Sex Differences in Attention and Attitude Toward Infant and Sexual Images.

Reproduction in mammals includes two general categories of behaviors: mating and parenting. Historically and cross-culturally, men invest more than women in mating; women invest more than men in parenting. Sex differences in attention and attitude toward mating and parenting stimuli have rarely been assessed together despite theoretical interest. To evaluate these differences simultaneously in a naturalistic setting, 582 study participants (459 women, 123 men) were presented with sexual and infant images, online in the privacy of their home, at three time periods spanning several weeks for a more reliable result. Attention was measured by covertly recording viewing time of images using Qualtrics software, and attitude was measured via self-report after each viewing session. Men reported a more positive attitude than women toward the sexual images; women reported a more positive attitude than men toward the infant images. Women viewed the infant images marginally longer than did men, and the infant-to-sexual viewing ratio was larger for women. The sexual-to-infant viewing ratio was larger for men than for women. Unexpectedly, both genders viewed the sexual images longer than the infant images, with no significant gender difference in the sexual image viewing time. The results suggest that women and men may give equal attention to visual sexual stimuli despite self-reported sex differences in interest. The possibly underestimated valence of visual sexual stimuli for women is discussed.

Digitalizing and Upgrading Severe Acute Respiratory Infections Surveillance in Malta: System Development.

BACKGROUND: In late 2020, the European Centre for Disease Prevention and Control and Epiconcept started implementing a surveillance system for severe acute respiratory infections (SARI) across Europe. OBJECTIVE: We sought to describe the process of digitizing and upgrading SARI surveillance in Malta, an island country with a centralized health system, during the COVID-19 pandemic from February to November 2021. We described the characteristics of people included in the surveillance system and compared different SARI case definitions, including their advantages and disadvantages. This study also discusses the process, output, and future for SARI and other public health surveillance opportunities. METHODS: Malta has one main public hospital where, on admission, patient data are entered into electronic records as free text. Symptoms and comorbidities are manually extracted from these records, whereas other data are collected from registers. Collected data are formatted to produce weekly and monthly reports to inform public health actions. From October 2020 to February 2021, we established an analogue incidence-based system for SARI surveillance. From February 2021 onward, we mapped key stakeholders and digitized most surveillance processes. RESULTS: By November 30, 2021, 903 SARI cases were reported, with 380 (42.1%) positive for SARS-CoV-2. Of all SARI hospitalizations, 69 (7.6%) were admitted to the intensive care unit, 769 (85.2%) were discharged, 27 (3%) are still being treated, and 107 (11.8%) died. Among the 107 patients who died, 96 (89.7%) had more than one underlying condition, the most common of which were hypertension (n=57, 53.3%) and chronic heart disease (n=49, 45.8%). CONCLUSIONS: The implementation of enhanced SARI surveillance in Malta was completed by the end of May 2021, allowing the monitoring of SARI incidence and patient characteristics. A future shift to register-based surveillance should improve SARI detection through automated processes.

The Effect of Supplemental Imaging on Interval Cancer Rates in Mammography Screening: Systematic Review.

Supplemental screening with MRI or ultrasound increases cancer detection rate (CDR) in women with standard screening mammography. Whether it also reduces interval cancer rate (ICR) is unclear. This study reviewed the evidence evaluating the effect of supplemental imaging on ICR in women undergoing screening mammography. This systematic review included studies that reported both CDR and ICR in women undergoing screening mammography alone compared to those undergoing screening mammography with supplemental imaging. Five studies (3 randomized trials) were eligible. These reported on 142,153 women undergoing mammography screening alone or mammography with supplemental imaging (3 ultrasound and 2 MRI studies). Two studies included a general screening population and 3 included special populations (young, high genetic risk and/or dense breasts). The incremental CDR for supplemental MRI was 14.2 to 16.5/1000 screens and for ultrasound was 0 to 4.4/1000 screens. Effect on ICR was variable but evidence of a reduced ICR was more consistent for studies using supplemental MRI (ICR 0.3 to 0.8 per 1000 screens) than those using ultrasound (ICR 0.49 to 1.9 per 1000 screens). The higher CDR and lower ICR with supplemental screening were associated with higher recall and biopsy rates particularly with supplemental MRI (9.5%-15.9%, up to 69/1000 screens). Cancers detected with supplemental imaging modalities were generally smaller and earlier stage. Mammography with supplemental MRI or ultrasound increases detection of cancers (versus mammography only) in some sub-groups but also increases recall and biopsy rates and may have a relatively modest effect in reducing ICR.

