Trends and correlates of marijuana use among late middle-aged and older adults in the United States, 2002–2014

BACKGROUND: Recent trend studies suggest that marijuana use is on the rise among the general population of adults ages 18 and older in the United States. However, little is known about the trends in marijuana use and marijuana-specific risk/protective factors among American adults during the latter part of adulthood. METHOD: Findings are based on repeated, cross-sectional data collected from late middle-aged (ages 50–64) and older adults (ages 65 and older) surveyed as part of the National Survey on Drug Use and Health between 2002 and 2014. RESULTS: The prevalence of past-year marijuana use among late middle-aged adults increased significantly from a low of 2.95% in 2003 to a high of 9.08% in 2014. Similarly, the prevalence of marijuana use increased significantly among older adults from a low of 0.15% in 2003 to a high of 2.04% in 2014. Notably, the upward trends in marijuana use remained significant even when accounting for sociodemographic, substance use, behavioral, and health-related factors. We also found that decreases in marijuana-specific protective factors were associated with the observed trend changes in marijuana use among late middle-aged and older adults, and observed a weakening of the association between late-middle aged marijuana use and risk propensity, other illicit drug use, and criminal justice system involvement over the course of the study. CONCLUSIONS: Findings from the present study provide robust evidence indicating that marijuana use among older Americans has increased markedly in recent years, with the most evident changes observed between 2008 and 2014

Ciprofloxacin and Clozapine: A Potentially Fatal but Underappreciated Interaction

Objective. Clozapine provides a 50%–60% response rate in refractory schizophrenia but has a narrow therapeutic index and is susceptible to pharmacokinetic interactions, particularly with strong inhibitors or inducers of cytochrome P450 (CYP) 1A2. Case Report. We report the case of a 28-year-old nonsmoking female with intellectual disability who was maintained for 3 years on clozapine 100 mg orally twice daily. The patient was treated for presumptive urinary tract infection with ciprofloxacin 500 mg orally twice daily and two days later collapsed and died despite resuscitation efforts. The postmortem femoral clozapine plasma level was dramatically elevated at 2900 ng/mL, and the cause of death was listed as acute clozapine toxicity. Conclusion. Given the potentially fatal pharmacokinetic interaction between clozapine and ciprofloxacin, clinicians are advised to monitor baseline clozapine levels prior to adding strong CYP450 1A2 inhibitors, reduce the clozapine dose by at least two-thirds if adding a 1A2 inhibitor such as ciprofloxacin, check subsequent steady state clozapine levels, and adjust the clozapine dose to maintain levels close to those obtained at baseline

Review of the United States Environmental Protection Agency Superfund Technical Assistance Grant Program

The EPA Technical Assistance Grant Program has been around for several years, but there are not many examples of its use in the Pacific Northwest from which citizens can learn from when considering applying for a Technical Assistance Grant. The EPA program is designed to provide citizens with technical assistance in understanding the issues related to a Superfund site (or proposed Superfund site) in their community. This report provides an overview of the Technical Assistance Grant Program with information on applying for the grant, selecting a Technical Advisor and managing the grant. Additionally two case studies are reviewed in order to provide some examples of the process and provide a better understanding of the steps involved for new communities interested in utilizing this EPA program. By examining both the TAG process and some examples of its implementation, interested citizens will be better prepared for the grant process, the efforts involved, and the benefits of the grant program

Evaluation of Various Culture Media for Detection of Rapidly-Growing Mycobacteria from Patients with Cystic Fibrosis.

Isolation of nontuberculous mycobacteria (NTM) from the sputum of patients with cystic fibrosis (CF) is challenging due to overgrowth by rapidly growing species that colonize the lungs of patients with CF. Extended incubation on Burkholderia cepacia selective agar (BCSA) has been recommended as an expedient culture method for the isolation of rapidly growing NTM in this setting. The aim of this study was to assess five selective media designed for the isolation of Burkholderia cepacia complex, along with two media designed for the isolation of mycobacteria (rapidly growing mycobacteria [RGM] medium and Middlebrook 7H11 agar), for their abilities to isolate NTM. All seven media were challenged with 147 isolates of rapidly growing mycobacteria and 185 isolates belonging to other species. RGM medium was then compared with the most selective brand of BCSA for the isolation of NTM from 224 sputum samples from patients with CF. Different agars designed for the isolation of B. cepacia complex varied considerably in their inhibition of other bacteria and fungi. RGM medium supported the growth of all isolates of mycobacteria and was more selective than any other medium. NTM were recovered from 17 of 224 sputum samples using RGM medium, compared with only 7 samples using the most selective brand of BCSA (P = 0.023). RGM medium offers a superior option, compared to other selective agars, for the isolation of rapidly growing mycobacteria from the sputum of patients with CF. Furthermore, the convenience of using RGM medium enables routine screening for rapidly growing NTM in all submitted sputum samples from patients with CF

