The Philosophy of the Counterculture

The traditional American framework for political and social action is being increasingly challenged by members of a counterculture calling for a radically different society

France: A Political Culture Divided Against Itself

On New Year\u27s Day, 1968, the President of the French Republic addressed the French nation on the prospects of the coming year. De Gaulle was quite sanguine about immediate future, and indeed he had reason to be

Program ACTIVE: Cognitive Behavioral Therapy to Treat Depression in Adults With Type 2 Diabetes in Rural Appalachia

High rates of type 2 diabetes (T2DM) and depression exist in rural Appalachia with limited access to psychotherapeutic treatment. No manualized cognitive behavioral therapy (CBT) treatment materials exist that are culturally tailored for individuals in this region with T2DM. We describe the development of the Program ACTIVE CBT intervention for use with adults with T2DM and depression by mental health providers in rural Appalachia. Qualitative and quantitative methods were used to test the feasibility and acceptability of Program ACTIVE. Intervention materials were rated at the 6th-7th grade reading level. Key informant interviews evaluated materials as culturally sensitive and accessible. Participants indicated high levels of satisfaction with therapy (94%), support from their therapist (86%), and usefulness of therapy and depression improvement (80.3%). Program ACTIVE was found to be a feasible and acceptable culturally tailored manualized CBT treatment for adults with T2DM and depression living in rural Appalachia. Implementation of these materials on a regional scale needs to be assessed

Prevalence of Treated Behavioral Disorders among Adult Shelter Users: A Longitudinal Study

Of 27,638 homeless adults admitted to Philadelphia public shelters in the years 1990 through 1992, 20.1% received treatment for a mental health disorder, and 25.3% for a substance use disorder in the years 1985 through 1993. An additional 20.7% were identified as having untreated substance use problems. Overall, a total of 65.5% of adult shelter users were identified as ever having had a mental health or substance use problem, treated or untreated

The Treated Prevalence of Mental Health and Substance Use Disorders among Adults Admitted to the Philadelphia Shelter System: Results from the Integration of Longitudinal Data on Shelter and Mental Health Services Utilization

This paper reports results from a study of the treated prevalence of mental health and substance use disorders among adults admitted to Philadelphia public shelters between 1990 and 1992 (N=28,638). Identifiers and service records from longitudinal databases on shelter and mental health services were merged, finding that 49% of single homeless adults and 33.2% of homeless adults with children had a treatment for a mental health or substance use disorder between 1985 and 1993. The rate of treatment for serious mental illness (SMI) was 10.7% (by most frequently occurring diagnosis). Single women (18.6%) had twice the rate of SMI as single men (9.9%), and single adults (12.1%) had twice the rate of SMI as adults with children (6.2%). The treatment rate of substance use disorders (25.2%) was higher than the rate of mental health disorders (20%), and was twice as high for single adults (28.6%) as for adults with children (14.6%). An additional 20% of adult shelter users were identified through shelter records as having untreated substance use problems. Veterans had comparable rates of disorders as nonveterans. Overall, 65% of adult shelter users were identified as ever having some mental health or substance use problem, treated or untreated. People with SMI were less represented among shelter users on two single day censuses than over three years, suggesting a higher rate of turnover among people with SMI, while people with substance use disorders were overrepresented by a third on the two single day censuses, suggesting a lower rate of turnover among people treated for substance abuse. Of the treated Medicaid population, 6.8% became homeless in the three year study period, representing 7.8% of the treated population with SMI, 9.5% of the treated schizophrenia population, and 20.1% of the population receiving inpatient substance abuse services. Approximately 3,000 people with SMI became homeless in the 3-year study period, with an average of 73 people with SMI entering shelter for the first time each month. An analysis of inpatient usage found that 25.7% of the SMI and 34.2% of the treated substance abuse population were hospitalized within 120 days of their first shelter admission (before or after). Fourteen percent of the SMI were also seen in an emergency room within 120 days of shelter admission (before or after)

Exploration of Latina/Hispanic Women\u27s Experiences Living With Non-Alcoholic Fatty Liver Disease: a Qualitative Study With Patients in Houston

OBJECTIVES: A deeper understanding of the lived experiences of Hispanic patients with non-alcoholic fatty liver disease (NAFLD) can help guide the development of behavioral programs that facilitate NAFLD management. This paper explores Hispanic women\u27s experiences living with NAFLD. DESIGN, SETTING, PARTICIPANTS: We collected brief sociodemographic questionnaires and conducted in-depth interviews with 12 low-income (all had household income ≤USD$55 000 per year) Hispanic women with NAFLD from the Houston area. Transcripts were audio-recorded and transcribed. We developed a coding scheme and used thematic analysis to identify emergent themes, supported by Atlas.ti. RESULTS: Participants identified physicians as their main information source on NAFLD but also consulted the internet, family, friends and peers. Many were still left wanting more information. Participants identified family history, sedentary lifestyles, poor diet and comorbid conditions as causes for their NAFLD. Participants also reported emotional distress after diagnosis. Participants experienced both successes and challenges in making lifestyle changes in nutrition and physical activity. Some participants received desired social support in managing NAFLD, although there were conflicting feelings about spousal support. CONCLUSION: Multifaceted programming that improves patient-provider communication, conveys accurate information and enhances social support is needed to support Hispanic women in managing NAFLD

Changing the spatial location of electricity generation to increase water availability in areas with drought: a feasibility study and quantification of air quality impacts in Texas

