Floodplain morphology influences arsenic and antimony spatial distribution in a seasonal acid sulfate soil wetland.

Arsenic (As) and antimony (Sb) often co-occur in floodplain depositional environments that are contaminated by legacy mining activities. However, the distribution of As and Sb throughout floodplains is not uniform, adding complexity and expense to management or remediation processes. Identifying floodplain morphology predictor variables that help quantify and explain As and Sb spatial distribution on floodplains is useful for management and remediation. We developed As and Sb risk maps estimating concentration and availability at a coastal floodplain wetland impacted by upper-catchment mining. Significant predictors of As and Sb concentrations included i) distance from distributary channel-wetland intersection and ii) elevation. Distance from channel explained 53 % (P < 0.01) and 28 % (P < 0.01), while elevation explained 42 % (P < 0.01) and 47 % (P < 0.01) of the variability in near-total Sb and As respectively. As had a higher extractability than Sb across all tested soil extractions, suggesting that As is more environmentally available. As and Sb dry mass estimates to a depth of 0.1 m scaled to the lower coastal Macleay floodplain ranged from 113-192 tonnes and 14-24 tonnes respectively. Landscape-scale modelling of metalloid distribution, informed by morphology variables, presented here may be a useful framework for the development of risk maps in other regions impacted by contaminated upper-catchment sediments.

Extreme iron cycling in a coastal lake-lagoon system driven by interactions between climate and entrance management.

Intermittently closed and open coastal lakes and lagoons (ICOLLs) are ecologically important and hydrologically sensitive estuarine systems. We explore how extreme drought and ICOLL entrance management intersect to influence the geochemical cycling of iron. Opening the ICOLL entrance just prior to an extreme drought in 2019 led to prolonged extremely low water levels, thereby exposing intertidal/subtidal sulfidic sediments and causing oxidation of sedimentary pyrite. Subsequent reflooding of exposed sediments for ∼4 months led to extremely elevated Fe2+(aq) (>10 mM) in intertidal hyporheic porewaters, consistent with Fe2+(aq) release via pyrite oxidation and via reductive dissolution of newly-formed Fe(III) phases. Re-opening the ICOLL entrance caused a rapid fall in water levels (∼1.5 m over 7 d), driving the development of effluent groundwater gradients in the intertidal zone, thereby transporting Fe2+-rich porewater into surface sediments and surface waters. This was accompanied by co-mobilisation of some trace metals and nutrients. On contact with oxic, circumneutral-pH estuarine water, the abundant Fe2+(aq) oxidised, forming a spatially extensive accumulation of poorly crystalline Fe(III) oxyhydroxide floc (up to 25 % Fe dry weight) in shallow intertidal zone benthic sediments throughout the ICOLL. Modelling estimates ∼4050 × 103 kg of poorly-crystalline Fe was translocated into surficial sediments. The newly formed Fe(III)-oxyhydroxides serve as a metastable sink encouraging enrichment of both phosphate and various trace metal(loid)s in near-surface sediments, which may have consequences for future cycling of nutrients, metals and ICOLL ecological function. The additional Fe also may enhance ICOLL sensitivity to similar future drought events by encouraging pyrite formation in shallow (<5 cm) benthic sediments. This system-wide translocation of Fe from deeper sediments into surficial benthic sediments represents a form of geochemical hysteresis with an uncertain recovery trajectory. This study demonstrates how climate extremes can interact with anthropogenic management to amplify ICOLL hydrological oscillations and influence biogeochemistry in complex ways.

Research priorities for the management of major trauma: an international priority setting partnership with the James Lind Alliance.

