Trauma-informed Care (TIC) is a paradigm that has gained much traction in medical and human services settings over the past decade, motivated by the recent research findings that many poor physical, mental, and behavioral outcomes are more likely in individuals who experienced trauma in childhood (Adverse Childhood Experiences [ACEs]) such as abuse and neglect. The TIC paradigm, offered as novel, seems to be a secular repackaging of the biblical mandate to love our neighbors (Mark 12:31; Gal 5:14). The central tenets of TIC include feeling empathy with and demonstrating empathy toward others in their suffering; understanding that having experienced past traumatic events changes a person physically, mentally, and emotionally; that efforts should be made to prevent retraumatization; and that every person is valuable and has strengths that can be cultivated. Empathy, or feeling what other feel, is taught in Rom 12:15, “Be happy with those who are happy, and weep with those who weep,” and Gal 6:2, “Share each other’s burdens, and in this way obey the law of Christ.” Having an understanding of the pain experienced by those who have experienced trauma and caring for that suffering part of the body is clearly a biblical concept. Paul states, in 1 Cor 12:25-26, “This makes for harmony among the members, so that all the members care for each other. If one part suffers, all the parts suffer with it, and if one part is honored, all the parts are glad.” This supports the emphasis on empathy as well. The ACE Study which sparked the development of the TIC paradigm, highlights the likely impacts of adversity on children who have been treated unjustly. Throughout the Bible, those who follow God’s principles are instructed to care for the child, the weak, and those experiencing injustice (Isa 1:17, “Learn to do good; seek justice, correct oppression; bring justice to the fatherless, plead the widow’s cause.”). Finally, in teaching the tenets of TIC, we foster a belief that everyone has value and we should help each other to capitalize on strengths. Hebrews 10:24 echoes this by saying, “And let us consider one another to provoke unto love and to good works.” How do we know people have strengths to be capitalized upon? Rom 12:6 says, “In his grace, God has given us different gifts for doing certain things well,” and 1 Pet 4:10 says, “Each of you has received a gift to use to serve others. Be good servants of God’s various gifts of grace.” ​ I and a colleague have been teaching TIC principles to health care professionals and human service workers over the past two years. We have trained almost 2,000 people in these concepts. It has been embraced like nothing I have seen in my three decades in the psychological and counseling profession. Is it that our secularized society is hungry for biblical wisdom? Is it that He who created us knows best what we need? I can’t say, but our current research seeks to verify effects as organizations implement TIC.

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Abstract available through the Annals of Behavioral Medicine.

USA Infant Court is a multisystem, trauma-focused approach designed to address the complex needs of infants, toddlers, and their parents involved in the child welfare system and to improve outcomes. Infant mental health values and principles as well as knowledge areas such as the impact of trauma on early brain development, attachment theory, and trauma -informed care are integrated into the practice of infant courts. The core components of evidenced informed infant and early childhood courts will be reviewed. Presenters will describe two pilot infant court projects and the expansion of infant courts statewide through legislation.

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Stormwater sewer infrastructure is at risk due to ageing, structural deterioration, population growth, and climate change. Since the consequences of the sewer system failure can adversely impact the community safety, environment and economy, a resilient infrastructure system is of essential importance. However, limited reinvestment budget and insufficient asset management practices impact the rehabilitation of urban sewerage systems. Therefore, an effective and efficient rehabilitation plan is needed to help proper investment decisions. An effective rehabilitation plan will maximize hydraulic performance while minimizing the overall failure risk within a limited budget. The current study aims to address this issue through designing a risk-informed methodology in three steps. First, the hydraulic risk index (obtained using the SWMM model) was combined with the ageing pipe index. The framework uses multi-objective optimization technique to generate solutions under specific sewerage conditions. We named this new framework as Hydraulics and Risk Combined Model (HRCM). Several scenarios including high hydraulic risk, high ageing risk, hydraulic risk and ageing risk (combined problems), and limited budget problems, are used to test the performance of the proposed methodology. The results show that the proposed model could provide a satisfactory solution. Then, in order to increase the calculation speed and improve the accuracy, sensitivity and cost-effectiveness analyses were also conducted for the proposed methodology with different algorithms. The results show that different algorithms offer various benefits. A new calculation method was offered by combining the advantages of the previous methods. Finally, a new optimization method named Phenotype Searching Method, which was enlightened by sexual selection processes, was offered. This method can enhance the selection processes to specific phenotypes (pipes) so that it can increase the convergence speed and increase the performance of the HRCM model.

