Recovery after severe skeletal muscle crush injury is a major research focus, especially for the armed forces and after major natural disasters. Evaluation of statistics in major American wars displays astonishing numbers of severely injured soldiers, many of them undergoing amputations of major limbs. Much of the research has focused on recovery from exercise-induced muscle injury but little is known about crush injury-induced recovery pattern. Cytokines such as interleukins and tumor-necrosis factors recruit immune cells to the site of injury to clear cell debris, repair cell injury, and stimulate the growth of satellite cells. The time course for the expression of proinflammatory cytokines IL-1beta, IL-6 and TNF-alpha is not well characterized in injured skeletal muscle of mice. The purpose of our investigation is to develop a crush injury animal model to study the expression pattern of these proinflammatory cytokines in the recovery process following crush injury. In our experiments, RNA was extracted and reverse transcribed into cDNA from the right gastrocnemius of injured mice for qPCR to determine the expression levels of IL-1beta, IL-6 and TNF-alpha at 0, 4, 8, 24, 48 and 72 hours post injury. From preliminary data, we see a linear increase in TNF-alpha expression from 0 to 24 hours, and a rapid increase in IL-1beta and IL-6 with a linear decrease over the following 4-24 hour time points. Analysis of later time points is ongoing. This work provides a baseline in preparation of treatment trials to study the healing process and related cytokine production following injury. By understanding the time course and functions of these cytokines and how they interact, we can contribute to the scientific foundation for evaluating the effectiveness of therapies used in managing wounded soldiers.

Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases (GOLD, 2011). There are two classes of medications to treat COPD, bronchodilators and corticosteroids. Some patients are prescribed multiple inhalers to maximize treatment effectiveness. Correct inhaler technique is important to ensure proper deposition of medications in the airways; however, administration techniques vary across devices. This raises the question as to if there is a relationship between the number of prescribed inhalers with patients’ confidence in their inhaler technique and medication behavior. We hypothesized that patients using multiple inhalers would have decreased confidence in their inhaler technique and adherence to inhaler use may be lower. To answer this question, we used data collected from an ongoing longitudinal observational study looking at biological causes and functional consequences of depression in COPD patients. Our analyses showed that patients who were on 3 or more inhalers had the same level of confidence in taking their inhalers correctly as patients who were on 2 or fewer inhalers. They also did not differ in forgetting to take or being careless about their medications compared to patients who took fewer inhalers. In addition, they were no less likely to take their inhalers when there were changes in their daily routine. These results refute our hypothesis, and instead, demonstrate that there is no relationship between the number of prescribed inhalers and inhaler technique confidence and medication behavior.

Our world is becoming increasingly integrated with motion sensor technology. However, the usefulness of motion sensor data is still vague and difficult to understand. Several applications using sensor infrastructure in the home, often referred to as smart homes, aim to support independence for older adults. The goal of this project is to try to understand smart homes for aging in place in general and complex motion sensor data within independent retirement communities. Our focus is in trying to understand how aggregated motion sensor data can be useful for clinicians, patients and family members, how to present aggregated motion sensor data, and how to proactively manage health to support aging in place. Our group is implementing ubiquitous motion sensors in independent retirement communities to assess mobility. Various parameters that influence mobility, including cognitive ability, psychosocial activity, and environmental characteristics, are noted and integrated into the data. The projects goal is to evaluate mobility in older adults and consider actions or treatments to prevent disease onset or discomfort. Preliminary findings from the ongoing longitudinal feasibility study provide strength to the argument that motion sensors may provide a supporting role for aging in place.

Somali women immigrants have significant trauma histories related to their experiences of torture, rape, and displacement. They commonly present with somatic complaints for which there is no "medical explanation" and few acceptable or helpful treatment options. A community health program, Daryel, was started 3 years ago by a nurse at Harborview Medical Center to address somatic pain among Somali women through yoga and massage. Daryel primarily serves women over 50 years of age who are not fluent in English. This project consists of preparatory work for the development of a culturally congruent training manual for Health Care Practitioners working with Somali women. The following three methods will guide training manual development: 1) Conducting a literature review using databases such as ETHNOMED, CINHAL, PUBMED and gathering background on Somali traditional medicine, beliefs, and the cultural practices of Muslim women with regard to health; 2) Participating in individual conversations with Somali women and the Health Care Practitioners who serve them; and 3) Outreach to massage therapists who have stopped volunteering at Daryel with a set of questions on their volunteer experience. The results: 1) Findings based on the literature review show that taking time to establish rapport, understanding Somali culture and traditions, listening to their explanatory model of illness, and working skillfully with interpreters are important factors that will help gain success with Somali women patients; 2) Conversations with Somali women in Seattle confirm that a program such as Daryel is helpful for Somali women immigrants; 3) A survey of past and current volunteer Massage Therapists showed they want more training on Somali culture and language. In conclusion, a culturally congruent training manual will aid Health Care Practitioners in providing essential quality care to Somali women immigrants.