1, 2, 3, Stop the Bleed: Analysis of a Bleeding Control Educational Course

Hemorrhaging, or uncontrolled bleeding, accounts for 40% of preventable deaths in the United States that occur after a traumatic injury. The Stop the Bleed campaign was launched in 2015 by the White House National Security Council to educate the public about methods to control and stop bleeding as well as empower individuals to take action if a traumatic accident occurs. The goal of this study was to evaluate the effectiveness of the “Stop the Bleed” bleeding control course to increase knowledge about the topic as well as increase confidence to take action and use the techniques that were taught during the course appropriately. Data was collected via a cross sectional pre-post survey design. At baseline, the participants were asked basic knowledge questions about bleeding control and techniques to use as well as how confident they felt using those skills. After being presented the bleeding control material and practicing the techniques in the hands-on portion of the course, the participants were asked to complete a post-test with similar questions to that of the pre-test. De-identified responses were collected to analyze the changes in the overall knowledge scores and overall confidence scores with the use of the paired-t statistical test on SPSS. The participants (N=32) were employees within the Thomas Jefferson University Campus Security department. The overall score for the knowledge-based questions were analyzed from pre to post and showed that the changes were statistically significant (8.163,

Composition, seasonal occurrences and habitat use of bird assemblages in wet forests on the Central Plateau ofTasmania

Bird communities in montane wet forest at three sites (altitudes 700,750 and 880 m) on the Central Plateau of Tasmania were surveyed over a 12-month period between December 1991 and November 1992. Monthly transect counts were carried out at each site. Snowfalls are common at all three sites during winter and snow can remain at the highest site for several weeks. Bird communities at the study sites showed significant differences in densities and seasonal patterns even though species composition was similar. These differences were influenced by the variation in habitats and the environments at the sites. Butlers Road, the lowest site with the mildest winters and greatest proportion of drier habitat, had the highest bird densities, while D'Arcys Bluff, at the highest altitude, had the lowest. The degree of seasonal changes of birds was similar to mainland montane wet forests, with over half the species moving either locally or to the mainland. However, there was variation in seasonal occurrences between the study sites, with proportionally more species moving from the highest site during the winter, Within the study sites, the wet forest habitats with a diverse shrub and/or fern understorey supported higher bird populations than did mixed forest and damp forest. Species richness is lower at these sites compared with equivalent montane forests on mainland southeastern Australia

Hepatic steatosis and fibrosis: Non-invasive assessment

Chronic liver disease is a major cause of morbidity and mortality worldwide and usually develops over many years, as a result of chronic inflammation and scarring, resulting in end-stage liver disease and its complications. The progression of disease is characterised by ongoing inflammation and consequent fibrosis, although hepatic steatosis is increasingly being recognised as an important pathological feature of disease, rather than being simply an innocent bystander. However, the current gold standard method of quantifying and staging liver disease, histological analysis by liver biopsy, has several limitations and can have associated morbidity and even mortality. Therefore, there is a clear need for safe and noninvasive assessment modalities to determine hepatic steatosis, inflammation and fibrosis. This review covers key mechanisms and the importance of fibrosis and steatosis in the progression of liver disease. We address non-invasive imaging and blood biomarker assessments that can be used as an alternative to information gained on liver biopsy

Effect of Relaxation on Neuro-Immune Responses of Persons Undergoing Chemotherapy

Chemotherapy can be considered both a physiologic and a psychological stressor. Anxiety, nausea, emesis, and immunosuppression are commonly associated with chemotherapy, and may adversely affect the outcome or the process of treatment. Chemotherapy-related anxiety can exacerbate negative side-effects. Some psychological stressors, such as anxiety, can result in down-regulation of certain immune functions. Studies have demonstrated that behavioral interventions, such as specific relaxation strategies, can modify stress-related immune modulation. These behavioral interventions have also been shown to decrease the degree of nausea and vomiting associated with chemotherapy. The purpose of this study was to examine whether a relaxation intervention would result in decreased anxiety, decreased nausea and vomiting, and decreased immune modulation in persons undergoing chemotherapy for breast cancer. A baseline neuro-immune assessment, including immune function tests, state and trait anxiety, and serum catecholamines, was performed on 12 women diagnosed with breast cancer and slated to undergo four cycles of Adriamycin/Cytoxan (AC) chemotherapy. Subjects were assigned to an experimental or a control group. The control group underwent chemotherapy according to the prescribed AC regimen. The experimental group underwent the same chemotherapy and a relaxation intervention. The neuro-immune assessment was repeated just before subjects received the third and fourth chemotherapy infusions, with the addition of assessment of nausea and emesis. Study findings revealed that state anxiety was significantly lower at measure two for the experimental group (t = 3.20, p = 0.02). No significant difference in anticipatory nausea and vomiting was found between groups. Evaluation of immune function tests was inconclusive. These findings suggest that a relaxation intervention may lower anxiety in individuals who are undergoing chemotherapy. Future research efforts should continue to explore whether relaxation interventions can modify the degree of side effects associated with chemotherapy, and potentially improve the quality of life for persons requiring the treatment