Barriers-enablers-ownership approach: a mixed methods analysis of a social intervention to improve surgical antibiotic prescribing in hospitals.

OBJECTIVES: To assess an intervention for surgical antibiotic prophylaxis (SAP) improvement within surgical teams focused on addressing barriers and fostering enablers and ownership of guideline compliance. DESIGN: The Queensland Surgical Antibiotic Prophylaxis (QSAP) study was a multicentre, mixed methods study designed to address barriers and enablers to SAP compliance and facilitate engagement in self-directed audit/feedback and assess the efficacy of the intervention in improving compliance with SAP guidelines. The implementation was assessed using a 24-month interrupted time series design coupled with a qualitative evaluation. SETTING: The study was undertaken at three hospitals (one regional, two metropolitan) in Australia. PARTICIPANTS: SAP-prescribing decisions for 1757 patients undergoing general surgical procedures from three health services were included. Six bimonthly time points, pre-implementation and post implementation of the intervention, were measured. Qualitative interviews were performed with 29 clinical team members. SAP improvements varied across site and time periods. INTERVENTION: QSAP embedded ownership of quality improvement in SAP within surgical teams and used known social influences to address barriers to and enablers of optimal SAP prescribing. RESULTS: The site that reported senior surgeon engagement showed steady and consistent improvement in prescribing over 24 months (prestudy and poststudy). Multiple factors, including resource issues, influenced engagement and sites/time points where these were present had no improvement in guideline compliance. CONCLUSIONS: The barriers-enablers-ownership model shows promise in its ability to facilitate prescribing improvements and could be expanded into other areas of antimicrobial stewardship. Senior ownership was a predictor of success (or failure) of the intervention across sites and time periods. The key role of senior leaders in change leadership indicates the critical need to engage other specialties in the stewardship agenda. The influence of contextual factors in limiting engagement clearly identifies issues of resource distributions/inequalities within health systems as limiting antimicrobial optimisation potential.

Measuring institutional community engagement: Adding value to academic health systems.

Beyond medical schools' historical focus on pillar missions including clinical care, education, and research, several medical schools now include community engagement (CE) as a mission. However, most academic health systems (AHSs) lack the tools to provide metrics, evaluation, and standardization for quantifying progress and contributions of the CE mission. Several nationwide initiatives, such as that driven by the Institute of Medicine recommending advances in CE metrics at institutions receiving Clinical and Translational Science Awards, have encouraged the research and development of systematic metrics for CE, but more progress is needed. The CE components practical model provides a foundation for analyzing and evaluating different types of CE activities at AHSs through five components: research, education, community outreach and community service, policy and advocacy, and clinical care. At the Medical College of Wisconsin (MCW), an annual survey administered to faculty and staff assessed the types and number of CE activities from the prior year. Survey results were combined to create a CE report for departments across the institution and inform MCW leadership. Insights gathered from the survey have contributed to next steps in CE tracking and evaluation, including the development of a CE dashboard to track CE activities in real time. The dashboard provides resources for how individuals can advance the CE mission through their work and guide CE at the institutional level.

Ingestion of Steamed and Dehydrated Placenta Capsules Does Not Affect Postpartum Plasma Prolactin Levels or Neonatal Weight Gain: Results from a Randomized, Double-Bind, Placebo-Controlled Pilot Study.

