An Initial miRNA Profile of Persons With Persisting Neurobehavioral Impairments and States of Disordered Consciousness After Severe Traumatic Brain Injury.

Objective: To examine the merits of using microRNAs (miRNAs) as biomarkers of disorders of consciousness (DoC) due to traumatic brain injury (TBI).

Settings: Acute and subacute beds.

Participants: Patients remaining in vegetative and minimally conscious states (VS, MCS), an average of 1.

Impact of a Mindfulness-Based Stress Reduction Program on Psychological Well-Being, Cortisol, and Inflammation in Women Veterans.

Background: Women veterans experience higher levels of stress-related symptoms than their civilian counterparts. Psychological stress is associated with greater inflammation and may increase risk for cardiovascular disease (CVD). Mindfulness-based stress reduction (MBSR) has been found to improve psychological well-being in other populations but no randomized controlled trials (RCT) have been conducted examining the impact of MBSR on well-being and inflammation in women veterans at risk for CVD.

Nursing Implications of Mindfulness-Informed Interventions for Stroke Survivors and Their Families.

The consequences of stroke can be devastating and include psychological distress, such as anxiety and depression, functional deficits, pain, and cognitive impairment. Symptoms are complex and impact not only the stroke survivor but may also be challenging for family caregivers. Studies have consistently demonstrated that mindfulness-informed interventions (MBI), such as mindfulness-based stress reduction and acceptance and self-compassion therapies, improve symptoms in a wide variety of clinical populations.

Preliminary evidence for a race-based stress reduction intervention for Black women at risk for cardiovascular disease.

Objective: Despite evidence that chronic stress, racism, and discrimination impact the well-being and the risk for cardiovascular disease (CVD) in Black women, there are few evidence-based interventions that improve well-being and reduce the risk for CVD in women of minority groups. The purpose of this pilot study was to evaluate the psychobehavioral and anti-inflammatory benefit of a race-based stress reduction program "Resilience, Stress, and Ethnicity (RiSE) for Black women at risk for CVD.

Methods: Black women were recruited from the Chicagoland community and randomized to either the 8-week RiSE intervention (n = 40) or control group (n = 34).

Nurse practitioners as antibiotic stewards: Examining prescribing patterns and perceptions.

Background: Advanced practice providers in the outpatient setting play a key role in antibiotic stewardship, yet little is known about how to engage these providers in stewardship activities and what factors influence their antibiotic prescribing practices.

Methods: We used mixed methods to obtain data on practices and perceptions related to antibiotic prescribing by nurse practitioners (NP) and Veteran patients. We interviewed NPs working in the outpatient setting at one Veterans Affairs facility and conducted focus groups with Veterans.

miRNAs as Potential Biomarkers for Traumatic Brain Injury: Pathway From Diagnosis to Neurorehabilitation.

Background: Biomarkers that can advance precision neurorehabilitation of the traumatic brain injury (TBI) are needed. MicroRNAs (miRNAs) have biological properties that could make them well suited for playing key roles in differential diagnoses and prognoses and informing likelihood of responsiveness to specific treatments.

Objective: To review the evidence of miRNA alterations after TBI and evaluate the state of science relative to potential neurorehabilitation applications of TBI-specific miRNAs.

Developing an animal-assisted support program for healthcare employees.

Background: Employee burnout and its associated consequences is a significant problem in the healthcare workforce. Workplace animal therapy programs offer a potential strategy for improving employee well-being; however, research on animal therapy programs for healthcare workers is lacking. This study aimed to evaluate the feasibility, acceptability and preliminary impact of an animal-assisted support program to improve healthcare employee well-being.

Qualitative evidence for Resilience, Stress, and Ethnicity (RiSE): A program to address race-based stress among Black women at risk for cardiovascular disease.