The feasibility, cost, and air quality impacts of using electrical grids to shift water use from drought-stricken regions to areas with more water availability were examined. Power plant cooling represents a large portion of freshwater withdrawals in the United States, and shifting where electricity generation occurs can allow the grid to act as a virtual water pipeline, increasing water availability in regions with drought by reducing water consumption and withdrawals for power generation. During a 2006 drought, shifting electricity generation out of the most impacted areas of South Texas (~10% of base case generation) to other parts of the grid would have been feasible using transmission and power generation available at the time, and some areas would experience changes in air quality. Although expensive, drought-based electricity dispatch is a potential parallel strategy that can be faster to implement than other infrastructure changes, such as air cooling or water pipelines.National Science Foundation (U.S.). Office of Emerging Frontiers in Research and Innovation (Grant 0835414)United States. Dept. of Energ

Long term health related quality of life following colorectal cancer surgery: patient reported outcomes in a remote follow-up population

Background: Remote follow-up (RFU) after colorectal cancer (CRC) surgery allows delivery of surveillance tests without the need for regular outpatient clinical appointments. However, little is known about health related quality of life (HRQoL) in RFU patients.Methods: EQ-5D, QLQ-C30 and QLQ-C29 questionnaires were distributed to CRC patients enrolled in a RFU programme. The primary outcome of HRQoL scores was analysed by year of RFU, demographics, operation-type, stoma and adherence to RFU protocols. Results:428 respondents (59.3%), mean age of 71years(SD 10.1) and a median RFU time of 2.6years (IQR: 1.6-4.8 years) were included. 26.6% of patients reported ‘perfect health’. The median EQ-5D index score was 0.785 (IQR: 0.671-1) and QLQ-C30 Global HRQoL score was 75 (IQR: 58.3-83.3). Females had significantly lower EQ-5D median score of 0.767 (IQR: 0.666-0.879, p=0.0088). Lower QLQ-C30 HRQoL scores were seen in stoma patients, median 66.6 (IQR: 58.3-83.3, p=0.0029). Erectile dysfunction (p=0.0006) and poor body image (p=0.001) were also reported more frequently in stoma patients. Patients undergoing right-sided resection reported a lower median EQ-5D score of 0.765 (IQR: 0.666-0.879, p=0.028) and higher pain severity (p=0.0367) compared with left-sided resections. There were 128 (29.4%) patients that breached RFU protocol and were seen in adhoc colorectal clinics. However, there was no statistical difference in HRQoL between patients who adhered to or breached RFU protocols.Conclusions: Overall HRQoL in patients in RFU is good, with no difference in those strictly followed up remotely. However, females, right-sided resections and patients with stomas may require additional clinical reviews.

Regional Climate Response Collaboratives: Multi-Institutional Support for Climate Resilience

Federal investments by U.S. agencies to enhance climate resilience at regional scales grew over the past decade (2010s). To maximize efficiency and effectiveness in serving multiple sectors and scales, it has become critical to leverage existing agency-specific research, infrastructure, and capacity while avoiding redundancy. We discuss lessons learned from a multi-institutional "regional climate response collaborative" that comprises three different federally supported climate service entities in the Rocky Mountain west and northern plains region. These lessons include leveraging different strengths of each partner, creating deliberate mechanisms to increase cross-entity communication and joint ownership of projects, and placing a common priority on stakeholder-relevant research and outcomes. We share the conditions that fostered successful collaboration, which can be transferred elsewhere, and suggest mechanisms for overcoming potential barriers. Synergies are essential for producing actionable research that informs climate-related decisions for stakeholders and ultimately enhances climate resilience at regional scales.</p

Evidence for the submarine weathering of silicate minerals in Black sea sediments: possible implications for the marine Li and B cycles

[1] The role of sediment diagenesis in the marine cycles of Li and B is poorly understood. Because Li and B are easily mobilized during burial and are consumed in authigenic clay mineral formation, their abundance in marine pore waters varies considerably. Exchange with the overlying ocean through diffusive fluxes should thus be common. Nevertheless, only a minor Li sink associated with the low-temperature alteration of volcanic ash has been observed. We describe a low-temperature diagenetic environment in the Black Sea dominated by the alteration of detrital plagioclase feldspars. Fluids expelled from the Odessa mud volcano in the Sorokin Trough originate from shallow (≈100–400 m deep) sediments which are poor in volcanic materials but rich in anorthite. These fluids are depleted in Na+, K+, Li+, B, and 18O and enriched in Ca2+ and Sr2+, indicating that anorthite is dissolving and authigenic clays are forming. Using a simple chemical model, we calculate the pH and the partial pressure of CO2 (PCO2) in fluids associated with this alteration process. Our results show that the pH of these fluids is up to 1.5 pH units lower than in most deep marine sediments and that PCO2 levels are up to several hundred times higher than in the atmosphere. These conditions are similar to those which favor the weathering of silicate minerals in subaerial soil environments. We propose that in Black Sea sediments enhanced organic matter preservation favors CO2 production through methanogenesis and results in a low pore water pH, compared to most deep sea sediments. As a result, silicate mineral weathering, which is a sluggish process in most marine diagenetic environments, proceeds rapidly in Black Sea sediments. There is a potential for organic matter-rich continental shelf environments to host this type of diagenesis. Should such environments be widespread, this new Li and B sink could help balance the marine Li and Li isotope budgets but would imply an apparent imbalance in the B cycle