INTRODUCTION: Clinical studies conducted in the early to mid-twentieth century, and recent self-reports by some maternal placentophagy practitioners, suggest that human maternal placentophagy improves breast milk quality and quantity, although little research has evaluated this claim. Some placentophagy providers and advocates suggest that increased prolactin levels after placenta ingestion could account for the purported lactation benefits. The current study was conducted to evaluate these claims by comparing plasma prolactin levels of women consuming steamed, dehydrated, and encapsulated placenta with those of women consuming a placebo. Neonatal weight gain was also compared between the 2 groups. METHODS: A randomized, double-blind, placebo-controlled pilot trial was conducted in which postpartum women (N = 27) were given a supplement containing their dehydrated placenta (n = 12) or placebo (n = 15). Plasma prolactin concentrations were measured 4 times across late pregnancy and early postpartum, and neonatal weights were recorded 3 times over the first 3 weeks postpartum. RESULTS: The results showed no statistically significant (P < .05) differences in either plasma prolactin levels or neonatal weight gain between groups. DISCUSSION: Maternal consumption of steamed, dehydrated, and encapsulated placenta postpartum does not appear to affect maternal postpartum prolactin or neonatal weight in the first 3 weeks postpartum. Further research is needed to investigate the possible effects of variation in placenta preparation methods or daily intake on human lactation.

Community Engagement in Academic Health Centers: A Model for Capturing and Advancing Our Successes.

Community engagement (CE) has come to the forefront of academic health centers' (AHCs) work because of two recent trends: the shift from a more traditional 'treatment of disease' model of health care to a population health paradigm (Gourevitch, 2014), and increased calls from funding agencies to include CE in research activities (Bartlett, Barnes, & McIver, 2014). As defined by the Centers for Disease Control and Prevention, community engagement is "the process of working collaboratively with and through groups of people affiliated by geographic proximity, special interest, or similar situations to address issues affecting the well-being of those people" (Centers for Disease Control and Prevention (CDC), 1997, p. 9). AHCs are increasingly called on to communicate details of their CE efforts to key stakeholders and to demonstrate their effectiveness. The population health paradigm values preventive care and widens the traditional purview of medicine to include social determinants of patients' health (Gourevitch, 2014). Thus, it has become increasingly important to join with communities in population health improvement efforts that address behavioral, social, and environmental determinants of health (Michener, et al., 2012; Aguilar-Gaxiola, et al., 2014; Blumenthal & Mayer, 1996). This CE can occur within multiple contexts in AHCs (Ahmed & Palermo, 2010; Kastor, 2011) including in education, clinical activities, research, health policy, and community service.

De novo formation of an aggregation pheromone precursor by an isoprenyl diphosphate synthase-related terpene synthase in the harlequin bug.

Insects use a diverse array of specialized terpene metabolites as pheromones in intraspecific interactions. In contrast to plants and microbes, which employ enzymes called terpene synthases (TPSs) to synthesize terpene metabolites, limited information from few species is available about the enzymatic mechanisms underlying terpene pheromone biosynthesis in insects. Several stink bugs (Hemiptera: Pentatomidae), among them severe agricultural pests, release 15-carbon sesquiterpenes with a bisabolene skeleton as sex or aggregation pheromones. The harlequin bug, Murgantia histrionica, a specialist pest of crucifers, uses two stereoisomers of 10,11-epoxy-1-bisabolen-3-ol as a male-released aggregation pheromone called murgantiol. We show that MhTPS (MhIDS-1), an enzyme unrelated to plant and microbial TPSs but with similarity to trans-isoprenyl diphosphate synthases (IDS) of the core terpene biosynthetic pathway, catalyzes the formation of (1S,6S,7R)-1,10-bisaboladien-1-ol (sesquipiperitol) as a terpene intermediate in murgantiol biosynthesis. Sesquipiperitol, a so-far-unknown compound in animals, also occurs in plants, indicating convergent evolution in the biosynthesis of this sesquiterpene. RNAi-mediated knockdown of MhTPS mRNA confirmed the role of MhTPS in murgantiol biosynthesis. MhTPS expression is highly specific to tissues lining the cuticle of the abdominal sternites of mature males. Phylogenetic analysis suggests that MhTPS is derived from a trans-IDS progenitor and diverged from bona fide trans-IDS proteins including MhIDS-2, which functions as an (E,E)-farnesyl diphosphate (FPP) synthase. Structure-guided mutagenesis revealed several residues critical to MhTPS and MhFPPS activity. The emergence of an IDS-like protein with TPS activity in M. histrionica demonstrates that de novo terpene biosynthesis evolved in the Hemiptera in an adaptation for intraspecific communication.

