Baseline Opioid Survey: Access, Consumption, Consequences, and Perceptions among Young Adults in Alaska

In September of 2015, SAMHSA awarded the Partnerships for Success (PFS) grant to the State of Alaska  Department of Health and Social Services, Division of Behavioral Health (DBH). The PFS grant program is  a five‐year effort that focuses on preventing and reducing substance use and building prevention  capacity at both the state and community levels. DBH provides leadership for the project and facilitates  the conduct of project activities by community‐level coalitions. Additionally, DBH contracted with the  Center for Behavioral Health Research and Services (CBHRS) at the University of Alaska Anchorage (UAA)  to conduct a comprehensive evaluation of the PFS project.   Using a data‐informed prioritization process to narrow the substance abuse focus of the grant, the State  Epidemiological Outcomes Workgroup chose two PFS priority areas: 1) non‐medical use of prescription  opioids among 12‐25 year olds; and 2) heroin use among 18‐25 year olds. Data on the use of and  consequences related to prescription opioids and heroin in Alaska are described below.  Partnerships for Success (PFS) Priority Area: Non‐Medical Use of Prescription Opioids  Data from the National Survey on Drug Use and Health (NSDUH) indicate that young adults aged 18‐25  consistently have the highest percentage of non‐medical use of prescription pain relievers in Alaska  compared to youth aged 12‐17 and adults aged 26 and older (see Figure 1).1,2,3 While small decreases in  use were observed among all age groups from 2009 to 2014, the age‐specific pattern remained  consistent.   Figure 1. Past year non‐medical use of prescription pain relievers in Alaska from 2009 to 2014 by age  Additional data requested from NSDUH (see Table 1) indicated no significant change in non‐medical use  of prescription pain reliever estimates among 12‐25 year olds in Alaska between years 2007‐2010 and  2011‐2014 but a decreasing trend was observed for past year use and past year prescription pain  reliever dependence or abuse.4 0 5 10 15 2009-2010 2011-2012 2013-2014 Percentage 12-17 years 18-25 years 26+ years 4 Table 1. Past year non‐medical use of prescription pain reliever estimates among individuals aged 12  to 25 in Alaska from 2007 to 2014  1 Dependence/abuse is based on definitions found in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM‐IV)  Estimates of past year non‐medical use of prescription pain relievers among individuals aged 12 and  older in Alaska are slightly higher than national estimates but both follow a small decreasing trend in use  from 2009 to 2014 (see Figure 2).1,2,3 Figure 2. Past year non‐medical use of prescription pain relievers among individuals aged 12 and older in  the U.S. and Alaska from 2009 to 2014  Other indicators related to non‐medical use of prescription opioids in Alaska have also decreased slightly  or stabilized in recent years. Treatment admissions for synthetic opiates (opiates or synthetics including  Methadone, Oxycodone, or Oxycontin) as a primary, secondary, or tertiary substance of abuse have  stayed relatively stable from 2013 to 2015 (1,052 to 1,011 treatment admissions), according to the  Alaska Automated Information Management System (AKAIMS).5  Age‐adjusted overdose death rates in  Alaska have decreased from 11.2 per 100,000 in 2009 to 8.5 per 100,000 in 2015. Although overdose  deaths from prescription opioids are decreasing, Alaska still has higher rates of overdose deaths from  prescription opioids than the nation overall (7.3 vs. 5.1 per 100,000 in 2012).6 Funded by the Substance Abuse and Mental Health Services Administration, Center for Mental  Health Services (Grant #SP020783) through the State of Alaska, Division of Behavioral Health Background / Survey Methods / Prescription Opioids / Heroin / Conclusion / Reference

Baseline Assessment: Alaska's Capacity and Infrastructure for Prescription Opioid Misuse Prevention

