Co-Occurring Disorders: An Outpatient Latent Class Analysis

Over the past 20 years researchers and health care practitioners have come to realize in addition to high prevalence rates, individuals with co-occurring disorders did not represent a homogeneous group (Drake, et al., 1998: 2001; Lehman, et al., 1994: 2000; Mueser, et al., 2000). It is essential to consider the heterogeneity of co-occurring disorders when considering new treatment modalities. Thus, it becomes pivotal to identify these differences for treatment approaches and program goals. Research shows that heterogeneity of treatment populations can be reduced through empirically-derived homogeneous groups based on multivariate analysis (Ries, et al., 1993; Lehman et al., 2000; Mueser, et al., 2000). The purpose of the current study was to address a significant void in knowledge on the heterogeneity of co-occurring disorders by determining if homogeneous subgroups exist within an outpatient population presenting for treatment and if so how many groups exist and what makes up group membership. Identification of subgroups can provide a mechanism to better understand the interrelationships between determinants that contribute to the etiology and problem severity at an individual and group level. Secondly, in an effort to improve service delivery, empirically-derived subgroups hold important clinical implications for treatment models. The exploratory research was conducted through a retrospective analysis seeking a parsimonious model of subgroups made up of individuals with co-occurring disorders entering an outpatient program using a latent class analysis (LCA). The best fitting statistical model in the latent class analysis was one in which the overall sample was composed of three (3) subgroups. The three-class model that included alcohol use, illegal drug use, education level and serious depression was identified as best fitting the data

Assessing the impact of the Lake Kissimmee restoration on apple snails

Seasonal fluctuations in rainfall occur naturally in Florida, historically producing correspondingly large intra-annual and inter-annual fluctuations in lake water levels. As a result, "normal" lake levels are elusive; the norm is for wide fluctuations, a pattern which earned them the descriptive title, "astatic", or unstable (Brenner et. al. 1990). Lake Kissimmee, in Osceola County, FL, had a mean average water level fluctuation of 1.4 meters, but over several years varied as much as 3.7 meters (Grocki 1975).The substrate and vegetative communities, in part, reflect the pattern of hydrologic fluctuations, their timing, duration, and frequency. Topographic variability in lake systems, coupled with their hydrologic patterns, yield a mosaic of shrubby, emergent and submerged plant habitats in the littoral zone of the lake. Fish and wildlife have adapted accordingly, and successfully forage and reproduce in these highly fluctuating systems. Installation and operation of water control structures over the past 40 to 50 years have dampened the degree of hydrologic fluctuations in many Florida lakes, resulting in long term stabilization oflake levels [Holcomb and Wegener 1971, Wegener et. al. 1974, Fox et. al. 1977, Moyer and Williams 1982, Florida Game and Fresh Water Fish Commission (GFC) 1995]. The mean annual flux on Lake Kissimmee was reduced from 1.4 meters to 0.9 meters (Wegener et al 1973). In addition, increased nutrient inputs to Florida's watersheds from agricultural and urban development have resulted in lake eutrophication (Wegener et. al. 1974, Moyer and Williams 1982). As nutrients increased and water levels stabilized, rooted aquatic macrophytes expanded and organic debris accumulated to form undesirable lake substrates. Fish populations suffer from drops in accumulated to form undesirable lake substrates. Fish populations suffer from drops in dissolved oxygen associated with decaying algae and plant matter, the alteration of plant community composition, and poor habitat quality of the substrate (Wegener and Williams 1974). To remedy these problems in Florida lakes, the Florida Game and Fresh Water Fish Commission initiated a lake restoration program in 1971 which emphasizes the use of a lake draw down to expose sediments (GFC 95). The objective ofthe program is to reduce undesirable plant species, expand desirable plant communities, and consolidate flocculent organic sediments (Holcomb and Wegener 1971, Wegener et. al. 1974, Fox et. al. 1977, Cooke 1980, Tarver 1980, GFC 1995). In addition, muck removal operations following lake level draw downs are meant to resolve the problem of extensive build up of organic sediments (GFC 1995, Moyer et. al. 1995). The goal of the draw down and restoration activity is to improve aquatic habitat in support of fisheries and wildlife while improving lake quality for recreational usage (e.g. sport fishing) (Wegener and Williams 1974, Tarver 1980,. GFC 1995). The Florida Game and Fresh Water Fish Commission (GFC), in cooperation with the South Florida Water Management District (SFWMD), conducted a draw down of Lake Kissimmee from December 1995- June 1996, dropping lake levels by approximately 1.7 meters. The Lake Kissimmee draw down provided an excellent opportunity to investigate the impact of management techniques on an invertebrate which is a critical component of the central lakes food web, the Florida apple snail (Pomacea paludosa, SAY). Although data on the responses of some invertebrate species 2 to draw downs in central Florida are available (Wegener et. al. 1974, Fox et. al. 1977, Butler et. al. 1992), no published studies document the responses of P. paludosa. The Florida apple snail belongs to the tropical family of aquatic snails, Pilidae, which inhabitant wetland areas in Florida, Central and South America, Africa and India. Most Pilidae habitat typically (under natural hydrologic patterns) experiences a seasonal dry down, and the Florida apple snail is no exception. Pilidae snails utilize both a lung and gill for respiration (Andrews 1965). The dual respiratory system enables these animals to tolerate daily and seasonal dissolved oxygen fluctuations, permits egg-laying above water level (eggs thus avoid hypoxia and predation), and, in some Pilid species, enables adults to maintain aerobic respiration during the dry-season (McClary 1964, Burky et al. 1972, Aldridge 1983). Apple snails are critical components of lake food webs in Florida. They are prey to alligators (Alligator mississippiensis)( Delany and Abercrombie 1986), fish (Lepomis microlophus)(Chable 1947), turtles (Trionyxferox) (Dalrymple 1977), and ibis (Eudocimus albus)(Kushlan 1974). Apple snails comprise over 75% ofthe diet of the limpkins (Aramus guaraunaXCottam 1942), and nearly 100% ofthe diet of endangered snail kite (Rostramus sociabilis)(Snyder and Snyder 1969). Although the majority of the snail kite population occupies wetland habitats in south Florida throughout the year, they have been found to emigrate from this area when the dry season escalates into a prolonged drought (Beissinger and Takekawa 1983, Bennetts and Kitchens 1997). Researchers have identified the central lakes system as a critical refuge for the snail kite during these droughts (Beissinger and Takekawa 1983, Bennetts and Kitchens 1997). In 3 addition, the kites have been consistently nesting (even in non-drought years) on Lake Kissimmee and Lake Tohopekaliga since the early 1980's, providing further support (in the form of suitable foraging and nesting habitat) for the endangered kite population (Beissinger and Takekawa 1983, Bennetts and Kitchens 1997). The impetus for the Lake Kissimmee draw down is habitat improvement for fisheries and wildlife (GFC 1995). A conservation priority ranking system for Florida wildlife identifies the snail kite and limpkin, largely due to their specialized diet of apple snails, as deserving special attention for monitoring and management (Milsap et. a1. 1990).Moyer et a1. 1991 specifically recommended an evaluation ofthe impact of lake draw downs on apple snails. In this report we present the findings of a three-year study ofthe immediate and long term impacts ofthe Lake Kissimmee draw down and restoration activity on apple snail populations. The objectives ofthis research are as follows: • To study the impacts oflake restoration activity (e.g. draw down, muck removal) on snail populations in several sites throughout the lake by assessing pre-draw down and post-draw down snail abundance~ • To study the movement patterns of snails to find out what proportion ofthe population migrates to deeper water or become stranded in the dry down area as lake levels recede; • To study the capacity for snails to survive in dry down conditions (Document has 55 pages