Objective: Growing evidence demonstrates that perceived discrimination and racism are significant contributing factors to psychological distress, low-grade chronic inflammation, and cardiovascular health disparities among minorities, particularly among Black women. Despite this evidence, there are no evidence-based complementary therapy interventions available to ameliorate chronic stress associated with racism and discrimination. The purpose of this study was to examine the feasibility and effectiveness of a novel, 8-week, group-based stress reduction program, Resilience, Stress and Ethnicity (RiSE), designed to help Black women at risk for cardiovascular disease (CVD) develop effective coping skills for dealing with chronic stress uniquely associated with being a minority.

Resilience in African American Women at Risk for Cardiovascular Disease: an Exploratory Study.

African Americans (AAs) have a higher risk for cardiovascular disease (CVD) which is not fully explained by traditional CVD risk factors such as smoking, obesity, hypertension, and diabetes. Evidence demonstrates that chronic stress, low subjective status, and lack of social support play important roles in increasing the risk for CVD, particularly in minority women. Increasing evidence demonstrates that resilience may ameliorate the effect of social stressors on the development of CVD.

"Maybe black girls do yoga": A focus group study with predominantly low-income African-American women.

Objective: To explore African American (AA) women's use of mind-body therapies, such as yoga and mindfulness, and factors that impact their experiences, observations and opinions.

Design: Focus groups were conducted to better understand how AA women perceive mind-body therapies and how to best bring these interventions into their community. Interviews were audiotaped and transcribed.

Perceived discrimination is associated with the inflammatory response to acute laboratory stress in women at risk for cardiovascular disease.

Cardiovascular disease (CVD) is the leading cause of death in the United States and exacts a disproportionate toll on minorities. Growing evidence demonstrates that perceived discrimination is a significant contributing factor to psychological distress, chronic low-grade inflammation, and cardiovascular health. However, little is known regarding the extent to which perceived discrimination contributes to the inflammatory response to acute stress.

Barriers and strategies for coordinating care among veterans with traumatic brain injury: a mixed methods study of VA polytrauma care team members.

Background: Veterans who experience traumatic brain injury (TBI) may have long-term needs placing a premium on well-coordinated care. This study aimed to (1) identify barriers to care coordination for Veterans with TBI; and (2) describe strategies used by VA polytrauma care team members to coordinate care for Veterans with TBI.

Methods: We utilised a mixed method design, including an online survey of VA polytrauma care team members (N = 236) and subsequent semi-structured interviews (N = 25).

Empowered to Serve: Implementing Community Stroke Outreach Using Peer Educators to Improve Readiness to Act Among Local Community Members.

The purpose of this project was to develop a community-based volunteer group of peer educators to provide stroke education to local residents aimed at increasing stroke awareness and action readiness using the American Heart Association and American Stroke Association's "Empowered to Serve" evidence-based curriculum. The "Don't Miss a Stroke" module addresses the recognition of stroke warning signs, actions to take during a stroke, and stroke prevention. A total of 16 volunteers were recruited and subsequently trained.

Meditation and Cardiovascular Risk Reduction: A Scientific Statement From the American Heart Association.

Despite numerous advances in the prevention and treatment of atherosclerosis, cardiovascular disease remains a leading cause of morbidity and mortality. Novel and inexpensive interventions that can contribute to the primary and secondary prevention of cardiovascular disease are of interest. Numerous studies have reported on the benefits of meditation.

Poststroke Fatigue: Emerging Evidence and Approaches to Management: A Scientific Statement for Healthcare Professionals From the American Heart Association.

At least half of all stroke survivors experience fatigue; thus, it is a common cause of concern for patients, caregivers, and clinicians after stroke. This scientific statement provides an international perspective on the emerging evidence surrounding the incidence, prevalence, quality of life, and complex pathogenesis of poststroke fatigue. Evidence for pharmacological and nonpharmacological interventions for management are reviewed, as well as the effects of poststroke fatigue on both stroke survivors and caregivers.

Perceived health, caregiver burden, and quality of life in women partners providing care to Veterans with traumatic brain injury.

Families of Veterans with traumatic brain injury (TBI) are often faced with providing long-term informal care to their loved one. However, little is known about how their perceived health and caregiving burden contribute to their quality of life (QOL). The purpose of this descriptive study was to describe perceived health, somatic symptoms, caregiver burden, and perceived QOL and to identify the extent to which these variables are associated with QOL in female partners/spouses of Veterans with TBI.