The State of Alaska Department of Health and Social Services (DHSS), Division of Behavioral Health (DBH) was awarded the Partnerships for Success (PFS) grant by the Substance Abuse and Mental Health Services Administration (SAHMSA) in 2015. DBH contracted with the Center for Behavioral Health Research and Services (CBHRS) at the University of Alaska Anchorage (UAA) to conduct a comprehensive project evaluation. As part of the evaluation, CBHRS performed a baseline assessment of the state’s capacity and infrastructure related to prescription opioid misuse prevention. Researchers conducted interviews with key stakeholders representing state government, healthcare agencies, law enforcement, substance abuse research, and service agencies. Interviews were semistructured, with questions addressing five domains of interest: (1) state climate and prevention efforts; (2) partnerships and coordinated efforts; (3) policies, practices, and laws; (4) data and data monitoring; and (5) knowledge and readiness. Thirteen interviews were conducted and analyzed using a qualitative template analysis technique combined with a SWOT analysis (i.e. strengths, weaknesses, opportunities, and threats). Emergent themes are displayed in Table 1 below. Table 1. Emergent themes from SWOT analysis Strengths Weaknesses Opportunities Threats (1) New and revised policies and guidelines (2) Activities and partnerships between state agencies and communities (3) Knowledge and awareness of state leadership (1) State policy limitations (2) Insufficient detox, treatment, and recovery support resources (3) Lack of full coordination within state agencies and with communities (1) Education enrichment (2) Policy improvements (3) Expansion of treatment, recovery, and mental health support (1) State fiscal crisis (2) Prescribing practices (3) Complexity and stigma of addiction (4) Legislative support Despite limitations in sample representativeness and interview timing, participants agreed that agencies, communities, and organizations across Alaska have demonstrated great concern about the opioid epidemic and that this concern has translated into considerable efforts to address and prevent opioid misuse. Participants also noted a variety of opportunities as targets for future work, many of which would address some of the current weaknesses that exist. Results yielded clear recommendations for increasing awareness and providing education to a variety of groups, further improving relevant policies to promote prevention, and expanding services for prevention and treatment.State of Alaska, Division of Behavioral Health Grant #SP020783Executive Summary / Introduction / Methodology / Results / Discussion / Reference

Reading Neighborhood Character : A Semiotic Analysis of Three Portland, Oregon Neighborhoods

The character of a neighborhood is demonstrated through environmental cues that tell the casual passerby about a neighborhood and its residents, including such aspects as privacy, neighboring, and wealth. Neighborhoods may be made up of residents all speaking the same message, such as exclusivity or independence; these neighborhoods give coherent messages and have strong identifiable character. Other neighborhoods may seem fragmented or have unclear character because the residential make-up is changing over time. Residents reflect aspects of themselves through the physical surroundings that make up a neighborhood. This study examines three neighborhoods in a preliminary effort to identify which characteristics convey neighborhood character. The neighborhoods were chosen to include one wealthy, relatively liberal neighborhood, one working class neighborhood, and one neighborhood in transition. The character of these neighborhoods was established using arc hi val data, including newspaper articles and 1990 U.S. Census data, and by cataloguing the types and mix of non-residential uses. Field research was undertaken to catalogue house-front and landscape elements by neighborhood. Within each neighborhood a random sample of streets was selected, totaling at least 50 houses observed per neighborhood. In addition, the neighborhood as a whole was driven through to form an overall impression of residential areas and mix of uses. These observations are given along with likely messages conveyed by residents. The observations, connected with the archival findings on the character of the neighborhoods culminate in an interpretation of neighborhood character as manifested in these three neighborhoods. These observations are given along with likely messages conveyed by residents. The observations, connected with the archival findings on the character of the neighborhoods culminate in an interpretation of neighborhood character as manifested in these three neighborhoods

Policy Evaluation During the Opioid Epidemic

This presentation provides an overview of research in Alaska's policy responses to rises in opioid use between 2016 and 2018. It outlines outcomes from qualitative analysis of interviews.Institute of Social and Economic Research (University of Alaska Anchorage) U.S. Department of Health and Human Services (SAMHSA #1U79SP020783

Promoting a Coordinated Multi-Site Evaluation for Community-Based Opioid Prevention Programs

The effectiveness of substance use prevention efforts is often difficult to measure over short grant cycles, especially for emerging issues such as prescription opioid misuse where data is less available and evidence-based strategies are not well understood. Coordinating state and community level evaluation efforts adds further complexity. Since 2016, six communities in Alaska, through a single federal funding stream, have worked to prevent opioid misuse among youth and young adults using policy, system, and environmental strategies. The project is focused on three key intervening variables to reduce prescription opioid misuse.The Alaska Partnerships for Success Project is funded by the Substance Abuse and Mental Health Services Administration, Center for Mental Health Services (Grant #SP020783) through the State of Alaska, Division of Behavioral Health.Institute of Social and Economic Research (University of Alaska Anchorage) Substance Abuse and Mental Health Services Administration, Center for Mental Health Services (Grant #SP020783

