplementation as adjunct therapy in people with COPD.The study is supported by a University of South Australia, Division of Health Sciences grant (DRDG 2011 (round 2))