Making Ketamine Work in the Long Run

Treatments such as ketamine psychotherapy face substantial financial and regulatory obstacles to dissemination into widespread use. Newly patented medications are able to generate enough capital to pay for studies required for FDA approval, personnel to apply for coverage on insurance plans, and marketing to establish a successful launch. Ketamine is an older drug with considerable evidence of efficacy for treatment resistant depression, and almost 50 years of data concerning safety as an anesthetic agent. However, it can no longer be patented, so there is no incentive for pharmaceutical companies to help get it into widespread use. In this paper we discuss some of the complex issues surrounding use of ketamine in the outpatient setting and share information and practice pearls that have been gathered through communication with other practitioners and through direct experience with over 1000 treatments involving 120 patients in the last eight years. The safety and appropriateness of intramuscular ketamine treatment in the outpatient psychiatric office is discussed. We hope to help proponents of effective mental health interventions navigate the actual and potential challenges involved in safe application of this treatment option outside of hospital-based programs

Geographically variable biotic interactions and implications for species ranges

This is the author accepted manuscript. The final version is available from Wiley via the DOI in this recordThe challenge: Understanding how biotic interactions affect species’ geographic ranges, biodiversity patterns, and ecological responses to environmental change is one of the most pressing challenges in macroecology. Extensive efforts are underway to detect signals of biotic interactions in macroecological data. However, efforts are limited by bias in the taxa and spatial scale for which occurrence data are available, and by difficulty in ascribing causality to co-occurrence patterns. Moreover, we are not necessarily looking in the right places: analyses are largely ad hoc, depending on data availability, rather than focusing on regions, taxa, ecosystems, or interaction types where biotic interactions might affect species’ geographic ranges most strongly. Unpicking biotic interactions: We suggest that macroecology would benefit from recognising that abiotic conditions alter two key components of biotic interaction strength: frequency and intensity. We outline how and why variation in biotic interaction strength occurs, explore the implications for species’ geographic ranges, and discuss the challenges inherent in quantifying these effects. In addition, we explore the role of behavioural flexibility in mediating biotic interactions to potentially mitigate impacts of environmental change. New data: We argue that macroecology should take advantage of “independent” data on the strength of biotic interactions measured by other disciplines, in order to capture a far wider array of taxa, locations and interaction types than are typically studied in macroecology. Data on biotic interactions are readily available from community, disease, microbial, and parasite ecology, evolution, palaeontology, invasion biology, and agriculture, but most are yet to be exploited within macroecology

Family to Family: Child Welfare for the 21st Century

Child welfare services have undergone many revisions and transformations since their initiation. Some scholars trace the beginning of child welfare in the United States to events such as a 1655 Massachusetts conviction for maltreatment leading to the death of a 12-year-old boy (Watkins, 1990). The predominant philosophy of child welfare has shifted over time from an early emphasis on child saving, to child protection, to family preservation. Building on family preservation, one of the current transformations in child welfare that is taking place in isolated pockets to whole states, is family-centered, neighborhood-based services. One force behind implementation of this transformation is the Family to Family Initiative of the Annie E. Casey Foundation. This paper places family-centered, neighborhood-based child welfare services within the historical context of development of child welfare and within the recent move to reinvent human services (Adams & Nelson, 1995). Against this backdrop, a locality-based implementation of the Family to Family Initiative is described

Broader niches revealed by fossil data don’t reduce estimates of range loss and fragmentation of African montane trees

This is the author accepted manuscript. The final version is available from Wiley via the DOI in this record.The data supporting the results already exists and is freely available in the Global Biodiversity Information Facility (GBIF) and the African Pollen Database (APD).Aim: Many species’ climate tolerances are broader than those estimated from current native ranges. Indeed, some Afromontane trees’ niches are up to 50% larger after incorporating fossil data. This expansion could reduce estimates of species’ future range loss due to climate change but also implies strong non-climatic limitations on species’ current ranges. One such limitation is land use, which fossil data suggest influences Afromontane tree distribution, preventing these trees from occupying warmer conditions than they currently do. We aim to assess the degree to which the broader climatic tolerances revealed by fossil data buffers projected range loss from climate and land use for Afromontane trees. Location: Africa. Time period: Last 21,000 years. Major taxa studied: Afromontane trees. Methods: We used species distribution models informed by both current and fossil distributions to project future ranges under climate and land-use projections. Results: We found that projected range reductions are only slightly ameliorated by incorporating fossil distributions and these improvements diminish further under severe land use or climate change scenarios. Taxa that are less impacted by climate are more impacted by intense land use. Depending on the severity of climate and land use, the geographic extent of Afromontane tree species’ ranges will contract by 40-85% and the trees will completely be lost from large portions of Africa. We projected that the surviving species’ ranges will become increasingly fragmented. Main conclusions: Maintaining Afromontane ecosystems will require mitigation of both climate and land-use change and protecting areas to optimize connectivity. Our findings caution that species with climate tolerances broader than their current range might not necessarily fare better under strong changes in climate or land use

Television and environmental sustainability: Arguing a case for a code of standards in NZ

