Defense Equal Opportunity Management Institute

UNLABELLED: The Eastern woodchuck (Marmota monax) is naturally infected with woodchuck hepatitis virus (WHV), a hepadnavirus closely related to the human hepatitis B virus (HBV). The woodchuck is used as an animal model for studying chronic hepatitis B (CHB) and HBV-associated hepatocellular carcinoma (HCC) in humans, but the lack of sequence information has hitherto precluded functional genomics analysis. To address this major limitation of the model, we report here the sequencing, assembly, and annotation of the woodchuck transcriptome, together with the generation of custom woodchuck microarrays. Using this new platform, we characterized the transcriptional response to persistent WHV infection and WHV-induced HCC. This revealed that chronic WHV infection, like HBV, is associated with (1) a limited intrahepatic type I interferon response; (2) intrahepatic induction of markers associated with T cell exhaustion; (3) elevated levels of suppressor of cytokine signaling 3 (SOCS3) in the liver; and (4) intrahepatic accumulation of neutrophils. Underscoring the translational value of the woodchuck model, this study also determined that WHV-induced HCC shares molecular characteristics with a subtype of human HCC with poor prognosis. CONCLUSION: Our data establish the translational value of the woodchuck model and provide new insight into immune pathways which may play a role either in the persistence of HBV infection or the sequelae of CHB.

The present study extends knowledge of the performance consequences of workgroup diversity climate. Building upon Kopelman, Brief, and Guzzo's ( ) climate model of productivity, we introduce workgroup discrimination as a behavioral mediator that explains the positive effects of diversity climate on workgroup performance. In addition, we investigate group size as a moderator upon which this mediated relationship depends. We test these moderated‐mediated propositions using a split‐sample design and data from 248 military workgroups comprising 8,707 respondents. Findings from structural equation modeling reveal that diversity climate is consistently positively related to workgroup performance and that this relationship is mediated by discrimination. Results yield a pattern of moderated mediation, in that the indirect relationship between workgroup diversity climate (through perceptions of workgroup discrimination) and group performance was more pronounced in larger than in smaller workgroups. These results illustrate that discrimination and group size represent key factors in determining how a diversity climate is associated with group performance and, thus, have significant implications for research and practice. © 2014 Wiley Periodicals, Inc.

Abstract Diversity in group membership can present both advantages and disadvantages for group performance. The authors examined how different percentages in workgroup diversity categories (gender, minority, and persons with disabilities) affected measures of group effectiveness (commitment, overall effectiveness, satisfaction, cohesion, trust, equal opportunity climate, and quality) taken from the Military Equal Opportunity Climate Survey Test Version 3.1 (Talking Paper, 1998). The gender and minority, but not persons with disabilities, categories showed increases in perceived work-group effectiveness at the 11–30% diversity level. Results are discussed in terms of possible optimum diversity levels, expanded measures of diversity, and team development of diverse work groups.

Abstract Sexual harassment is hurtful for victims, observers, and the organizations that employ them. Although previous studies have identified numerous gender‐specific antecedents such as sex similarity and climate for sexual harassment, the present study considers the role of a more general contextual construct—organizational justice climate. Beyond examining justice climate as a predictor of sexual harassment, we also assess its potential moderation of well‐established relationships between antecedents (i.e., climate for sexual harassment and sex similarity) and sexual harassment at both the individual and unit levels. In two large military samples ( N s = 26,018 and 8,197), we found that psychological and collective justice climates (a) related negatively to sexual harassment and (b) moderated the effects of sex similarity and sexual harassment climate on sexual harassment. These findings indicate that harassment is less prevalent and established antecedents are less impactful when greater value is perceived to be placed on fairness. Moreover, the attenuating effects of justice climate appear interchangeable with those of harassment climate or sex similarity, suggesting that managing justice climate effectively generally helps to deter sexual harassment.

the Department of Anesthesiology, Wilford Hall USAF Medical Center, Lackland AFB, Texas. Address correspondence to Joseph V. Mirenda, Major, USAF, MC, Department of Anesthesiology, Wilford Hall USAF Medical Center, Lackland AFB, TX 78236. The opinions or assertions expressed herein are those of the authors and are not to be construed as official or as reflecting the views of the United States Air Force or the Department of Defense. The authors thank Dr. Edward D. Miller, Jr., of the Department of Anesthesiology (College of Physicians and Surgeons of Columbia University) for his support in preparation of this manuscript. Accepted for publication November 26, 1990.