Dry Down Tolerance of the Florida Apple Snail (Pomacea paludosa, Say): Effects of Age and Season

This Research Work Order includes three experiments to look at apple snail dry down survival as a function of age and season. Two of those experiments have been completed and the third one will likely run through February (depending on snail survival). The third experiment began on September 2 1, 1998. The detailed results of Experiment # 1 and #2 were reported in the update report of 10/15/98. The overall survival for Experiments #I and #2 are included herein for comparison with Experiment #3. (7 page document

Sex Education in the Schools: What Role Does it Play?

Information regarding pubertal development, sex, pregnancy, and contraception should be provided to children and adolescents in an age-appropriate manner from parents, health care providers, and schools. This article reviews the medical literature on school sex education programs, adolescents\u27 perception of these programs, and the role played by the media, parents, and health care professionals in sexual education of teens

Evaluating Split Nitrogen Applications and In-Season Tests for Organic Winter Bread Wheat

Achieving high grain yields and crude protein (CP) standards in organic winter wheat (Triticum aestivum L.) is challenging because ensuring that adequate nitrogen (N) is available at key periods of wheat growth is difficult in organic systems. Split application regimes and in-season N management tests may improve organic production. In field trials conducted over four site-years in Maine and Vermont, USA, N application regimes were analyzed for their effects on organic winter wheat, N uptake, grain yield, and CP. Tiller density and tissue N tests were evaluated as in-season decision tools. Eight treatments arranged in a non-factorial design differed in terms of N application timing (pre-plant (PP), topdress at tillering (T1), and topdress at pre-stem extension (T2)) and N rate. Treatments were: (1) an untreated check, (2) pre-plant N at a low rate of 78 kg N ha−1(PPL), (3) pre-plant N at a high rate of 117 or 157 kg N ha−1 (PPH), (4) T178, (5) PPL + T139, (6) PPL + T239, (7) PPH + T239, and (8) PPL + T139 +T239. Responses to N treatments were variable among site-years, however some common results were identified. The PP-only treatments increased grain yields more than they increased CP. The T178 and PPH + T239 treatments were the most effective at increasing yield and CP, compared with the PP-only treatments. Tiller density and tissue N tests were good predictors of grain yield (r = 0.52, p < and CP (r = 0.75, p < 0.001) respectively. Future work should test in-season decision tools using a wider range of tiller densities, and topdress N rates against tissue N measurements