This article explores the portrayal of the environment and environmental sustainability by free-to-air network television in New Zealand. The results are based on a three-month survey of a) the portrayal of the use and treatment of the environment, and b) the reporting of environmental news. While television includes environmentally-oriented programmes (eg. some BBC Horizon documentaries), there are no regular programmes about the state of the environment, sustainable use of resources and energy, and there is no regular environmental slot in the news in New Zealand. Some programmes and advertisements are environmentally unfriendly and a few trivialise resource abuse. It is argued that the media has an ‘orchestrational’ influence on social norms and behaviours, and that to eliminate counter-messages requires the addition of a new ‘environmental standard’ to the Code of Broadcasting Practice. It is also argued that coverage of environmental news is quite narrow and, in the case of Television New Zealand, inconsistent with the stated aims of the Television Charter. New Zealand  television could and should make a valuable contribution to environmental sustainability

Promoting physical activity in patients with colon adenomas: a randomized pilot intervention trial

BACKGROUND: Physical activity decreases risk of colon polyps and colon cancer and might reduce risk of colon cancer recurrence. Focusing on recent calls for translation of epidemiologic evidence into clinical care, our pilot study delivered an evidence-based physical activity intervention in adults with polyps, who are thus at elevated risk of developing colon cancer. The objective was to evaluate change in physical activity, measured by steps per day and minutes of moderate/vigorous physical activity. METHODS: Sixteen adults with adenomas detected and removed at screening colonoscopy were recruited to a 12-week physical activity intervention. Participants were randomized to receive a standard (30 minutes/day) or high (60 minutes/day) walking program. Physical activity was measured via blinded pedometer and accelerometer at baseline and follow-up. Intervention messages focused on self-monitoring using pedometers and overcoming barriers to engaging in physical activity. RESULTS: Participants in both arms significantly increased objectively measured minutes of moderate/vigorous physical activity over the course of the intervention. Both arms exceeded the intervention goal, but there was not a significant difference between arms at follow-up. Results were similar for pedometer measured physical activity, with a significant overall increase in steps/day from baseline to follow-up, but no between arm difference in change. CONCLUSION: Simple interventions of minimal contact time focusing on walking can significantly increase physical activity in individuals at increased risk of developing colon cancer. TRIAL REGISTRATION: ClinicalTrials.gov NCT0147663

Autologous Chondrocyte Implantation: Scaffold-Based Solutions

Autologous chondrocyte implantation is a surgical technique utilized for repair of articular cartilage defects. The originally described technique for autologous chondrocyte implantation involves applying a liquid suspension of the cultured chondrocytes to a cartilage defect and sealing the defect with a periosteum or collagen patch. Scaffolds for housing chondrocytes were introduced to allow for increased ease of delivery and application, to avoid leakage of chondrocytes out of the defect, and to allow for an implant that more closely mimics the non-uniform tissue architecture of healthy articular cartilage. In this chapter we describe the design, clinical outcomes, and commercial availability of various scaffolds reported in the clinical literature for autologous chondrocyte implantation

Properties of HxTaS2

The preparation of Hx TaS2 (0 \u3c x \u3c 0.87) is described. The compounds are only marginally stable at room temperature, slowly evolving H2S and H2 (and possibly Hp in air). Magnetic susceptibility data show that a low temperature transformation in 2H ... TaS2 (at so•K) is suppressed with the addition of hydrogen, and· at the same time the superconducting transition temperature T c rises from 0.8 to ~4.2•K at x = 0.11. Heat capacity measurements near this concentration show the superconductivity to be a bulk effect. Finally, by correlation of this data with susceptibility and T c measurements in other intercalation compounds, we suggest that the rise of T c (at low electron transfer) is due to suppression of the low temperature transformation and not due to an excitonic mechanism of superconductivity

Community Risk Factors and Health Inspection Violations in Mississippi Delta Census Tracts

A concerning public health issue in America is about food deserts urban and rural communities that lack grocery retailers that offer affordable, nutritious, and diverse foods. Empirical evidence has shown significant associations between neighborhood disadvantage/disorder risk factors of high poverty and high percentages of ethnic minority residents with presence/ absence of healthy food retailers in food deserts. The purpose of this quantitative correlational study, framed by the disparities in food safety conceptual model, was to examine if county-level poverty, number of African American residents, number of elderly (i.e., age 65 or older) residents, vehicle ownership, and crime rates were significantly associated with presence/absence of healthy food retail environments in a stratified random sample of 160 Mississippi Delta Region counties. Variables were measured using SPSS 25.0 data set from federal sources. Data were analyzed using binary logistic regression. Findings indicated that the percentage of households below poverty level was significantly associated with absence of healthy food retailers, (Wald X2 = 7.62, p = .006). Logistic regression findings further showed that the county percentage of households with at least one vehicle was significantly associated with the presence of healthy food retailers, (Wald X2= 8.75, p = .003). As a result of this study, residents of the Mississippi Delta Region (MDR) may begin to petition their local, county, and state governments to enhance access to healthy foods, and in turn, such government institutions may develop programs and initiatives that help to make healthy foods affordable