Placentophagy's effects on mood, bonding, and fatigue: A pilot trial, part 2.

BACKGROUND: Human maternal placentophagy is gaining popularity among a growing number of women who believe it provides maternal benefits, including prevention of postpartum blues/depression, improved maternal bonding, and reduced fatigue. METHODS: We conducted a randomized, double-blind, placebo-controlled pilot study (N=27) in which participants consumed either their processed, encapsulated placenta (n=12), or similarly prepared placebo (n=15). Maternal mood, bonding, and fatigue were assessed via validated scales across four time points during late pregnancy and early postpartum. Psychometric data were analyzed for changes between and within both groups over time. RESULTS: No significant main effects related to maternal mood, bonding, or fatigue were evident between placenta and placebo group participants. However, examination of individual time points suggested that some measures had specific time-related differences between placenta and placebo groups that may warrant future exploration. Though statistical significance should not be interpreted in these cases, we did find some evidence of a decrease in depressive symptoms within the placenta group but not the placebo group, and reduced fatigue in placenta group participants at the end of the study compared to the placebo group. CONCLUSIONS: No robust differences in postpartum maternal mood, bonding, or fatigue were detected between the placenta and placebo groups. This finding may be especially important for women considering maternal placentophagy as a 'natural' (i.e., non-pharmacological) means of preventing or treating blues/depression. Given the study limitations, these findings should be interpreted as preliminary. Small, time-related improvements in maternal mood and lower fatigue post-supplementation among placenta group participants may warrant further research.

Effects of placentophagy on maternal salivary hormones: A pilot trial, part 1.

BACKGROUND: Recent studies show that human placenta, processed and encapsulated for postpartum consumption, contains a host of trace minerals and hormones that could conceivably affect maternal physiology. Our objective was to investigate whether salivary hormone concentrations of women ingesting their own encapsulated placenta during the early postpartum differed from those of women consuming a placebo. METHODS: Randomly assigned participants (N=27) were given a supplement containing either their dehydrated and homogenized placenta (n=12), or placebo (n=15). Saliva samples were collected during late pregnancy and early postpartum. Samples of participants' processed placenta, and the encapsulated placebo, were also collected. Hormone analyses were conducted on all samples utilizing liquid chromatography-tandem mass spectrometry. RESULTS: There were no significant differences in salivary hormone concentrations between the placenta and placebo groups post-supplementation that did not exist pre-supplementation. There were, however, significant dose-response relationships between the concentration of all 15 detected hormones in the placenta capsules and corresponding salivary hormone measures in placenta group participants not seen in the placebo group. The higher salivary concentrations of these hormones in the placenta group reflects the higher concentrations of these hormones in the placenta supplements, compared to the placebo. CONCLUSIONS: Some hormones in encapsulated placenta lead to small but significant differences in hormonal profiles of women taking placenta capsules compared to those taking a placebo, although these dose-response changes were not sufficient to result in significant hormonal differences between groups. Whether modest hormonal changes due to placenta supplementation are associated with therapeutic postpartum effects, however, awaits further investigation.

Effects of Human Maternal Placentophagy on Maternal Postpartum Iron Status: A Randomized, Double-Blind, Placebo-Controlled Pilot Study.