Alaska’s Partnerships for Success Grant ‐ Technical Report No.3

The opioid epidemic has continued in Alaska and nationwide. Information about the types of opioids that are misused first, the age of first use, and the circumstances and mode of initial and progressive use of opioids can help to inform effective prevention and early intervention efforts. These topics were explored during interviews with adults in Alaska who use heroin for the Partnerships for Success project. Results indicate that most participants were exposed to opioids through a legitimate prescription in their teens to early twenties for a severe injury or multiple surgeries before developing an addiction. Some obtained prescription opioids for misuse initially from social sources such as a friend, at a party, or stealing them from a neighbor. Only two participants began their use of opioids with heroin. All participants eventually went on to use heroin which became cheaper, more effective, and easier to obtain than prescription opioids. Few participants indicated that social influences, rather than price or availability, were a factor in their transition to heroin. Recommendations and an overview of recent state prevention initiatives and policy efforts related to the findings are presented.Funded by the Substance Abuse and Mental Health Services Administration, Center for Mental Health Services (Grant #SP020783) through the State of Alaska, Division of Behavioral Health

Single Nucleotide Polymorphism Typing of Bacillus anthracis from Sverdlovsk Tissue

A small number of conserved canonical single nucleotide polymorphisms (canSNP) that define major phylogenetic branches for Bacillus anthracis were used to place a Sverdlovsk patient’s B. anthracis genotype into 1 of 12 subgroups. Reconstruction of the pagA gene also showed a unique SNP that defines a new lineage for B. anthracis

The genomic landscape of balanced cytogenetic abnormalities associated with human congenital anomalies

Despite the clinical significance of balanced chromosomal abnormalities (BCAs), their characterization has largely been restricted to cytogenetic resolution. We explored the landscape of BCAs at nucleotide resolution in 273 subjects with a spectrum of congenital anomalies. Whole-genome sequencing revised 93% of karyotypes and demonstrated complexity that was cryptic to karyotyping in 21% of BCAs, highlighting the limitations of conventional cytogenetic approaches. At least 33.9% of BCAs resulted in gene disruption that likely contributed to the developmental phenotype, 5.2% were associated with pathogenic genomic imbalances, and 7.3% disrupted topologically associated domains (TADs) encompassing known syndromic loci. Remarkably, BCA breakpoints in eight subjects altered a single TAD encompassing MEF2C, a known driver of 5q14.3 microdeletion syndrome, resulting in decreased MEF2C expression. We propose that sequence-level resolution dramatically improves prediction of clinical outcomes for balanced rearrangements and provides insight into new pathogenic mechanisms, such as altered regulation due to changes in chromosome topology

The PREDICTS database: a global database of how local terrestrial biodiversity responds to human impacts

Biodiversity continues to decline in the face of increasing anthropogenic pressures such as habitat destruction, exploitation, pollution and introduction of alien species. Existing global databases of species’ threat status or population time series are dominated by charismatic species. The collation of datasets with broad taxonomic and biogeographic extents, and that support computation of a range of biodiversity indicators, is necessary to enable better understanding of historical declines and to project – and avert – future declines. We describe and assess a new database of more than 1.6 million samples from 78 countries representing over 28,000 species, collated from existing spatial comparisons of local-scale biodiversity exposed to different intensities and types of anthropogenic pressures, from terrestrial sites around the world. The database contains measurements taken in 208 (of 814) ecoregions, 13 (of 14) biomes, 25 (of 35) biodiversity hotspots and 16 (of 17) megadiverse countries. The database contains more than 1% of the total number of all species described, and more than 1% of the described species within many taxonomic groups – including flowering plants, gymnosperms, birds, mammals, reptiles, amphibians, beetles, lepidopterans and hymenopterans. The dataset, which is still being added to, is therefore already considerably larger and more representative than those used by previous quantitative models of biodiversity trends and responses. The database is being assembled as part of the PREDICTS project (Projecting Responses of Ecological Diversity In Changing Terrestrial Systems – www.predicts.org.uk). We make site-level summary data available alongside this article. The full database will be publicly available in 2015

Behavior of 3-D steel moment frame structures under the influence of bi-directional ground excitation

http://deepblue.lib.umich.edu/bitstream/2027.42/4899/5/bab2437.0001.001.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/4899/4/bab2437.0001.001.tx