OBJECTIVE: The objective of this study is to determine research priorities for the management of major trauma, representing the shared priorities of patients, their families, carers and healthcare professionals. DESIGN/SETTING: An international research priority-setting partnership. PARTICIPANTS: People who have experienced major trauma, their carers and relatives, and healthcare professionals involved in treating patients after major trauma. The scope included chest, abdominal and pelvic injuries as well as major bleeding, multiple injuries and those that threaten life or limb. METHODS: A multiphase priority-setting exercise was conducted in partnership with the James Lind Alliance over 24 months (November 2021-October 2023). An international survey asked respondents to submit their research uncertainties which were then combined into several indicative questions. The existing evidence was searched to ensure that the questions had not already been sufficiently answered. A second international survey asked respondents to prioritise the research questions. A final shortlist of 19 questions was taken to a stakeholder workshop, where consensus was reached on the top 10 priorities. RESULTS: A total of 1572 uncertainties, submitted by 417 respondents (including 132 patients and carers), were received during the initial survey. These were refined into 53 unique indicative questions, of which all 53 were judged to be true uncertainties after reviewing the existing evidence. 373 people (including 115 patients and carers) responded to the interim prioritisation survey and 19 questions were taken to a final consensus workshop between patients, carers and healthcare professionals. At the final workshop, a consensus was reached for the ranking of the top 10 questions. CONCLUSIONS: The top 10 research priorities for major trauma include patient-centred questions regarding pain relief and prehospital management, multidisciplinary working, novel technologies, rehabilitation and holistic support. These shared priorities will now be used to guide funders and teams wishing to research major trauma around the globe.

Rapid bark-mediated tree stem methane transport occurs independently of the transpiration stream in Melaleuca quinquenervia.

Tree stem methane emissions are important components of lowland forest methane budgets. The potential for species-specific behaviour among co-occurring lowland trees with contrasting bark characteristics has not been investigated. We compare bark-mediated methane transport in two common lowland species of contrasting bark characteristics (Melaleuca quinquenervia featuring spongy/layered bark with longitudinally continuous airspaces and Casuarina glauca featuring hard/dense common bark) through several manipulative experiments. First, the progressive cutting through M. quinquenervia bark layers caused exponential increases in methane fluxes (c. 3 orders of magnitude); however, sapwood-only fluxes were lower, suggesting that upward/axial methane transport occurs between bark layers. Second, concentrated methane pulse-injections into exposed M. quinquenervia bark, revealed rapid axial methane transport rates (1.42 mm s-1 ), which were further supported through laboratory-simulated experiments (1.41 mm s-1 ). Laboratory-simulated radial CH4 diffusion rates (through bark) were c. 20-times slower. Finally, girdling M. quinquenervia stems caused a near-instantaneous decrease in methane flux immediately above the cut. By contrast, girdling C. glauca displayed persistent, though diminished, methane fluxes. Overall, the experiments revealed evidence for rapid 'between-bark' methane transport independent from the transpiration stream in M. quinquenervia, which facilitates diffusive axial transport from the rhizosphere and/or sapwood sources. This contrasts with the slower, radial 'through-bark' diffusive-dominated gas transportation in C. glauca.

Microbiome mediating methane and nitrogen transformations in a subterranean estuary.

Subterranean estuaries (STEs) are important coastal biogeochemical reactors facilitating unique niches for microbial communities. A common approach in determining STE greenhouse gas and nutrient fluxes is to use terrestrial endmembers, not accounting for microbially mediated transformations throughout the STE. As such, the microbial ecology and spatial distribution of specialists that cycle compounds in STEs remain largely underexplored. In this study, we applied 16S rRNA amplicon sequencing with paired biogeochemical characterisations to spatially evaluate microbial communities transforming greenhouse gases and nutrients in an STE. We show that methanogens are most prevalent at the terrestrial end (up to 2.81% relative abundance) concomitant to the highest porewater methane, carbon dioxide and dissolved organic carbon concentrations (0.41 ± 0.02 µM, 273.31 ± 6.05 µM and 0.51 ± 0.02 mM, respectively). Lower ammonium concentrations corresponded with abundant nitrifying and ammonia-oxidising prokaryotes in the mixing zone (up to 11.65% relative abundance). Methane, ammonium and dissolved organic carbon concentrations all decreased by >50% from the terrestrial to the oceanic end of the 15 m transect. This study highlights the STE's hidden microbiome zonation, as well as the importance of accounting for microbial transformations mitigating nutrient and greenhouse gas fluxes to the coastal ecosystems.