INTRODUCTION: Advocates of human maternal placentophagy report that encapsulated placenta is an excellent source of dietary iron. Our study compared the effect of ingested encapsulated placenta on maternal postpartum iron status versus that of a beef placebo. METHODS: A randomized, double-blind, placebo-controlled pilot study (N = 23) was conducted among healthy human research participants experiencing a normal pregnancy. Maternal iron status was measured via hemoglobin, transferrin, and ferritin taken from blood samples drawn in the participants' homes at 4 time points: the 36th week of pregnancy, within 96 hours of parturition, between days 5 and 7 postpartum, and during week 3 postpartum. Iron concentrations in the encapsulated placenta and encapsulated beef placebo were compared using inductively coupled plasma mass spectrometry. RESULTS: Seventy-eight percent (18/23) of study participants' hemoglobin concentrations were above the World Health Organization cutoff for gestational iron deficiency (≥ 11.0 g/dL) during the 36th week of pregnancy. Results revealed no statistically significant differences (hemoglobin, P = .603; ferritin, P = .852; transferrin, P = .936) in maternal iron status (including postpartum iron rebound in the first week postpartum) between women in the placenta supplement (n = 10) and placebo (n = 13) groups. Average iron concentrations were considerably higher in encapsulated placenta (0.664 mg/g) compared to the encapsulated beef placebo (0.093 mg/g) but provided only 24% of the recommended daily allowance (RDA) for iron among lactating women based on the study's maximum daily intake. DISCUSSION: The current study suggests that encapsulated placenta supplementation neither significantly improves nor impairs postpartum maternal iron status for women consuming the RDA of dietary iron during pregnancy and lactation, compared to a beef placebo. This may be an especially important finding for women who are iron deficient postpartum and whose only source of supplemental dietary iron is encapsulated placenta, as this may provide an inadequate source of supplemental iron in cases of deficiency.

Towards a practical model for community engagement: Advancing the art and science in academic health centers.

INTRODUCTION: Community engagement (CE) has become more prevalent among academic health centers (AHCs), with significant diversity in practices and language. The array of approaches to CE contributes to confusion among practitioners. METHODS: We have reviewed multiple models of CE utilized by AHCs, Clinical and Translational Science Awards, and higher education institutions overall. Taking these models into consideration, we propose a comprehensive model of CE that encompasses a broader spectrum of activities and programs. RESULTS: The CE Components Practical Model includes 5 components: Community Outreach and Service, Education, Clinical Care, Research, and Policy and Advocacy. The components are supported by the foundational elements within administrative functions and infrastructure. CONCLUSIONS: This model will accomplish the following: (1) reduce confusion about CE; (2) provide a broader understanding of CE; and (3) increase the ability of CE practitioners to interact with each other through this common reference and engage in advancing CE scholarship.

Human placenta processed for encapsulation contains modest concentrations of 14 trace minerals and elements.

Maternal placentophagy has recently emerged as a rare but increasingly popular practice among women in industrialized countries who often ingest the placenta as a processed, encapsulated supplement, seeking its many purported postpartum health benefits. Little scientific research, however, has evaluated these claims, and concentrations of trace micronutrients/elements in encapsulated placenta have never been examined. Because the placenta retains beneficial micronutrients and potentially harmful toxic elements at parturition, we hypothesized that dehydrated placenta would contain detectable concentrations of these elements. To address this hypothesis, we analyzed 28 placenta samples processed for encapsulation to evaluate the concentration of 14 trace minerals/elements using inductively coupled plasma mass spectrometry. Analysis revealed detectable concentrations of arsenic, cadmium, cobalt, copper, iron, lead, manganese, mercury, molybdenum, rubidium, selenium, strontium, uranium, and zinc. Based on one recommended daily intake of placenta capsules (3300 mg/d), a daily dose of placenta supplements contains approximately 0.018 ± 0.004 mg copper, 2.19 ± 0.533 mg iron, 0.005 ± 0.000 mg selenium, and 0.180 ± 0.018 mg zinc. Based on the recommended dietary allowance (RDA) for lactating women, the recommended daily intake of placenta capsules would provide, on average, 24% RDA for iron, 7.1% RDA for selenium, 1.5% RDA for zinc, and 1.4% RDA for copper. The mean concentrations of potentially harmful elements (arsenic, cadmium, lead, mercury, uranium) were well below established toxicity thresholds. These results indicate that the recommended daily intake of encapsulated placenta may provide only a modest source of some trace micronutrients and a minimal source of toxic elements.