DNA methylation and the social gradient of osteoporotic fracture: A conceptual model.

Introduction: Although there is a documented social gradient for osteoporosis, the underlying mechanism(s) for that gradient remain unknown. We propose a conceptual model based upon the allostatic load theory, to suggest how DNA methylation (DNAm) might underpin the social gradient in osteoporosis and fracture. We hypothesise that social disadvantage is associated with priming of inflammatory pathways mediated by epigenetic modification that leads to an enhanced state of inflammatory reactivity and oxidative stress, and thus places socially disadvantaged individuals at greater risk of osteoporotic fracture.

The Man I Once Knew: Grief and Inflammation in Female Partners of Veterans With Traumatic Brain Injury.

Grief, although traditionally conceptualized as a bereavement-related reaction, is also experienced by significant others in response to the profound cognitive and personality changes associated with a traumatic brain injury (TBI) in a loved one. Grief associated with the death of a loved one is related to increases in proinflammatory cytokines, yet it is not clear whether this is the case for grief experienced by individuals caring for a significant other with TBI. The purpose of this cross-sectional, exploratory study was to examine grief and its association with a proinflammatory cytokine, tumor necrosis factor α (TNF-α), in wives/partners caring for veterans with TBI.

He Looks Normal But … Challenges of Family Caregivers of Veterans Diagnosed with a Traumatic Brain Injury.

Purpose: To describe the experience of family caregivers providing care to veterans with traumatic brain injury (TBI).

Design/methods: Using a qualitative design, interviews were conducted with a purposeful sample of women caregivers. Data were analyzed using content analysis procedures.

Epigenetics and social context: implications for disparity in cardiovascular disease.

Background: Although it is well established that African Americans (AA) experience greater social stressors than non-Hispanic Whites (NHW), the extent to which early life adversity and cumulative social stressors such as perceived discrimination, neighborhood violence, subjective social status, and socioeconomic status contribute to disparity in coronary heart disease (CHD) and stroke between AA and NHW are not well understood.

Purpose: The purpose of this paper is to propose a conceptual model based upon McEwen's Allostatic Load Model suggesting how the relationships among social context, early life adversity, psychological stress, inflammation, adaptation, and epigenetic signature may contribute to the development of CHD and ischemic stroke. We hypothesize that social context and prior life adversity are associated with genome-wide as well as gene-specific epigenetic modifications that confer a proinflammatory epigenetic signature that mediates an enhanced proinflammatory state.

Healthcare utilization following mild traumatic brain injury in female veterans.

Background: Mild traumatic brain injury (TBI) is a significant problem for Veterans. Gender differences in mild TBI outcomes such as return-to-work, resolution of symptoms and mental health diagnoses have been reported. The purpose of the study is to characterize gender differences in VA healthcare utilization in the year following mild TBI diagnosis.

Social determinants and heat shock protein-70 among African American and non-Hispanic white women with atherosclerosis: a pilot study.

African American (AA) women are nearly twice as likely as non-Hispanic White (NHW) women to develop atherosclerosis associated with cardiovascular disease. Compelling evidence demonstrates that stress-related biomarkers, such as heat shock protein-70 (HSP70), are associated with increased atherosclerosis risk. Yet little is known about how social factors such as perceived discrimination, subjective social status, and socioeconomic status contribute to the levels of these biomarkers in women with atherosclerosis.

Burnout and coping strategies of polytrauma team members caring for veterans with traumatic brain injury.

Objective: The aims of this national study were to (1) examine the extent of job burnout among VA Polytrauma team members engaged in the diagnosis and treatment of traumatic brain injury (TBI); and (2) identify their coping strategies for dealing with job-related stress.

Design: A cross-sectional sample of 233 VA Polytrauma team members completed the Maslach Burnout Inventory (MBI) and identified strategies for coping with work stress as part of an online survey.

Results: VA Polytrauma team members experience moderate levels of emotional exhaustion, but low levels of depersonalization and high levels of personal accomplishment.