Seasonal Trends in Emergency Department Visits for Mental and Behavioral Health Conditions Among Children and Adolescents Aged 5-17 Years - United States, January 2018-June 2023.

Mental and behavioral health conditions among school-aged children, including substance use disorders and overall emotional well-being, are a public health concern in the United States. Timely data on seasonal patterns in child and adolescent conditions can guide optimal timing of prevention and intervention strategies. CDC examined emergency department (ED) visit data from the National Syndromic Surveillance Program for 25 distinct conditions during January 2018-June 2023 among U.S. children and adolescents aged 5-17 years, stratified by age group. Each year, during 2018-2023, among persons aged 10-14 and 15-17 years, the number and proportion of weekly ED visits for eight conditions increased in the fall school semester and remained elevated throughout the spring semester; ED visits were up to twice as high during school semesters compared with the summer period. Among children aged 5-9 years, the number and proportion of visits increased for five mental and behavioral health conditions. Seasonal increases in ED visits for some conditions among school-aged children warrant enhanced awareness about mental distress symptoms and the challenges and stressors in the school environment. Systemic changes that prioritize protective factors (e.g., physical activity; nutrition; sleep; social, community, or faith-based support; and inclusive school and community environments) and incorporate preparedness for increases in conditions during back-to-school planning might improve child and adolescent mental health.

Psychological endurance: how grit, resilience, and related factors contribute to sustained effort despite adversity.

Many concepts describe how individuals sustain effort despite challenging circumstances. For example, scholars and practitioners may incorporate discussions of grit, hardiness, self-control, and resilience into their ideas of performance under adversity. Although there are nuanced points underlying each construct capable of generating empirically sound propositions, the shared attributes make them difficult to differentiate. As a result, substantial confusion arises when debating how these related factors concomitantly contribute to success, especially when practitioners attempt to communicate these ideas in applied settings. The model proposed here-psychological endurance-is a unified theory to explore how multiple concepts contribute to sustained goal-directed behaviors and individual success. Central to this model is the metaphor of a psychological battery, which potentiates and sustains optimal performance despite adversity. Grit and hardiness are associated with the maximum charge of the psychological battery, or how long an individual could sustain effort. Self-control modulates energy management that augments effort required to sustain endurance, whereas resilience represents the ability to recharge. These factors are constrained by both psychological and physiological stressors in the environment that drain the psychology battery. Taken together, these ideas form a novel framework to discuss related psychological concepts, and ideally, optimize intervention to enhance psychological endurance.

Mechanisms of Arsenic and Antimony Co-sorption onto Jarosite: An X-ray Absorption Spectroscopic Study.

Jarosite, a common mineral in acidic sulfur-rich environments, can strongly sorb both As(V) and Sb(V). However, little is known regarding the mechanisms that control simultaneous co-sorption of As(V) and Sb(V) to jarosite. We investigated the mechanisms controlling As(V) and Sb(V) sorption to jarosite at pH 3 (in dual and single metalloid treatments). Jarosite was found to sorb Sb(V) to a greater extent than As(V) in both single and dual metalloid treatments. Relative to single metalloid treatments, the dual presence of both As(V) and Sb(V) decreased the sorption of both metalloids by almost 50%. Antimony K-edge EXAFS spectroscopy revealed that surface precipitation of an Sb(V) oxide species was the predominant sorption mechanism for Sb(V). In contrast, As K-edge EXAFS spectroscopy showed that As(V) sorption occurred via bidentate corner-sharing complexes on the jarosite surface when Sb(V) was absent or present at low loadings or by formation of similar complexes on the Sb(V) oxide surface precipitate when Sb(V) was present at high loadings. These results point to a novel mechanism by which Sb(V) impacts the co-sorption of As(V). Overall, these findings highlight a strong contrast in the sorption mechanisms of Sb(V) versus As(V) to jarosite under acidic environmental conditions.

