Trauma-Informed Care Training in the Women’s Healthcare Setting

Purpose: This project is designed to improve knowledge and use of trauma-informed care in the midwifery setting. Background: Research has shown that medical procedures and treatments can be distressing and trigger post-traumatic stress disorder symptoms in those with trauma histories. Obstetric and gynecological evaluations and procedures are intimate and invasive, putting the patient in a vulnerable situation. Midwifery facilities are in a unique position to provide support through trauma-informed care. However, despite evidence showing the benefit of trauma-informed care provision, training and implementation in the women’s healthcare setting are limited. Design: A validated pre- and post-survey was utilized to assess changes in knowledge, attitude, and practice of trauma-informed care at a small, rural clinic in Montana following a traumainformed care training. Results: A statistically significant increase between the pre- and post-survey scores for the questions measuring attitude (MD = 0.167, p \u3c 0.05) and the overall score (MD = 0.198, p \u3c 0.05) was identified. A statistically significant difference in mean scores for questions measuring practice of trauma-informed care between job roles was identified, with those with an administrative support job role having a statistically lower mean scores for questions measuring practice of trauma-informed care, than participants with a healthcare support job role (MD=1.375, p\u3c0.05). Implications: The results suggest not all job roles practice trauma-informed care equally. Further investigation should focus on looking at the differences in knowledge, attitude, and practice between job roles and how those gaps can be closed to improve the overall provision of trauma-informed care and to focus training efforts

Numerical estimation of entropy loss on dimerization: improved prediction of the quaternary structure of the GCN4 leucine zipper

A lattice based model of a protein is used to study the dimerization equilibrium of the GCN4 leucine zipper. Replica exchange Monte Carlo is used to determine the free energy of both the monomeric and dimeric forms as a function of temperature. The method of coincidences is then introduced to explicitly calculate the entropy loss associated with dimerization, and from it the free energy difference between monomer and dimer, as well as the corresponding equilibrium reaction constant. We find that the entropy loss of dimerization is a strong function of energy (or temperature), and that it is much larger than previously estimated, especially for high energy states. The results confirm that it is possible to study the dimerization equilibrium of GCN4 at physiological concentrations within the reduced representation of the protein employed

Inclusive Concurrent Education Partnership

The Inclusive Concurrent Education Grant was implemented at the beginning of the fall 2012 semester after a planning period covering the spring and summer of 2012. Seven students from Boston Public Schools participated in the program’s first semester at UMass Boston, auditing a class each chosen from their personal interests. Five students completed. The objective of the Inclusive Concurrent Education partnership is to provide secondary students with significant intellectual disabilities an opportunity to take an undergraduate course at UMass Boston. The goals are to provide an opportunity for these students to pursue their interests and to learn such skills as self-advocacy and self-sufficiency in a post-secondary school setting

Ketogenesis prevents diet-induced fatty liver injury and hyperglycemia

Nonalcoholic fatty liver disease (NAFLD) spectrum disorders affect approximately 1 billion individuals worldwide. However, the drivers of progressive steatohepatitis remain incompletely defined. Ketogenesis can dispose of much of the fat that enters the liver, and dysfunction in this pathway could promote the development of NAFLD. Here, we evaluated mice lacking mitochondrial 3-hydroxymethylglutaryl CoA synthase (HMGCS2) to determine the role of ketogenesis in preventing diet-induced steatohepatitis. Antisense oligonucleotide–induced loss of HMGCS2 in chow-fed adult mice caused mild hyperglycemia, increased hepatic gluconeogenesis from pyruvate, and augmented production of hundreds of hepatic metabolites, a suite of which indicated activation of the de novo lipogenesis pathway. High-fat diet feeding of mice with insufficient ketogenesis resulted in extensive hepatocyte injury and inflammation, decreased glycemia, deranged hepatic TCA cycle intermediate concentrations, and impaired hepatic gluconeogenesis due to sequestration of free coenzyme A (CoASH). Supplementation of the CoASH precursors pantothenic acid and cysteine normalized TCA intermediates and gluconeogenesis in the livers of ketogenesis-insufficient animals. Together, these findings indicate that ketogenesis is a critical regulator of hepatic acyl-CoA metabolism, glucose metabolism, and TCA cycle function in the absorptive state and suggest that ketogenesis may modulate fatty liver disease

Non-Equilibrium Statistical Physics of Currents in Queuing Networks

We consider a stable open queuing network as a steady non-equilibrium system of interacting particles. The network is completely specified by its underlying graphical structure, type of interaction at each node, and the Markovian transition rates between nodes. For such systems, we ask the question ``What is the most likely way for large currents to accumulate over time in a network ?'', where time is large compared to the system correlation time scale. We identify two interesting regimes. In the first regime, in which the accumulation of currents over time exceeds the expected value by a small to moderate amount (moderate large deviation), we find that the large-deviation distribution of currents is universal (independent of the interaction details), and there is no long-time and averaged over time accumulation of particles (condensation) at any nodes. In the second regime, in which the accumulation of currents over time exceeds the expected value by a large amount (severe large deviation), we find that the large-deviation current distribution is sensitive to interaction details, and there is a long-time accumulation of particles (condensation) at some nodes. The transition between the two regimes can be described as a dynamical second order phase transition. We illustrate these ideas using the simple, yet non-trivial, example of a single node with feedback.Comment: 26 pages, 5 figure

Cultural safety involves new professional roles: A rapid review of interventions in Australia, the United States, Canada and New Zealand

Abstract Cultural safety is a decolonizing and transformative approach to health care aimed at achieving health care that recognizes, respects and nurtures the needs, rights and identities of Indigenous peoples. Such a transformation requires new or radically reimagined professional roles. Based on a rapid review design, this synthesis aimed to identify fundamental characteristics of cultural safety interventions that involved the creation or transformation of professional roles. The 23 included studies presented three main categories of professional roles for cultural safety. These roles were focused on (a) supporting health care system navigation, (b) providing a new or improved service offering, and (c) building organizational capacity to provide culturally safe health care. Our results demonstrate that cultural safety can be implemented by key actors playing different roles at different levels of the health care organization. These roles should be viewed as complementary to one another and be defined and implemented in partnership with Indigenous partners. © The Author(s) 2023

Gram Negative Wound Infection in Hospitalised Adult Burn Patients-Systematic Review and Metanalysis-

BACKGROUND: Gram negative infection is a major determinant of morbidity and survival. Traditional teaching suggests that burn wound infections in different centres are caused by differing sets of causative organisms. This study established whether Gram-negative burn wound isolates associated to clinical wound infection differ between burn centres. METHODS: Studies investigating adult hospitalised patients (2000-2010) were critically appraised and qualified to a levels of evidence hierarchy. The contribution of bacterial pathogen type, and burn centre to the variance in standardised incidence of Gram-negative burn wound infection was analysed using two-way analysis of variance. PRIMARY FINDINGS: Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumanni, Enterobacter spp., Proteus spp. and Escherichia coli emerged as the commonest Gram-negative burn wound pathogens. Individual pathogens' incidence did not differ significantly between burn centres (F (4, 20) = 1.1, p = 0.3797; r2 = 9.84). INTERPRETATION: Gram-negative infections predominate in burn surgery. This study is the first to establish that burn wound infections do not differ significantly between burn centres. It is the first study to report the pathogens responsible for the majority of Gram-negative infections in these patients. Whilst burn wound infection is not exclusive to these bacteria, it is hoped that reporting the presence of this group of common Gram-negative "target organisms" facilitate clinical practice and target research towards a defined clinical demand.peer-reviewe