Legalization of Medical Cannabis and Potential Implications for Healthcare Delivery in the United States

Cannabis legalization is currently a topic of significant interest within the American healthcare system. Existing research has demonstrated the effects of medical cannabis in alleviating manifestations of several common health conditions which affect many Americans, including cancer and chronic pain. Additionally, research has demonstrated that medical cannabis programs have positive implications for the objectives of government health initiatives such as the Institute for Healthcare Improvement (IHI) Triple Aim. Economic benefits from cannabis taxation have also been documented in states with active medical cannabis programs. While federal restrictions inhibit extensive cannabis research, the legalization of medical cannabis has significant implications for the American healthcare system in terms of cost, access, and quality. This paper is a review of current literature and research regarding medical cannabis legalization in the United States

Early childhood Child and Adolescent Needs and Strengths (CANS): Indiana multi-system comprehensive Glossary, v 2.2

The early childhood or Birth to Five CANS assessment tool is developmentally appropriate for infants, toddlers and preschoolers. Similar to the Comprehensive Child and Adolescent Needs and Strengths (CANS, Lyons, 2009) 5 to 17 tool, the early childhood version considers basic life dimensions or domains (social/emotional needs, risk factors, risk behaviors, daily life functioning, child strengths, acculturation and caregiver strengths and needs).Funded by the Indiana Family and Social Service Administration, Division of Mental Health and Addiction through a contract with Indiana University for Training and Consultative Services to support the meaningful use of the Child and Adolescent Needs and Strengths (CANS) and Adult Needs and Strengths Assessment (ANSA) tools

A Comparison of Ultraviolet, Optical, and X-Ray Imagery of Selected Fields in the Cygnus Loop

During the Astro-1 and Astro-2 Space Shuttle missions in 1990 and 1995, far ultraviolet (FUV) images of five 40' diameter fields around the rim of the Cygnus Loop supernova remnant were observed with the Ultraviolet Imaging Telescope (UIT). These fields sampled a broad range of conditions including both radiative and nonradiative shocks in various geometries and physical scales. In these shocks, the UIT B5 band samples predominantly CIV 1550 and the hydrogen two-photon recombination continuum. Smaller contri- butions are made by emission lines of HeII 1640 and OIII] 1665. We present these new FUV images and compare them with optical Halpha and [OIII], and ROSAT HRI X-ray images. Comparing the UIT images with those from the other bands provides new insights into the spatial variations and locations of these different types of emission. By comparing against shock model calculations and published FUV spectroscopy at select locations, we surmise that resonance scattering in the strong FUV permitted lines is widespread in the Cygnus Loop, especially in the bright optical filaments typically selected for observation in most previous studies.Comment: 21 pages with 10 figures. See http://www.pha.jhu.edu/~danforth/uit/ for full-resolution figure

Is confounding considered when estimating treatment-covariate interactions in individual participant data meta-analyses of randomised trials? Protocol for a methodological study

A key question for meta-analyses is reliably assessing whether treatment effects vary across different participant groups, thereby informing how best to treat individual patients. However, it is possible that evidence of an interaction is driven by a different, confounding factor. In a methodological study, we are aiming to assess what methods currently exist to deal with confounding when estimating treatment-covariate interactions and what methods are currently being used in practice. In this protocol, we describe the methodology we are employing in this study

The Importance of Data Visualization: Incorporating Storytelling into the Scientific Presentation

From its inception in 2000, one of the primary tasks of the Biomedical Data Reduction Analysis (BDRA) group has been translation of large amounts of data into information that is relevant to the audience receiving it. BDRA helps translate data into an integrated model that supports both operational and research activities. This data integrated model and subsequent visual data presentations have contributed to BDRA's success in delivering the message (i.e., the story) that its customers have needed to communicate. This success has led to additional collaborations among groups that had previously not felt they had much in common until they worked together to develop solutions in an integrated fashion. As more emphasis is placed on working with "big data" and on showing how NASA's efforts contribute to the greater good of the American people and of the world, it becomes imperative to visualize the story of our data to communicate the greater message we need to share. METHODS To create and expand its data integrated model, BDRA has incorporated data from many different collaborating partner labs and other sources. Data are compiled from the repositories of the Lifetime Surveillance of Astronaut Health and the Life Sciences Data Archive, and from the individual laboratories at Johnson Space Center that support collection of data from medical testing, environmental monitoring, and countermeasures, as designated in the Medical Requirements Integration Documents. Ongoing communication with the participating collaborators is maintained to ensure that the message and story of the data are retained as data are translated into information and visual data presentations are delivered in different venues and to different audiences. RESULTS We will describe the importance of storytelling through an integrated model and of subsequent data visualizations in today's scientific presentations and discuss the collaborative methods used. We will illustrate the discussion with examples of graphs from BDRA's past work supporting operations and/or research efforts

3-D modelling and assessment of tidal current resources in the Bay of Fundy, Canada

The Bay of Fundy, located between the Canadian Provinces of Nova Scotia and New Brunswick, is home to the world’s largest tides and has long been identified as one of the world’s premier resources of tidal energy. This paper describes the development of a high resolution three-dimensional hydrodynamic model of tidal flows in the Bay of Fundy, and its application to help quantify and assess the kinetic energy resource throughout the Bay. Information on the scale and character of the tidal currents and the associated kinetic energy resource is presented herein for three of the most energetic parts of the Bay: near Long Island, Passamaquoddy Bay and Minas Passage (where a $70 million pre-commercial deployment of in-stream turbines is presently underway)