Antimony(V) Incorporation into Schwertmannite: Critical Insights on Antimony Retention in Acidic Environments.

This study examines incorporation of Sb(V) into schwertmannite─an Fe(III) oxyhydroxysulfate mineral that can be an important Sb host phase in acidic environments. Schwertmannite was synthesized from solutions containing a range of Sb(V)/Fe(III) ratios, and the resulting solids were investigated using geochemical analysis, powder X-ray diffraction (XRD), dissolution kinetic experiments, and extended X-ray absorption fine structure (EXAFS) spectroscopy. Shell-fitting and wavelet transform analyses of Sb K-edge EXAFS data, together with congruent Sb and Fe release during schwertmannite dissolution, indicate that schwertmannite incorporates Sb(V) via heterovalent substitution for Fe(III). Elemental analysis combined with XRD and Fe K-edge EXAFS spectroscopy shows that schwertmannite can incorporate Sb(V) via this mechanism at up to about 8 mol % substitution when formed from solutions having Sb/Fe ratios ≤0.04 (higher ratios inhibit schwertmannite formation). Incorporation of Sb(V) into schwertmannite involves formation of edge and double-corner sharing linkages between SbVO6 and FeIII(O,OH)6 octahedra which strongly stabilize schwertmannite against dissolution. This implies that Sb(V)-coprecipitated schwertmannite may represent a potential long-term sink for Sb in acidic environments.

Remediation of Pb-contaminated soil using modified bauxite refinery residue.

This study examines amendment of Pb-contaminated soil with modified bauxite refinery residue (MBRR) to decrease soil Pb mobility and bioaccessibility. Amendment experiments were conducted using four soils contaminated with Pb from various sources, including smelting, shooting-range activities and Pb-based paint waste. Lead L3-edge X-ray absorption spectroscopy (XAS) indicated that Pb speciation in these soils was a mixture of Pb sorbed to Fe (hydr)oxide and clay minerals, along with Pb bound to organic matter. Amendment with MBRR decreased water-soluble Pb and/or Toxicity Characteristic Leachate Procedure (TCLP) Pb concentrations. Lead L3-edge XAS and X-ray diffraction (XRD) indicated that Pb retention by MBRR occurred via sorption to Fe- and Al-(hydr)oxides at low Pb loadings, in addition to formation of hydrocerussite (Pb3(CO3)2(OH)2) at high loadings. Soil amendment with MBRR had relatively little effect on gastric-phase Pb bioaccessibility; as quantified via the Solubility/Bioavailability Research Consortium, SBRC, in vitro assay. In contrast, amendment with MBRR caused substantial decreases in relative intestinal-phase Pb bioaccessibility (Rel-SBRC-I) due to increased Pb sorption by MBRR's Fe- and Al-hydr(oxide) minerals as simulated GI tract conditions shifted from the gastric- to the intestinal-phase. These decreases in Rel-SBRC-I point to the potential efficacy of using amendment with MBRR to decrease soil Pb bioavailability.

Drought, megafires and flood - climate extreme impacts on catchment-scale river water quality on Australia's east coast.