Presence and concentration of 17 hormones in human placenta processed for encapsulation and consumption.

Human maternal placentophagy is a rare but growing practice in several industrialized countries among postpartum mothers seeking a variety of purported health benefits attributed to the practice. These postpartum mothers typically consume their placenta as a processed, encapsulated supplement. To determine whether free (unconjugated) steroid hormones and melatonin in placenta can survive the encapsulation process (namely steaming and dehydration), we analyzed 28 placenta samples processed for encapsulation using liquid chromatography tandem-mass spectrometry (LC-MS/MS) to evaluate the concentration of 17 hormones. The results revealed detectable concentrations for 16 of the hormones analyzed, some in concentrations that could conceivably yield physiological effects.

Health effects following subacute exposure to geogenic dusts from arsenic-rich sediment at the Nellis Dunes Recreation Area, Las Vegas, NV.

Geogenic dust from arid environments is a possible inhalation hazard for humans, especially when using off-road vehicles that generate significant dust. This study focused on immunotoxicological and neurotoxicological effects following subacute exposure to geogenic dust generated from sediments in the Nellis Dunes Recreation Area near Las Vegas, Nevada that are particularly high in arsenic; the naturally-occurring arsenic concentrations in these surficial sediments ranged from 4.8 to 346µg/g. Dust samples from sediments used in this study had a median diameter of 4.5µm and also were a complex mixture of naturally-occurring metals, including aluminum, vanadium, chromium, manganese, iron, cobalt, copper, zinc, strontium, cesium, lead, uranium, and arsenic. Adult female B6C3F1 mice exposed via oropharyngeal aspiration to 0.01 to 100mg dust/kg body weight, four times, a week apart, for 28days, were evaluated 24h after the last exposure. Peripheral eosinophils were increased at all concentrations, serum creatinine was dose responsively increased beginning at 1.0mg/kg/day, and blood urea nitrogen was decreased at 10 and 100mg/kg/day. Antigen-specific IgM responses and natural killer cell activity were dose-responsively suppressed at 0.1mg/kg/day and above. Splenic CD4+CD25+ T cells were decreased at 0.01, 0.1, 10, and 100mg/kg/day. Antibodies against MBP, NF-68, and GFAP were selectively reduced. A no observed adverse effect level of 0.01mg/kg/day and a lowest observed adverse effect level of 0.1mg/kg/day were determined from IgM responses and natural killer cell activity, indicating that exposure to this dust, under conditions similar to our design, could affect these responses.

Opening the Black Box: Conceptualizing Community Engagement From 109 Community-Academic Partnership Programs.

BACKGROUND: This research effort includes a large scale study of 109 community-academic partnership projects funded by the Healthier Wisconsin Partnership Program (HWPP), a component of the Advancing a Healthier Wisconsin endowment at the Medical College of Wisconsin (MCW) in Milwaukee, Wisconsin. The study provides an analysis unlike other studies, which have been smaller, and/or more narrowly focused in the type of community-academic partnership projects analyzed. OBJECTIVES: To extract themes and insights for the benefit of future community-academic partnerships and the field of community-engaged research (CEnR). METHODS: Content analysis of the final reports submitted by 109 community-academic partnership projects awards within the time frame of March 2005 to August 2011. RESULTS: Thirteen themes emerged from the report analysis: community involvement, health accomplishments, capacity building, sustainability, collaboration, communication, best practices, administration, relationship building, clarity, adjustment of plan, strategic planning, and time. Data supported previous studies in the importance of some themes, and provided insights regarding how these themes are impactful. CONCLUSION: The case analysis revealed new insights into the characteristics of these themes, which the authors then grouped into three categories: foundational attributes of successful community-academic partnership, potential challenges of community-academic partnerships, and outcomes of community-academic partnerships. The insights gained from these reports further supports previous research extolling the benefits of community-academic partnerships and provides valuable direction for future partners, funders and evaluators in how to deal with challenges and what they can anticipate and plan for in developing and managing community-academic partnership projects.