Survival outcome and EMT suppression mediated by a lectin domain interaction of Endo180 and CD147

Epithelial cell-cell contacts maintain normal glandular tissue homeostasis, and their breakage can trigger epithelial-to-mesenchymal transition (EMT), a fundamental step in the development of metastatic cancer. Despite the ability of C-type lectin domains (CTLD) to modulate cell-cell adhesion, it is not known if they modulate epithelial adhesion in EMT and tumor progression. Here, the multi-CTLD mannose receptor, Endo180 (MRC2/uPARAP), was shown using the Kaplan-Meier analysis to be predictive of survival outcome in men with early prostate cancer. A proteomic screen of novel interaction partners with the fourth CTLD (CTLD4) in Endo180 revealed that its complex with CD147 is indispensable for the stability of three-dimensional acini formed by nontransformed prostate epithelial cells (PEC). Mechanistic study using knockdown of Endo180 or CD147, and treatment with an Endo180 mAb targeting CTLD4 (clone 39.10), or a dominant-negative GST-CTLD4 chimeric protein, induced scattering of PECs associated with internalization of Endo180 into endosomes, loss of E-cadherin (CDH1/ECAD), and unzipping of cell-cell junctions. These findings are the first to demonstrate that a CTLD acts as a suppressor and regulatory switch for EMT; thus, positing that stabilization of Endo180-CD147 complex is a viable therapeutic strategy to improve rates of prostate cancer survival

Effect of drive row ground covers on hop (Rosales: Cannabaceae) yard arthropod pests in Vermont, USA

Alternatives to pesticides are necessary for the management of hop (Humulus lupulus L.) arthropod pests. The three major arthropod pests in northeastern US hop production include two-spotted spider mite, Tetranychus urticae Koch, hop aphid Phorodon humuli (Schrank), and potato leafhopper, Empoasca fabae Harris. This 3-yr study (2012-2014) in Vermont investigated the effect of flowering ground covers on arthropod pest abundance. Hop cultivars \u27Nugget\u27 and \u27Cascade\u27 were evaluated under a strip-split plot experimental design. Ground cover treatments included 1) Control: mowed red clover (Trifolium pratense) and resident weeds, 2) Clover: red clover, and 3) Diverse: common yarrow (Achillea millefolium), beebalm (Monarda fistulosa), red clover, and annual sunflower (Helianthus annuus). Natural enemies were grouped by associated pest and indicated by our mixed model to be strong predictors of the number of hop aphid and potato leafhopper on hop plants. In year two, ground cover treatment had a significant effect on two-spotted spider mite abundance where fewer two-spotted spider mite were observed on hop plants in Diverse plots. The established, un-mowed Clover treatment was preferred by potato leafhopper over Diverse ground cover and hop plants. This revealed the potential for clover ground cover to serve as a trap crop for potato leafhopper management in northeastern hop yards. Our findings are evidence that ground covers implemented for conservation biological control may serve more specific pest management functions instead of or in addition to boosting top-down pest pressure

Educating Adolescents about Puberty: What are we Missing?

Adolescents undergo significant physical and cognitive changes during their pubertal development. These changes contribute to and impact their future development. Educating adolescents at an early age about their expected development decreases the possible anxiety associated with this period of life and also helps adolescents make better choices in regards to their sexuality. In order to assess the degree of education regarding pubertal development and sexuality, we conducted a survey of late adolescents (Median age 19 years) and parents of adolescents. A total of 409 adolescents (237 females, 172 males) and 124 parents completed the survey. 14.4% of teens (36.6% of males and 2% of females) reported that no one spoke to them prior or during puberty about pubertal development or sexuality issues. Teens receiving some form of puberty/sexuality education did so at a median age of 13 for girls and 15 for boys. More than one source of information was the most common (49%) followed by mother only (20%). 85% of parents reported talking to their teens about pubertal development and sexuality. There were several differences between areas reported covered by parents but not by teens, for example 72% of parents reported talking to their teens about gender differences in growth but only 31% of teens reported being spoken to about that. Areas that are very poorly covered are breast development in boys and sexual assault/date rape in girls at 5% and 26% respectively. In summary, it appears that we continue to do a relatively poor job in educating our kids about their development and sexuality and we do it late. Boys are even less likely than girls to be talked to about many areas of pubertal development and sexuality and when that is done, it is done at a later age