Background: Myofascial pain is defined as pain that originates from myofascial trigger points in skeletal muscle. It is prevalent in regional musculoskeletal pain syndromes, either alone or in combination with other pain generators. The myofascial pain syndrome is one of the largest groups of under diagnosed and under treated medical problems encountered in clinical practice. Trigger points are commonly seen in patients with myofascial pain which is responsible for localized pain in the affected muscles as well as referred pain patterns. Correct needle placement in a myofascial trigger point is vital to prevent complications and improve efficacy of the trigger point injection to help reduce or relieve myofascial pain. In obese patients, these injections may not reach the target tissue. In the cervicothoracic spine, a misguided or misplaced injection can result in a pneumothorax. Here, we describe an ultrasound-guided trigger point injection technique to avoid this potential pitfall. Office based ultrasound-guided injection techniques for musculoskeletal disorders have been described in the literature with regard to tendon, bursa, cystic, and joint pathologies. For the interventionalist, utilizing ultrasound yields multiple advantages technically and practically, including observation of needle placement in real-time, ability to perform dynamic studies, the possibility of diagnosing musculoskeletal pathologies, avoidance of radiation exposure, reduced overall cost, and portability of equipment within the office setting. To our knowledge, the use of ultrasound guidance in performing trigger point injection in the cervicothoracic area, particularly in obese patients, has not been previously reported. Methods: A palpable trigger point in the cervicothoracic musculature was localized and marked by indenting the skin with the tip of a plastic needle cover. The skin was then sterile prepped. Then, using an ultrasound machine with sterile coupling gel and a sterile latex free transducer cover, the musculature in the cervicothoracic spine where the palpable trigger point was detected was visualized. Then utilizing direct live ultrasound guidance, a 25-gauge 1.5 inch needle connected to a 3 mL syringe was placed into the muscle at the exact location of the presumed trigger point. This guidance helps confirm needle placement in muscle tissue and not in an adipose tissue or any other non-musculature structure. Results: The technique is simple to be performed by a pain management specialist who has ultrasound system training. Conclusion: Ultrasound-guided trigger point injections may help confirm proper needle placement within the cervicothoracic musculature. The use of ultrasound-guided trigger point injections in the cervicothoracic musculature may also reduce the potential for a pneumothorax by an improperly placed injection. Key words: Trigger point injection, myofascial pain, ultrasound

Purpose: Sexual harassment remains a persistent problem in the U.S. military despite extensive research and policy initiatives. Theoretical explanations identify individual circumstances (e.g., power differentials) and organizational factors (e.g., climate, culture). However, data constraints limit the capacity to link individual contexts with independent measures of environments. Data/Methods: A unique Defense Equality Opportunity Climate Survey allows assessment of organizational climates and individual experiences with multilevel analyses. Results: Sexist environmental context increases the likelihood of personal harassment experiences after controlling for individual-level variables. However, unit-level climate, group cohesion, and job satisfaction are not significant. Conclusion: Both individual and organizational factors are important. However, the organizational context has less to do with culture or unit cohesion and more to do with tolerance of sexism. Focusing on problem units may be effective for reducing the prevalence and persistence of sexual harassment.