Historisk informerte framføringer av klassisk musikk blir en mer og mer vanlig tilnærmingsmetode for moderne musikere. Denne oppgaven utforsker ulike aspekter av en slik innstuderingsprosess. Oppgaven beskriver hvordan kunnskap om romantisk tolkningstradisjon og spillestil kan berike og frigjøre musikeren, men problematiserer samtidig aspekter som tradisjon og stilmessig korrekthet. Som grunnlag for denne diskusjonen ligger Johannes Brahms sonate i Ess-dur for bratsj og klaver, samt tre forskjellige innspillinger gjort av fiolinisten Joseph Joachim i 1903. Ved hjelp av disse kildene viser jeg hvordan man kan tenkes at denne sonaten kunne blitt tolket i Brahms sin samtid, og diskuterer videre hvordan jeg vil tolke sonaten selv i lys av denne kunnskapen. Resultatet er en informert framføring av sonaten, hvor jeg har tatt i betraktning den romantiske spillestilen, men ikke på bekostning av min selvstendige tolkning av verket.

Background: Genomic sequencing is used in the Neonatal Intensive Care Unit (NICU) to diagnose babies with genetic disorders. Purpose: To explore the experiences and knowledge of nurses working in NICUs related to genomic sequencing. Methods: This was a mixed-methods, cross-sectional descriptive survey of NICU nurses attending a national conference. Quantitative data were analyzed using descriptive statistics. Qualitative data were coded into categories and themes. Results: Of 188 NICU nurses, nearly half reported experience with genomic sequencing. Among nurses with experience, 62.7% rated the amount of discussion they had with families about genomic sequencing as "0". Additionally, 72.7% of participants reported feeling unprepared to discuss genomic sequencing. NICU nurses identified potential harms and benefits associated with disclosing incidental findings, and most (83.6%) were in support of revealing incidental findings. Conclusions: To better support NICU families, nurses need to increase their understanding of genomic sequencing and increase their ability to provide genomics-informed nursing care.

Children with developmental coordination disorders (DCD) inherently have neuromotor disruptions that impact their functional performance (Watemberg et al., 2007). The prevalence of developmental coordination disorder is high among children with diagnoses such as ADHD and autism (Maciver et al., 2011). DCD presents with motor coordination problems, visual motor integration difficulties, sensory processing differences, and communication and behavior challenges. These difficulties lead to specific learning delays that affect reading, writing, and math as well as related mental health problems. There is an emerging body of evidence substantiating the need for effective diagnosis, which would lead to improved management of the population. Evidenced-based occupational therapy interventions for children with DCD are limited, which impacts the training opportunities for occupational therapists who are interested in using effective interventions in their practice. The literature highlights the Cognitive Orientation to daily Occupational Performance (CO-OP) method as the only evidence-based practice intervention method, however sensory integration treatment is the preferred treatment used by 90% of pediatric occupational therapists in the United States (AOTA, 2015b). Although there is limited evidence supporting popular interventions such as sensory integration, neurodevelopmental therapies, and deficit-oriented interventions, there is a growing interest and desire for ways to address the needs of the DCD population. Consistent themes throughout the literature are to promote awareness and develop appropriate evidence-based interventions for children being diagnosed with DCD. I propose that this clinical gap can be remediated by providing an evidence-informed, multi-faceted intervention model that is supported by current neuroscience research. With growing bodies of literature in the neuroscience research community, I propose using an integrated model such as the Margow Model (Margow, 2014). The model integrates several philosophies of treatment that can be easily implemented with a clear plan of intervention. Occupational therapists need an accessible tool that incorporates task-oriented interventions, sensory processing strategies, cognitive strategies and functional activities that can be carried over into daily living skills.

BACKGROUND: The Emergency Department is a quick-moving environment in which rapid identification of illness and prompt treatment is the mainstay of care. Obtaining informed consent from a patient for a high-risk or invasive procedure is required both legally and ethically regardless of the setting. However, informed consent in the Emergency Department is routinely inadequate. LITERATURE REVIEW: Research thus far has identified several of the barriers to obtaining proper informed consent; a few including language barriers, gaps in intellectual levels, fragmented care of different emergency providers, vulnerability of patients in the ED, and the complexity of the informed consent forms. Investigation into improving the informed consent discussion and patient comprehension has shown promise in implementing patient centered modalities that aid in communication. Such modalities include repeat-back mechanisms, easy-read documents, and implemented multimedia presentations. PROPOSED PROJECT: In this proposed study, we will focus on a pre-intervention (control) group and an intervention group. The intervention to be implemented will be a paracentesis informed consent video and a provider checklist including procedure, diagnosis/intervention, risks, benefits, and alternatives all to be checked off after being discussed with and repeated back by the patient. Patient understanding will be analyzed using a post-discussion questionnaire completed by all participants. We hypothesize that this intervention will improve overall comprehension of the informed consent discussion regarding the paracentesis procedure. CONCLUSION: Patient comprehension of the informed consent discussion in the Emergency Department is often lacking in meeting both legal and ethical standards. Reviewing the data for a significant change between the control and intervention group will allow us to determine if enhancing the informed consent discussion to a more patient-centered process will improve patient understanding of all aspects of the informed consent discussion. In the end, this will guarantee ED patients their lawful right to truly informed consent. SIGNIFICANCE: This informed consent video and checklist will allow for an informed consent process that remains standardized but is more patient focused to improve patient comprehension of the process and protect the rights of all parties involved.