Here We Come Ready or Not: Occupational Therapy Program to Help Prepare Prisoners for Reentry into Society

poster abstractAbstract Background: In 2013 about 10 million people were involved in various stages of imprisonment world-wide. In that same year there were about 1,574,700 persons in state and federal prisons in the United States, and 29,905 in Indiana (state and federal) prisons. Most of those people will return to society, but for how long? According to the most recent data available, a little over two-thirds (67.8%) of those released were arrested for a new crime within 3 years and over three-quarters (76.6%) were arrested for a new crime within 5 years. Education is one of the most effective reducers of recidivism, but it is unclear what kinds of education best prepare people to not only return to society, but to thrive in society. Objectives: The first of a two-part study explored how 27 residents of a minimum security prison responded to an Occupational Therapy Community Living Skills Program (OTCLS) developed to help prepare residents for successful reentry into society. Method: Using a participatory action research (PAR) approach, we interviewed 27 residents who completed the program. Once the semi-structured interviews were transcribed, the PAR team conducted a summative content analysis of the data. Results: Initial content analysis yielded five concepts: doing; information; re-entry fears (socialization); technology; and self-worth. Participants seemed to gain a sense of self-worth by doing activities related to information gathering, socialization, and technology. Further interpretation yielded three overlapping themes: 1) validation of self-worth (participants expressed how self-validating it is to have “real people” come in to help), 2) doing (role playing, a common activity, “…was kind of nerve-wracking at first then [I] began to slowly ease into it…”), and 3) concerns about the future (one resident summed up the value of the program: having “…something real positive you’re looking forward to…helps in dissipating the fears perhaps in reentry.”). Conclusions: This retrospective study identified potentially powerful elements of a successful re-entry program. In the second part of the study we will evaluate a revised program using a pre-test; post-test and follow-up approach to learn more about what kinds of education best prepare people to not only return to society, but to thrive in society

Impairment of early fracture healing by skeletal muscle trauma is restored by FK506

BACKGROUND: Heightened local inflammation due to muscle trauma or disease is associated with impaired bone regeneration. METHODS: We hypothesized that FK506, an FDA approved immunomodulatory compound with neurotrophic and osteogenic effects, will rescue the early phase of fracture healing which is impaired by concomitant muscle trauma in male (~4 months old) Lewis rats. FK506 (1 mg/kg; i.p.) or saline was administered systemically for 14 days after an endogenously healing tibia osteotomy was created and fixed with an intermedullary pin, and the overlying tibialis anterior (TA) muscle was either left uninjured or incurred volumetric muscle loss injury (6 mm full thickness biopsy from middle third of the muscle). RESULTS: The salient observations of this study were that 1) concomitant TA muscle trauma impaired recovery of tibia mechanical properties 28 days post-injury, 2) FK506 administration rescued the recovery of tibia mechanical properties in the presence of concomitant TA muscle trauma but did not augment mechanical recovery of an isolated osteotomy (no muscle trauma), 3) T lymphocytes and macrophage presence within the traumatized musculature were heightened by trauma and attenuated by FK506 3 days post-injury, and 4) T lymphocyte but not macrophage presence within the fracture callus were attenuated by FK506 at 14 days post-injury. FK506 did not improve TA muscle isometric torque production CONCLUSION: Collectively, these findings support the administration of FK506 to ameliorate healing of fractures with severe muscle trauma comorbidity. The results suggest one potential mechanism of action is a reduction in local T lymphocytes within the injured musculoskeletal tissue, though other mechanisms to include direct osteogenic effects of FK506 require further investigation

The α/β hydrolase fold

We have identified a new protein fold-the α/β hydrolase fold-that is common to several hydrolytic enzymes of widely differing phylogenetic origin and catalytic function. The core of each enzyme is similar: an α/β sheet, not barrel, of eight β-sheets connected by α-helices. These enzymes have diverged from a common ancestor so as to preserve the arrangement of the catalytic residues, not the binding site. They all have a catalytic triad, the elements of which are borne on loops which are the best-conserved structural features in the fold. Only the histidine in the nucleophile-histidine-acid catalytic triad is completely conserved, with the nucleophile and acid loops accommodating more than one type of amino acid. The unique topological and sequence arrangement of the triad residues produces a catalytic triad which is, in a sense, a mirror-image of the serine protease catalytic triad. There are now four groups of enzymes which contain catalytic triads and which are related by convergent evolution towards a stable, useful active site: the eukaryotic serine proteases, the cysteine proteases, subtilisins and the α/β hydrolase fold enzymes

Metabolic balance of coastal Antarctic waters revealed by autonomous pCO2 and ΔO2/Ar measurements

Author Posting. © American Geophysical Union, 2014. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Geophysical Research Letters 41 (2014): 6803–6810, doi:10.1002/2014GL061266.We use autonomous gas measurements to examine the metabolic balance (photosynthesis minus respiration) of coastal Antarctic waters during the spring/summer growth season. Our observations capture the development of a massive phytoplankton bloom and reveal striking variability in pCO2 and biological oxygen saturation (ΔO2/Ar) resulting from large shifts in community metabolism on time scales ranging from hours to weeks. Diel oscillations in surface gases are used to derive a high-resolution time series of net community production (NCP) that is consistent with 14C-based primary productivity estimates and with the observed seasonal evolution of phytoplankton biomass. A combination of physical mixing, grazing, and light availability appears to drive variability in coastal Antarctic NCP, leading to strong shifts between net autotrophy and heterotrophy on various time scales. Our approach provides insight into the metabolic responses of polar ocean ecosystems to environmental forcing and could be employed to autonomously detect climate-dependent changes in marine primary productivity.This study was supported by funds from the U.S. National Science Foundation (OPP awards ANT-0823101, ANT-1043559, ANT-1043593, and ANT-1043532) as well as support for PDT and ECA from the National Science and Engineering Research Council of Canada.2015-04-0