To date, minimal work has explored associations between equal opportunity (EO) climate and employee work attitudes, and no known research has investigated the effects of EO climate beyond the individual level. We address these gaps in the literature by testing a multilevel structural equation model in which effects of EO climate are considered at both the individual and unit levels. At the individual level, we predicted that psychological EO climate would be directly associated with job stress and job satisfaction, as well as indirectly related to job satisfaction via stress. In addition, cross-level associations between unit EO climate and job stress and job satisfaction were hypothesized to be mediated by cohesion. Findings supported the proposed model; hypothesized relations were supported at both levels of analysis. We conclude with a discussion of the findings, study limitations, and directions for future EO climate research.

Summary Our research examined how team age diversity can be either detrimental or beneficial for team performance depending on team agreeableness minimum. In age diverse teams, a disagreeable teammate may trigger age‐based stereotypes about his/her social group, thereby activating social categorization. This would result in decreased relational team functioning and worsened team performance. When the least agreeable member scores high on agreeableness, negative social categorization processes may not be triggered in age diverse teams. They may focus on informational diversity with beneficial effects for team relational processes and team performance. We tested our model in three samples (Study 1: k = 81, N = 254; Study 2: k = 109, N = 434; Study 3: k = 195, N = 1784) wherein performance was measured both objectively (Studies 1 and 2) and subjectively (Study 3). In both Studies 1 and 2, team age diversity was positively related to team performance when team agreeableness minimum was high. In Study 2, when the least agreeable person scored low on agreeableness, greater age diversity resulted in lower performance, and this relationship was mediated by higher interpersonal conflict. In Study 3, these interactive effects transpire via reduced team cohesion—another aspect of relational team functioning.

OBJECTIVE: To investigate the clinical features of patients who had two demonstrated coronavirus disease 2019 (COVID-19) episodes. METHODS: Data of patients with both COVID-19 episodes were recruited from 22 March to 27 December 2020. The following outcomes were studied: epidemiological, comorbidities, prevalence and severity of general and otolaryngological symptom, olfactory, aroma, and gustatory dysfunctions. A comparison between first and second episodes was performed. RESULTS: Forty-five patients reported having two confirmed COVID-19 episodes. The majority of patients had mild infections in both episodes. The second clinical episode was significantly similar to the first. The symptom duration of the second episode was shorter than the first. The occurrence of loss of smell was unpredictable from the first to the second episode. CONCLUSION: The recurrence of COVID-19 symptoms is associated with a similar clinical picture than the first episode in patients with initial mild-to-moderate COVID episode. The pathophysiological mechanisms underlying the development of second episode remain uncertain and may involve either true reinfection or virus reactivation from sanctuaries.

AbstractRecent analyses of the perceptions of equal opportunity (EO) climate in the military highlight differences among various demographic subgroups. Prior research (CitationDansby, 1994) indicates minority female officers have the least favorable views of EO climate in military organizations when contrasted to comparable demographic subgroups (i.e., Caucasian male officers, etc.). Differences based on race, gender, and representation index (number in the subgroup divided by the total unit population) are explored in a sample of 190 U.S. Army units (N = 47,823) that conducted the Military Equal Opportunity Climate Survey between 1990 and 1995. As predicted, minority female officers' perceptions of the favorability of the EO climate improved as their representation in the organization increased (p < .05). Contrary to the expected negative relation, higher educational attainment positively correlated with improved perceptions of EO climate. The findings are interpreted as supporting consideration of representation issues as a means to improving perceived EO climate.