Bremelanotide for Treatment of Female Hypoactive Sexual Desire

Hypoactive sexual desire disorder (HSDD) is a persistent deficiency or absence of sexual fantasies and desire resulting in significant distress or interpersonal difficulty. Women with this disorder may display a lack of motivation for sexual activity, reduced responsiveness to erotic cues, a loss of interest during sexual activity, and avoidance of situations that could lead to sexual activity. The pathophysiology of HSDD is thought to be centered around inhibitory and excitatory hormones, neurotransmitters, and specific brain anatomy. Due to the multifactorial nature of HSDD, treatment can be complex and must attempt to target the biological and psychosocial aspects of the disorder. Bremelanotide is a melanocortin receptor agonist and has been recently approved by the FDA to treat HSDD. Bremelanotide is administered intranasally or as a subcutaneous injection. The recommended dosage of bremelanotide is 1.75 mg injected subcutaneously in the abdomen or thigh at least 45 min before sexual activity. Studies showed improvements in desire, arousal, and orgasm scores when 1.75 mg of bremelanotide was administered before sexual activity compared to a placebo. Bremelanotide is a promising way to treat HSDD

Antipsychotic Polypharmacy-Related Cardiovascular Morbidity and Mortality: A Comprehensive Review

Schizophrenia is a psychotic disorder that exists at the more extreme end of a spectrum of diseases, and significantly affects daily functioning. Cardiovascular adverse effects of antipsychotic medications are well known, and include changes in blood pressure and arrhythmias. Sudden cardiac death is the leading cause of death worldwide, and antipsychotic medications are associated with numerous cardiac side effects. A possible link exists between antipsychotic medications and sudden cardiac death. Common prescribing patterns that may influence cardiovascular events include the use of multiple antipsychotics and/or additional drugs commonly prescribed to patients on antipsychotics. The results of this review reflect an association between antipsychotic drugs and increased risk of ventricular arrhythmias and sudden cardiac death by iatrogenic prolongation of the QTc interval. QTc prolongation and sudden cardiac death exist in patients taking antipsychotic monotherapy. The risk increases for the concomitant use of specific drugs that prolong the QTc interval, such as opioids, antibiotics, and illicit drugs. However, evidence suggests that QTc intervals may not adequately predict sudden cardiac death. In considering the findings of this narrative review, we conclude that it is unclear whether there is a precise association between antipsychotic polypharmacy and sudden cardiac death with QTc interval changes. The present narrative review warrants further research on this important potential association

Lumateperone tosylate, A Selective and Concurrent Modulator of Serotonin, Dopamine, and Glutamate, in the Treatment of Schizophrenia

Purpose of Review This is a comprehensive review of the literature regarding the use of Lumateperone tosylate for schizophrenia. This review presents the background, evidence, and indications for the use of lumateperone tosylate in the treatment of schizophrenia. Recent Findings Schizophrenia is a chronic mental health disorder that affects approximately 3.3 million people in the United States. Its symptoms, which must be present more than six months, are comprised of disorganized behavior and speech, a diminished capacity to comprehend reality, hearing voices unheard by others, seeing things unseen by others, delusions, decreased social commitment, and decreased motivation. The majority of these symptoms can be managed with antipsychotic medication. Lumateperone is a selective and concurrent modulator of serotonin, dopamine, and glutamate, which all mediate or modulate serious mental illness. Summary Schizophrenia is a complex, severe mental illness that affects how the brain processes information. There are many medications used to treat schizophrenia. One antipsychotic agent, lumateperone tosylate, is a newer agent that the FDA recently approved. The most common adverse effects are shown to be mild such as somnolence, constipation, sedation, and fatigue, with the 42 mg recommended dose. Lumateperone tosylate is an FDA-approved drug that can be given only at the 42mg dose once daily with no titration requirements

The Possible Application of Ketamine in the Treatment of Depression in Alzheimer\u27s Disease

Depression is a leading cause of disability globally, with a prevalence of 3.8% among the whole population, 5% of the adult population, and 5.7% of the elderly population over 60 years of age. There is evidence that depression is linked to certain neurodegenerative diseases, one being Alzheimer\u27s disease (AD). The efficacy of conventional antidepressants to treat depression in AD is conflicting, especially regarding selective serotonin reuptake inhibitors (SSRIs). A recent systemic review and meta-analysis of 25 randomized controlled trials including fourteen antidepressant medications showed no high efficacy in treating AD patients\u27 symptoms. However, ketamine, a nonselective N-methyl-D-aspartate (NMDA) receptor antagonist, can mediate a wide range of pharmacological effects, including neuroprotection, anti-inflammatory and anticancer properties, multimodal analgesia, and treatment of depression, suicidal attempts, and status epilepticus. Esketamine, which is ketamine formulated as a nasal spray, was approved by the Federal Drug Administration (FDA) in March 2019 as an adjuvant drug to treat treatment-resistant depression. NMDA receptor antagonists treat AD through offsetting AD-related pathological stimulation of subtypes of glutamate receptors in the central nervous system. Recent clinical findings suggest that ketamine may provide neuroprotection and reduce neuropsychiatric symptoms associated with AD. In the present investigation, we evaluate the potential role of ketamine and its postulated mechanism in AD management