Increased frequency and intensity of drought, wildfires and flooding due to climate change has major implications for river water quality, yet there are limited high-temporal resolution data capturing the combined transient impacts of these extreme events at large catchment scales. We present flow-stratified water quality data from a large coastal catchment (Macleay River, Australia) spanning severe drought and extensive fires followed by flooding. We examine concentrations (C), discharge (Q) and flux of suspended sediment, major ions, dissolved organic carbon (DOC) and key nutrients (NO3 and PO4), with a focus on the critical first-flush period after the fires. Highly elevated suspended sediment (∼5500 mg L-1; >100x median pre-fire levels) during the initial post-fire period reflected enhanced erosion from fire-impacted, high-relief landscapes, with peak monthly suspended sediment loads of ∼1.1-3.7 t ha-1. The greatest sensitivity to erosion was during initial flow events following fire, highlighting the compounding effect of sequential extreme events on sediment transport. Maximum solute concentrations typically occurred during the first hydrograph peak post-fire with significantly (P = 0.01) elevated major ions following the order of K>Ca>SO4>HCO3≈Mg>Cl>Na, broadly reflecting the composition of ash materials. Distorted CQ relationships for major ions, DOC and nutrients indicated mobilisation behaviour and enhanced surface runoff during initial hydrograph peaks post-fire, with mean concentrations and CQ relationships progressively shifting to those approximating pre-fire within ∼3-12 months. Elevated DOC (∼7x; P = 0.01) displays distinct changes in fluorescence excitation-emission matrix spectral characteristics, attributable to both fire and drought. Both NO3N (160 µM) and PO4 (7.5 µM) were significantly elevated after the fires (∼15-22x; P = 0.01), with maximum monthly loads of 0.82 and 0.14 kg ha-1 respectively. Fast biogeochemical cycling of dissolved inorganic nitrogen (DIN) species occurred during initial flow events following fire, with NH4N initially dominant (>80% of DIN) and exceeding ecosystem guideline threshold values (>100 µM NH4N), followed by rapid (∼1 week) nitrification. The extreme dynamism and transience of water quality parameters highlights the critical importance of high-frequency sampling to adequately capture the compound impacts drought, fires and floods on aquatic systems.

Antimonate Controls Manganese(II)-Induced Transformation of Birnessite at a Circumneutral pH.

Manganese (Mn) oxides, such as birnessite (δ-MnO2), are ubiquitous mineral phases in soils and sediments that can interact strongly with antimony (Sb). The reaction between birnessite and aqueous Mn(II) can induce the formation of secondary Mn oxides. Here, we studied to what extent different loadings of antimonate (herein termed Sb(V)) sorbed to birnessite determine the products formed during Mn(II)-induced transformation (at pH 7.5) and corresponding changes in Sb behavior. In the presence of 10 mM Mn(II)aq, low Sb(V)aq (10 µmol L-1) triggered the transformation of birnessite to a feitknechtite (ß-Mn(III)OOH) intermediary phase within 1 day, which further transformed into manganite (γ-Mn(III)OOH) over 30 days. Medium and high concentrations of Sb(V)aq (200 and 600 µmol L-1, respectively) led to the formation of manganite, hausmannite (Mn(II)Mn(III)2O4), and groutite (αMn(III)OOH). The reaction of Mn(II) with birnessite enhanced Sb(V)aq removal compared to Mn(II)-free treatments. Antimony K-edge extended X-ray absorption fine structure (EXAFS) spectroscopy revealed that heterovalent substitution of Sb(V) for Mn(III) occurred within the secondary Mn oxides, which formed via the Mn(II)-induced transformation of Sb(V)-sorbed birnessite. Overall, Sb(V) strongly influenced the products of the Mn(II)-induced transformation of birnessite, which in turn attenuated Sb mobility via incorporation of Sb(V) within the secondary Mn oxide phases.

Unconventionally Acquired Brain Injury: Guidance and Instruction About an Emerging Challenge to Warfighter Brain Health.

Special Operations Forces have made brain health a medical priority in recent years, and new guidance identified a new challenge-unconventionally acquired brain injury (UBI). Although this emerging condition is described as a cluster of neurosensory and cognitive symptoms with unknown etiology/ origin, there remain critical questions about how this diagnosis differs from other brain injuries. More importantly, there are limited recommendations about how medical personnel should approach the problem. The current discussion will provide context and information about UBI based on higher guidance and will also review the scant literature to provide context. Foremost, UBI can be distinguished from traumatic brain injury (TBI) largely due to an unknown point of injury. The described symptoms otherwise appear to be largely the same as TBI. Likewise, the recommended course of treatment is to follow the Clinical Practice Guidelines for mild TBI/TBI even if the injury is an actual or suspected UBI. Personnel must be careful to avoid entering sensitive information into the medical record, which may be particularly challenging if identifying the cause involves classified information about an unconventional weapon. Finally, we briefly discuss the literature about several suspected incidents fitting UBI diagnostic criteria, and we conclude with five primary takeaways for medical personnel to follow.