Cultural competence is a vital component of many missions in today's military. Cultural competence enables one to further a mission, save resources, and save lives. Conversely, a lack of cultural competence may bring about challenges to mission completion, requirement for more resources, waste of resources, and destruction of lives. Cultural competence involves many components. One particular component is cultural heritage awareness and protection of cultural property. This study sought to assess current understanding of cultural property protection and determine the effectiveness of a training aimed at increasing cultural property protection awareness, knowledge, and comfort within the military setting. It was hypothesized that participants would vary in their level of awareness, knowledge, and comfort of cultural property protection, and that all would show a significant improvement in knowledge scores post training. Factors such as deployment experience were examined for potential correlation with measures such as awareness. A 14 question pre-read survey was developed to assess participants' demographics, awareness, knowledge, and comfort with cultural property protection. Awareness included value, laws, and procedures while knowledge examined "know how" such as how to bed down in a protected structure or communicate information about the structure. Comfort assessed one's comfort with engaging in the knowledge based tasks. A 24 question post read survey was administered to assess awareness, knowledge, and comfort, and to solicit additional feedback on the manual itself. The survey utilized a 1-5 rating scale with 1 representing no awareness, knowledge, or comfort and 5 representing absolute awareness, knowledge, and comfort with different aspects of cultural property protection. Cultural property protection value was highest pre and post training while knowledge regarding recovery of property was rated lowest pre and post training. Results are encouraging for the pursuit of cultural property education. Further studies should include knowledge assessment versus self rating as well as tracking of incidents and outcomes in the field. Implications for mission readiness and success are discussed.

Situational judgment tests (SJTs) are well suited for training evaluation, especially when measures of on-the-job behaviors/performances are unavailable. Yet, SJTs are underutilized in the training evaluation context. This research details the development and use of an SJT to evaluate equal opportunity/diversity training in the military. We focus on issues that differentiate the development of SJTs for training evaluation from the development of SJTs for selection. Finally, results are presented for two cycles of training evaluation using an SJT, and the strengths and limitations of using SJTs in the training context are discussed.

BACKGROUND: Myofascial pain is defined as pain that originates from myofascial trigger points in skeletal muscle. It is prevalent in regional musculoskeletal pain syndromes, either alone or in combination with other pain generators. The myofascial pain syndrome is one of the largest groups of under-diagnosed and under-treated medical problems encountered in clinical practice. Trigger points are commonly seen in patients with myofascial pain that can be responsible for localized pain in the affected muscles as well as referred pain patterns. Correct needle placement in a myofascial trigger point is vital to prevent complications and improve efficacy of the trigger point injection to help reduce or relieve myofascial pain. In the obese patients, these injections may not reach the target tissue. In the cervicothoracic spine, a misguided or misplaced injection can result in a pneumothorax. Here, we review an electromyographically guided trigger point injection technique to avoid this potential pitfall. METHODS: Using a disposable Teflon coated hypodermic injection needle attached to an electromyography (EMG) machine, a trigger point injection can be performed utilizing electromyographic guidance. This guidance by observing motor unit action potentials (MUAPs) on the EMG screen helps confirm the needle placement to be within the muscle tissue and not in an adipose tissue or any other non-musculature structure. RESULTS: The technique is simple when performed by a pain management specialist who has electromyographic training. CONCLUSION: This technique helps confirm proper needle placement within the cervicothoracic musculature in an obese patient in whom the musculature is not readily palpated. This, thus, reduces the potential for a pneumothorax by an improperly placed injection.

Chronic ulcerations are a physical and financial burden to the health and economic establishment in the United States and Worldwide. Improvements in biotechnology and knowledge in stem cell applications have progressed and basic science results are making their way slowly into the clinical arena. Chronic wounds and diabetic bone healing are the key components in the limb salvage of the common diabetic foot. We have examined the current available literature and present the latest on stem cells applications as a novel clinical technique in the treatment of chronic wound and diabetic bone healing and their impact in the treatment paradigm of patients.

The military unit is a critical center of gravity in the military's efforts to enhance resilience and the health of the force. The purpose of this article is to augment the military's Total Force Fitness (TFF) guidance with a framework of TFF in units. The framework is based on a Military Demand-Resource model that highlights the dynamic interactions across demands, resources, and outcomes. A joint team of subject-matter experts identified key variables representing unit fitness demands, resources, and outcomes. The resulting framework informs and supports leaders, support agencies, and enterprise efforts to strengthen TFF in units by (1) identifying TFF unit variables aligned with current evidence and operational practices, (2) standardizing communication about TFF in units across the Department of Defense enterprise in a variety of military organizational contexts, (3) improving current resources including evidence-based actions for leaders, (4) identifying and addressing of gaps, and (5) directing future research for enhancing TFF in units. These goals are intended to inform and enhance Service efforts to develop Service-specific TFF models, as well as provide the conceptual foundation for a follow-on article about TFF metrics for units.