Age-Independent Increases in Male Salivary Testosterone During Horticultural Activity Among Tsimane Forager-Farmers

Testosterone plays an important role in mediating male reproductive trade-offs in many vertebrate species, augmenting muscle and influencing behavior necessary for male-male competition and mating-effort. Among humans, testosterone may also play a key role in facilitating male provisioning of offspring as muscular and neuromuscular performance are deeply influenced by acute changes in testosterone. This study examines acute changes in salivary testosterone among 63 Tsimane men ranging in age from 16–80 (mean 38.2) years during one-hour bouts of treechopping while clearing horticultural plots. The Tsimane forager-horticulturalists living in the Bolivian Amazon experience high energy expenditure associated with food production, have high levels of parasites and pathogens, and display significantly lower baseline salivary testosterone than age-matched US males. Mixed-effects models controlling for BMI and time of specimen collection reveal increased salivary testosterone (p\u3c0.001) equivalent to a 48.6% rise, after one hour of tree chopping. Age had no effect on baseline (p=0.656) or change in testosterone (p=0.530); self-reported illness did not modify testosterone change (p=0.488). A comparison of these results to the relative change in testosterone during a competitive soccer tournament in the same population reveals larger relative changes in testosterone following resource production (tree chopping), compared to competition (soccer). These findings highlight the importance of moving beyond a unidimensional focus on changes in testosterone and male-male aggression to investigate the importance of testosterone-behavior interactions across additional male fitness-related activities. Acutely increased testosterone during muscularly intensive horticultural food production may facilitate male productivity and provisioning

MANAGING COMMON NIGHTHAWKS AT MCCONNELL AIR FORCE BASE, KANSAS, TO REDUCE AIRCRAFT STRIKES

McConnell Air Force Base (AFB) experiences a unique bird/aircraft hazard problem with migrating common nighthawks from August to October. Nighthawks are the most commonly struck species at McConnell AFB, representing about 38% of reported bird/aircraft strikes. During August and September, nighthawks represented 82% of the bird strikes found on the airfield. Approaches for managing nighthawks on and around airfields are limited because of the night environment, logistics and an incomplete understanding of nighthawk behavior. We determined the number of nighthawks using McConnell AFB and associated foraging, loafing and roosting areas, analyzed their food habits, and developed a translocation management strategy to reduce hazards to aircraft. During 1998, 1999 and 2000, we observed 600, 540 and 920 nighthawks, respectively, on the airfield. The greatest activity on the airfield occurred from September 27-30 in 1998, September 9- 14 in 1999, and September 6-8 in 2000. The peak number of nighthawks observed using the airfield during these periods was 142, 90 and 118, respectively. Nighthawks foraged around the airfield mainly between 1800 and 2200 and usually roosted on the airfield about 1800 with a peak between 2200 and 0200. During one 2-hour survey period in 1999 and 2000, 37 and 59 nighthawks, respectively, were flushed from the airfield. Thirty-seven nighthawks collected during the study consumed mostly corn earworm moths (Noctuidae) and beetles (Scarabaeidae). Management of nighthawks on McConnell AFB has been difficult because commonly used hazing techniques seem to be ineffective; these birds usually return to the same roosting location after being flushed, which can present an even greater risk to aircraft. We developed and evaluated a unique technique for capturing and translocating nighthawks from the airfield. Only 1 of 214 nighthawks translocated 88 km from McConnell AFB returned. Nighthawk/aircraft strikes at McConnell AFB declined from 9 in 1998, when no translocation was conducted, to 0 in 1999 and 3 in 2000