Bark-dwelling methanotrophic bacteria decrease methane emissions from trees.

Tree stems are an important and unconstrained source of methane, yet it is uncertain whether internal microbial controls (i.e. methanotrophy) within tree bark may reduce methane emissions. Here we demonstrate that unique microbial communities dominated by methane-oxidising bacteria (MOB) dwell within bark of Melaleuca quinquenervia, a common, invasive and globally distributed lowland species. In laboratory incubations, methane-inoculated M. quinquenervia bark mediated methane consumption (up to 96.3 µmol m-2 bark d-1) and reveal distinct isotopic δ13C-CH4 enrichment characteristic of MOB. Molecular analysis indicates unique microbial communities reside within the bark, with MOB primarily from the genus Methylomonas comprising up to 25 % of the total microbial community. Methanotroph abundance was linearly correlated to methane uptake rates (R2 = 0.76, p = 0.006). Finally, field-based methane oxidation inhibition experiments demonstrate that bark-dwelling MOB reduce methane emissions by 36 ± 5 %. These multiple complementary lines of evidence indicate that bark-dwelling MOB represent a potentially significant methane sink, and an important frontier for further research.

Isotopic evidence for axial tree stem methane oxidation within subtropical lowland forests.

Knowledge regarding mechanisms moderating methane (CH4 ) sink/source behaviour along the soil-tree stem-atmosphere continuum remains incomplete. Here, we applied stable isotope analysis (δ13 C-CH4 ) to gain insights into axial CH4 transport and oxidation in two globally distributed subtropical lowland species (Melaleuca quinquenervia and Casuarina glauca). We found consistent trends in CH4 flux (decreasing with height) and δ13 C-CH4 enrichment (increasing with height) in relation to stem height from ground. The average lower tree stem δ13 C-CH4 (0-40 cm) of Melaleuca and Casuarina (-53.96‰ and -65.89‰) were similar to adjacent flooded soil CH4 ebullition (-52.87‰ and -62.98‰), suggesting that stem CH4 is derived mainly by soil sources. Upper stems (81-200 cm) displayed distinct δ13 C-CH4 enrichment (Melaleuca -44.6‰ and Casuarina -46.5‰, respectively). Coupled 3D-photogrammetry with novel 3D-stem measurements revealed distinct hotspots of CH4 flux and isotopic fractionation on Melaleuca, which were likely due to bark anomalies in which preferential pathways of gas efflux were enhanced. Diel experiments revealed greater δ13 C-CH4 enrichment and higher oxidation rates in the afternoon, compared with the morning. Overall, we estimated that c. 33% of the methane was oxidised between lower and upper stems during axial transport, therefore potentially representing a globally significant, yet previously unaccounted for, methane sink.

Managing the observatory: discipline, order and disorder at Greenwich, 1835-1933.

This article presents a case study of life and work at the Royal Observatory at Greenwich (1835-1933) which reveals tensions between the lived reality of the observatory as a social space, and the attempts to create order, maintain discipline and project an image of authority in order to ensure the observatory's long-term stability. Domestic, social and scientific activities all intermingled within the observatory walls in ways which were occasionally disorderly. But life at Greenwich was carefully managed to stave off such disorder and to maintain an appearance of respectability which was essential to the observatory's reputation and output. The article focuses on three areas of management: (1) the observatory's outer boundaries, demonstrating how Greenwich navigated both human and environmental intrusions from the wider world; (2) the house, examining how Greenwich's domestic spaces provided stability, while also complicating observatory life via the management of domestic servants; and (3) the scientific spaces, with an emphasis on the work and play of the observatory's boy computers. Together, these three parts demonstrate that the stability of the observatory was insecure, despite being perpetuated via powerful physical and social boundaries. It had to be continually maintained, and was regularly challenged by Greenwich's occupants and neighbours.