Gianturco Z-stent placement for the treatment of chronic central venous occlusive disease: implantation of 208 stents in 137 symptomatic patients

PURPOSETo report the technical successes, adverse events, and long-term stent patency rates of Gianturco Z-stents for management of chronic central venous occlusive disease.METHODSOverall, 137 patients, with mean age 48.6±16.1 years (range, 16-89 years), underwent placement of Gianturco Z-stents for chronic central venous occlusions. Presenting symptoms included lower extremity edema (n=66, 48.2%), superior vena cava syndrome (n=30, 21.9%), unilateral upper extremity swelling (n=20, 14.6%), hemodialysis fistula or catheter dysfunction (n=11, 8.0%), ascites (n=8, 5.8%), and both ascites and lower extremity edema (n=2, 1.5%). Most common etiologies of central venous occlusion were prior central venous access placement (n=58, 42.3%), extrinsic compression (n=29, 21.2%), and post-surgical anastomotic stenosis (n=27, 19.7%). Number of stents placed, stent implantation location, stent sizes, technical successes, adverse events, need for re-intervention, follow-up evaluation, stent patencies, and mortality were recorded. Technical success was defined as recanalization and stent reconstruction with restoration of in-line venous flow. Adverse events were defined by the Society of Interventional Radiology Adverse Event Classification criteria. Primary and primary-assisted stent patencies were analyzed using Kaplan-Meier analysis.RESULTSIn total, 208 Z-stents were placed. The three most common placement sites were the inferior vena cava (n=124, 59.6%), superior vena cava (n=44, 21.2%), and brachiocephalic veins (n=27, 13.0%). Technical success was achieved in 133 patients (97.1%). There were two (1.5%) severe adverse events (two cases of stent migration to the right atrium), one (0.7%) moderate adverse event, and one (0.7%) mild adverse event. Mean follow-up was 43.6±52.7 months. Estimated 1-, 3-, and 5-year primary stent patency was 84.2%, 84.2%, and 82.1%, respectively. Estimated 1-, 3-, and 5-year primary-assisted patency was 92.3%, 89.6%, and 89.6%, respectively. The 30- and 60- day mortality rates were 2.9% (n=4) and 5.1% (n=7), none of which were directly attributable to Z-stent placement.CONCLUSIONGianturco Z-stent placement is safe and effective for the treatment for chronic central venous occlusive disease with durable short- and long-term patencies

Veterans Affairs Health System and Mental Health Treatment Retention among Patients with Serious Mental Illness: Evaluating Accessibility and Availability Barriers

We examine the impact of two dimensions of access—geographic accessibility and availability—on VA health system and mental health treatment retention among patients with serious mental illness (SMI). Methods . Among 156,631 patients in the Veterans Affairs (VA) health care system with schizophrenia or bipolar disorder in fiscal year 1998 (FY98), we used Cox proportional hazards regression to model time to first 12-month gap in health system utilization, and in mental health services utilization, by the end of FY02. Geographic accessibility was operationalized as straight-line distance to nearest VA service site or VA psychiatric service site, respectively. Service availability was assessed using county-level VA hospital beds and non-VA beds per 1,000 county residents. Patients who died without a prior gap in care were censored. Results . There were 32, 943 patients (21 percent) with a 12-month gap in health system utilization; 65,386 (42 percent) had a 12-month gap in mental health services utilization. Gaps in VA health system utilization were more likely if patients were younger, nonwhite, unmarried, homeless, nonservice-connected, if they had bipolar disorder, less medical morbidity, an inpatient stay in FY98, or if they lived farther from care or in a county with fewer VA inpatient beds. Similar relationships were observed for mental health, however being older, female, and having greater morbidity were associated with increased risks of gaps, and number of VA beds was not significant. Conclusions . Geographic accessibility and resource availability measures were associated with long-term continuity of care among patients with SMI. Increased distance from providers was associated with greater risks of 12-month gaps in health system and mental health services utilization. Lower VA inpatient bed availability was associated with increased risks of gaps in health system utilization. Study findings may inform efforts to improve treatment retention.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73433/1/j.1475-6773.2006.00642.x.pd

Rand Patents and Exclusion Orders: Submission of 19 Economics and Law Professors to the International Trade Commission

In this comment to ITC Investigation 337-TA-745 (Certain Wireless Communication Devices, Motorola v. Apple) we, as teachers and scholars of economics, antitrust and intellectual property, remedies, administrative, and international intellectual property law, former Department of Justice lawyers and chief economists, a former executive official at the Patent and Trademark Office, a former counsel at the ITC Office of the General Counsel, and a former Member of the President’s Council of Economic Adviser take the position that ITC exclusion orders generally should not be granted under § 1337(d)(1) on the basis of patents subject to obligations to license on “reasonable and non-discriminatory” (RAND) terms. Doing so would undermine the significant pro-competitive and pro-consumer benefits that RAND promises produce and the investments they enable. A possible exception may arise if district court jurisdiction is lacking, the patent is valid and infringed, and the public interest favors issuing an exclusion order. We explain our position in the comment