Funding Resilient Infrastructure in New Jersey: Attitudes Following a Natural Disaster

Recent major natural disasters in New Jersey have demonstrated the need to increase the resilience of transportation infrastructure. This research examines public attitudes toward revenue sources that can be dedicated to protecting vulnerable areas, most notably the transportation linkages on which the state depends. A statewide survey was conducted to gather data approximately four months following Superstorm Sandy, the costliest natural disaster in the state’s history. The authors’ objective was to sample public attitudes while the impacts of the disaster were still fresh. They found little support for temporary tax increases to improve resiliency, with the most positive support for taxing visitors (i.e., a hotel and recreational tax) and for a 30-year bond measure (i.e., taxing the future). This observation seemingly contradicts broad support for investing in new infrastructure, as well as maintaining and protecting existing infrastructure. Multivariate analysis to understand the underlying attitudes toward raising revenue found that more left-leaning or communitarian attitudes are associated with more support for gasoline, income, or sales taxes devoted to mitigating vulnerability. Those who supported investment in transit and protecting infrastructure also were more likely to support these taxes. There was no parallel finding of factors associated with taxing visitors or issuing bonds

MDMA (‘ecstasy’) use, and its association with high risk behaviors, mental health, and other factors among gay/bisexual men in New York City

This study assesses patterns of use of methylenedioxymethamphetamine (MDMA or ‘ecstasy’), and the characteristics of users, in a sample of 733 men who have sex with men (MSM) in New York City. Among respondents, 13.7% reported using MDMA in the past 6 months, with mean frequency of use of 6.24 times in that period. MDMA users were found to be younger, less educated, to have had more male partners, more one night stands with men, more visits to bars or clubs and sex clubs or bathhouses, to have unprotected anal sex with a male, to be likely to have been the victim of physical domestic violence, to have more gay/bisexual friends, to have disclosed their sexual orientation to more friends, family members, and coworkers, and to have higher levels of gay community participation and affiliation. Among MDMA users, higher frequency of MDMA use was associated with being younger, having more visits to bars or clubs, more gay/bisexual friends, and having an HIV negative test result or never having been tested. MDMA users thus constitute a group at risk for sexually transmitted diseases, including HIV, and other problems. The data suggest that MDMA use is associated with being more ‘out’, which may be advantageous in helping gay men deal with harmful psychological effects of stigma, but may place individuals in settings that expose them to MDMA. These men have also presumably already been well exposed to safer sex messages within the gay community, thus raising challenges for interventions aimed at prevention, as well as opportunities (e.g. MSM and community specific interventions) that need to be further explored

Patterns of Communication Between Gay and Lesbian Patients and Their Health Care Providers

Objectives: To determine whether gay men and lesbians disclose their sexual orientation, and other sensitive behaviors to their primary care physicians; whether they have a chance of finding a gay friendly physician; and what factors are involved. Methods: A self-report questionnaire was administered to 66 gay men and 28 lesbians at a gay and lesbian community center. Results: Less than half of participants felt their health insurance plan gave them a choice of finding a lesbian, gay, or bisexual (LGB) doctor. Those who did were more likely to be older, male, and to feel more comfortable discussing sex. Men were more likely to disclose their sexual orientation to their health care provider (HCP), to feel very comfortable discussing sex, to have a male doctor, to have a choice of finding a LGB provider through their insurance plan, and to think their provider is LGB. Those who disclosed their sexual orientation to their providers were more likely to be white males with male doctors, who felt their doctor was very gay friendly, and to have also discussed substance use, sexual behavior, and HIV with their HCP, and to feel comfortable discussing sex. Discussion: Lesbians in particular have difficulty disclosing their sexual orientation to providers, possibly due to continuing stigma, and to have less of a choice of finding a gay or lesbian provider. The data suggest that health insurance plans should provide patients with the opportunity to find gay friendly physicians, as it may facilitate communication about substance use, high risk sexual behavior and other health topics

Surfaces, depths and hypercubes: Meyerholdian scenography and the fourth dimension