Rates and correlations of change in three dimensions of recovery within a recovery model oriented therapeutic community.

This is a 10 year longitudinal study of recovery progress within a residential program based upon therapeutic community principles and a Seven Domains Enhanced Recovery Model (Young and Ensing, 1999). A broad suite of measures associated with one of three definitions of recovery (symptom, function, and personal focused recovery) were administered along three longitudinal courses. Normalized mean rates of change and mean shared variances for these scales were examined for three subgroups based on length of stay. Measures associated with the same definition of recovery correlated moderately to strongly but measures did not correlate between facets, suggesting relative independence between definition facets. The results of this analysis suggest the existence of qualitatively distinct subgroups with different change dynamics. The aggregate means of these facets showed correlated change, while individual recovery pathways did not, suggesting significant heterogeneity in individual pathways of recovery. These findings support the conceptualization of recovery as a complex, heterogeneous and multi-faceted process. Practically, these findings emphasize the need for holistic, flexible and individualized recovery supports and that research into these constructs should include at least these facets over a longitudinal time frame.

Disposable Diaper Absorbency: Improvements via Advanced Designs.

Absorbency effectiveness in diapers has improved significantly in recent years with the advent of new ingredient combinations and advanced design features. With these features, many leading products maintain their dryness performance overnight. Considering the importance of holding liquid away from the skin, ongoing research in diaper construction focuses on strategies to increase the effectiveness to capture liquid and help avoid rewetting of infant skin. The layout and design of a disposable diaper allows for distribution of absorbency features where they can provide the optimal benefit. Clinical evidence indicates materials can keep moisture away from the skin in the diapered area, helping maintain proper skin hydration, minimizing irritation, and contributing to reduced rates of diaper rash.

Increasing military social work knowledge: an evaluation of learning outcomes.

Service members and veterans face a myriad of health, mental health, and social challenges stemming from the combat and operational stressors experienced during deployment and the challenges ofreintegration to civilian life. To intervene effectively with this population, social workers must be knowledgeable about these issues and the cultural context within which they occur. Although schools of social work across the country are developing course work in military social work, little is known about the learning outcomes of these courses. This article describes a military social work course that was developed to increase student preparedness to work with a military or veteran population and the learning outcomes achieved. Using a quasi-experimental pre-post design, this study compared the learning outcomes of students enrolled in the course with a group of students who had not taken the course. To measure this knowledge, the authors developed a 50-item Military Social Work Knowledge Scale for the study. Significant differences between pre- and posttest scores were found for the social work students enrolled in the course. Specific areas of knowledge that increased for the class participants included knowledge about cultural sensitivity to military populations and knowledge about service and advocacy frameworks.

Early report on the effectiveness of a recovery model oriented therapeutic community for individuals with complex and persistent recovery challenges.

This study summarizes the results of a 10 year longitudinal study of individual recovery progress within a residential program based upon therapeutic community principles and a Seven Domains Enhanced Recovery Model that emerged from a grounded theory analysis of real life recovery experiences (Young and Ensing, Psychiatr Rehab J 22:219-231, 1999). The four primary hypotheses of the study predicted significant and moderately sized effect sizes on a holistic set of measures, corresponding to the Enhanced Recovery Model. Results indicate support for all hypotheses; statistically significant and moderate to large effects were found in all domain measures for the participants, most of whom had multiple unsuccessful previous treatment attempts. These results indicate that this theoretical structure and residential model is effective in supporting recovery for individuals with complex and persistent challenges across the broad range of recovery domains. Conceptually, this also adds quantitative support for the Seven Domains Enhanced Recovery Model, complementing previous qualitative studies.