= 8,196 employees in 546 work units). Results generally show that bystanders who are women or similar in gender to the target of mistreatment reported different levels of emotional and cognitive identity threat that related to psychological gender mistreatment climate and workplace injustice following the incident as compared to men and those not similar in gender to the target. Overall, by integrating and extending bystander theory and dual-process models of injustice perceptions, through this work, we provide a potentially overlooked reason why negative behaviors like incivility, ostracism, and discrimination continue to occur in organizations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Cross-cultural competence (3C) is critical for military personnel to understand and perform effectively in complex cultural environments and to interact with individuals from other cultures. The knowledge, skills, and abilities that make up 3C can result in clearer communication, build trust, and strengthen relationships in cross-cultural social contexts ( Selmeski, 2009 Selmeski, B. (February, 2009). Military Cross-cultural competence: Core concepts and individual development. Proceedings from the 7th Biennial Equal Opportunity, Diversity, and Culture Research Symposium. Patrick Air Force Base, FL. [Google Scholar]). This research investigated the role of emotional regulation and optimism in the development of 3C in military personnel. Results demonstrate that the ability to regulate emotions is positively related to 3C, both directly and through its effect on optimism.

To describe the prenatal presentation, including ultrasonographic, histologic, and molecular findings, in 2 fetuses affected with LMOD3-related nemaline myopathy. Prenatal ultrasonographic examinations and histopathologic studies were performed on 2 fetuses with evidence of nemaline myopathy. To establish a molecular diagnosis, whole-exome sequencing was pursued for the affected fetuses. Nemaline myopathy is a common form of congenital myopathy manifesting with nonprogressive generalized muscle weakness, hypotonia, and electron-dense protein inclusions in skeletal myofibers. Although clinically, nemaline myopathy can be viewed as a common pathway phenotype, its molecular basis is heterogeneous, with mutations in 11 identified genes implicated in its pathogenesis so far. Whole-exome sequencing revealed that the affected fetuses were compound heterozygous for 2 newly reported pathogenic variants in the LMOD3 gene, which encodes leiomodin 3. To our knowledge, this article is the first report of LMOD3-related nemaline myopathy since the original reported cohort. We provide a detailed description of the prenatal imaging of these affected fetuses, which we hope, in combination with next-generation sequencing, may contribute to further diagnosis in additional families.

BACKGROUND: Osteonecrosis of the knee (ONK) is a form of aseptic necrosis resulting from ischemia to subchondral bone tissue. Typically, treatment is invasive. Hyperbaric oxygen therapy (HBOT) may provide a noninvasive alternative by improving oxygenation and reperfusion of ischemic areas. This study evaluates the efficacy of HBOT in a series of ONK patients. METHODS: This retrospective study evaluates 37 ONK patients (29 male, 8 female; mean age ± 1 standard deviation: 54 ± 14); 83.7% of patients presented with Aglietti stage I-II; 16.3% presented with Aglietti stage III. Patients were treated with HBOT once a day, 5 days a week, at 2.5 atmosphere absolute with 100% inspired oxygen by mask for an average of 67.9 ± 15 sessions. Magnetic resonance imaging was performed before HBOT, within 1 year after completion of HBOT, and in 14 patients, 7 years after treatment. Oxford Knee Scores (OKSs) were recorded before HBOT and at the end of each HBOT treatment cycle. RESULTS: After the 30 sessions of HBOT, 86% of patients experienced improvement in their OKS, 11% worsened, and 3% did not change. All patients improved in OKS after 50 sessions. Magnetic resonance imaging evaluation 1 year after HBOT completion showed that edema at the femoral condyle had resolved in all but 1 patient. CONCLUSIONS: < .01) from 1.7 ± 0.7 to 0.3 ± 0.6.