An appreciation of Meyerhold’s engagement with theatrical space is fundamental to understanding his directorial and pedagogic practice. This article begins by establishing Meyerhold’s theoretical and practical engagement with theatre as a fundamentally scenographic process, arguing for a reconceptualisation of the director as ‘director-scenographer’. Focusing on the construction of depth and surface in Meyerholdian theatre, the article goes on to identify trends in the director’s approach to space, with an emphasis on the de-naturalisation of depth on stage. This denaturalisation is seen as taking three forms: the rejection of depth as a prerequisite in theatrical space, the acknowledgement of the two-dimensional surface as surface, and the restructuring of depth space into a series of restricted planes. The combination of these trends indicates a consistent and systematic process of experimentation in Meyerhold’s work. In addition, this emphasis on depth and surface, and the interaction between the two, also highlights the contextualisation of Meyerhold’s practice within the visual, philosophical and scientific culture of the early twentieth century, echoing the innovations in n-dimensional geometry and particularly, the model of the fourth spatial dimension seen in the work of Russian philosopher P. D. Ouspensky

The assessment of usability of electronic shopping: A heuristic evaluation

Today there are thousands of electronic shops accessible via the Web. Some provide user-friendly features whilst others seem not to consider usability factors at all. Yet, it is critical that the electronic shopping interface is user-friendly so as to help users to obtain their desired results. This study applied heuristic evaluation to examine the usability of current electronic shopping. In particular, it focused on four UK-based supermarkets offering electronic services: including ASDA, Iceland, Sainsbury, and Tesco. The evaluation consists of two stages: a free-flow inspection and a task-based inspection. The results indicate that the most significant and common usability problems have been found to lie within the areas of ‘User Control and Freedom’ and ‘Help and Documentation’. The findings of this study are applied to develop a set of usability guidelines to support the future design of effective interfaces for electronic shopping

Comparative effectiveness and safety of rituximab versus subsequent anti-tumor necrosis factor therapy in patients with rheumatoid arthritis with prior exposure to anti-tumor necrosis factor therapies in the United States Corrona registry

INTRODUCTION: Patients with active rheumatoid arthritis (RA) despite anti-tumor necrosis factor(anti-TNF)agent treatment can switch to either a subsequent anti-TNF agent or a biologic with an alternative mechanism of action, such as rituximab; however, there are limited data available to help physicians decide between these 2 strategies. The objective of this analysis was to examine the effectiveness and safety of rituximab versus a subsequent anti-TNF agent in anti-TNF-experienced patients with RA using clinical practice data from the Corrona registry. METHODS: Rituximab-naive patients from the Corrona registry with prior exposure to \u3e /=1 anti-TNF agent who initiated rituximab or anti-TNF agents (2/28/2006-10/31/2012) were included. Two cohorts were analyzed: the trimmed population (excluding patients who fell outside the propensity score distribution overlap) and the stratified-matched population (stratified by 1 vs \u3e /=2 anti-TNF agents, then matched based on propensity score). The primary effectiveness outcome was achievement of low disease activity (LDA)/remission (Clinical Disease Activity Index \u3c /=10) at 1 year. Secondary outcomes included achievement of modified American College of Rheumatology (mACR) 20/50/70 responses and meaningful improvement ( \u3e /=0.25) in modified Health Assessment Questionnaire (mHAQ) score at 1 year. New cardiovascular, infectious and cancer events were reported. RESULTS: Estimates for LDA/remission, mACR response and mHAQ improvement were consistently better for rituximab than for anti-TNF agent users in adjusted analyses. The odds ratio for likelihood of LDA/remission in rituximab versus anti-TNF patients was 1.35 (95 % CI, 0.95-1.91) in the trimmed population and 1.54 (95 % CI, 1.01-2.35) in the stratified-matched population. Rituximab patients were significantly more likely than anti-TNF patients to achieve mACR20/50 and mHAQ improvement in the trimmed population and mACR20 and mHAQ in the stratified-matched population. The rate of new adverse events per 100 patient-years was similar between groups. CONCLUSIONS: In anti-TNF-experienced patients with RA, rituximab was associated with an increased likelihood of achieving LDA/remission, mACR response and physical function improvement, with a comparable safety profile, versus subsequent anti-TNF agent users. TRIAL REGISTRATION: ClinicalTrials.gov NCT01402661. Registered 25 July 2011