Reductive transformation of birnessite and the mobility of co-associated antimony.

Manganese (Mn) oxide minerals, such as birnessite, are thought to play an important role in affecting the mobility and fate of antimony (Sb) in the environment. In this study, we investigate Sb partitioning and speciation during anoxic incubation of Sb(V)-coprecipitated birnessite in the presence and absence of Mn(II)aq at pH 5.5 and 7.5. Antimony K-edge XANES spectroscopy revealed that Sb(V) persisted as the only solid-phase Sb species for all experimental treatments. Manganese K-edge EXAFS and XRD results showed that, in the absence of Mn(II), the Sb(V)-bearing birnessite underwent no detectable mineralogical transformation during 7 days. In contrast, the addition of 10 mM Mn(II) at pH 7.5 induced relatively rapid (within 24 h) transformation of birnessite to manganite (~93%) and hausmannite (~7%). Importantly, no detectable Sb was measured in the aqueous phase for this treatment (compared with up to ∼90 µmol L-1 Sb in the corresponding Mn(II)-free treatment). At pH 5.5 , birnessite reacted with 10 mM Mn(II)aq displayed no detectable mineralogical transformation, yet had substantially increased Sb retention in the solid phase, relative to the corresponding Mn(II)-free treatment. These findings suggest that the Mn(II)-induced transformation and recrystallization of birnessite can exert an important control on the mobility of co-associated Sb.

Disability-Related Questions for Administrative Datasets.

High rates of unemployment among people with disability are long-standing and persistent problems worldwide. For public policy, estimates of prevalence and population profiles are required for designing support schemes such as Australia's National Disability Insurance Scheme; for monitoring implementation of the United Nations Convention on Rights of Persons with Disabilities; and for monitoring service access, participation, and equity for people with disability in mainstream systems including employment. In the public sector, creating a succinct identifier for disability in administrative systems is a key challenge for public policy design and monitoring. This requires concise methods of identifying people with disability within systems, producing data comparable with population data to gauge accessibility and equity. We aimed to create disability-related questions of value to the purposes of an Australian state and contribute to literature on parsimonious and respectful disability identification for wider application. The research, completed in 2017, involved mapping and identification of key disability concepts for inclusion in new questions, focus groups to refine wording of new questions, and online surveys of employees evaluating two potential new question sets on the topic of disability and environment. Recommendations for new disability-related questions and possible new data collection processes are being considered and used by the leading state authority.

Embedded Mental Health in the United States Marine Corps.

INTRODUCTION: Despite the rich history and progression of mental health assets and their utilization within the Marine Corps, the implementation of these assets has been varied and inconsistent. This article strives to take the lessons learned from the past and improve on them. The goal is to develop a consistent program focused on resiliency and retention, and propose an integrated organized structure across all the Marine Expeditionary Forces (MEF). MEANS AND METHODS: Review of the literature, current practices, and future recommendations. RESULTS: This article demonstrates that continuing to utilize mental health resources at the Regimental level with a focus on community mental health principles rather than the medical model allows for proximity to members and leadership of their primary command, immediate access to them as their Special Staff Officer, the ability to set the expectation of recovery, resiliency, and readiness, and the capability to implement simple principles of nonmedical recuperation and advisement. CONCLUSIONS: Improving on the organizational structure of mental health in the Marine Corps by placing a mental health Special Staff Officer at the MEF level and focusing on the principles of community mental health will shift the focus back to the primary and secondary prevention care efforts across all levels of the Marine Corps and provide clinical and leadership oversight as it relates to the philosophy, role, and implementation of organic mental health Officers.