Comorbidities and Race/Ethnicity Among Adults with Stimulant Use Disorders in Residential Treatment

Comorbid physical and mental health problems are associated with poorer substance abuse treatment outcomes; however, little is known about these conditions among stimulant abusers at treatment entry. This study compared racial and ethnic groups on baseline measures of drug use patterns, comorbid physical and mental health disorders, quality of life, and daily functioning among cocaine and stimulant abusing/dependent patients. Baseline data from a multi-site randomized clinical trial of vigorous exercise as a treatment strategy for a diverse population of stimulant abusers (N = 290) were analyzed. Significant differences between groups were found on drug use characteristics, stimulant use disorders, and comorbid mental and physical health conditions. Findings highlight the importance of integrating health and mental health services into substance abuse treatment and could help identify potential areas for intervention to improve treatment outcomes for racial and ethnic minority groups

Geochemical characteristics of carbonatite-related volcanism and sub-volcanic metasomatism at Oldoinyo Lengai, Tanzania

The eruption of xenolithic material during large explosive eruptions, at any volcano, supply vital samples of the sub-surface lithologies upon which it is built, which in turn provides an indication of the evolution of the volcanic complex, in particular the volcanic conduit, magma storage zones and crustal / mantle lithologies. This is particularly important at alkaline-carbonatite complexes which are known to have “exotic” chemistries and also cause extensive zones of alteration through fenitisation processes. As the only active carbonatite volcano on Earth and also the unusual nature of Oldoinyo Lengai, Tanzania, it is an excellent study site to better understand the generation and chemical influence of carbonate-rich melts and fluids from source to surface. This study has attempted to better constrain the sub-volcanic environment, the source of the carbon within the material and the processes which lead to the formation of such unique rocks. Using geochemistry, isotopic studies and fluid inclusions, this thesis highlights the importance of fluid circulation within the volcanic system, both at the surface but also within the sub-volcanic mantle, leading to metasomatised material rich in carbon and alkali elements from which natrocarbonatite and potentially kimberlitic material could be derived. Almost all of the geochemical evidence and composition of fluid inclusions trapped within fenitised aureoles indicates a mantle derivation of carbonatitic material with isotopic signatures typical of the pre-defined “mantle-box”. The nature of the fluids is also investigated using trace element modelling and argued to be both carbonatitic and siliceous in origin, which have been circulating within the mantle beneath the Gregory Rift since before the establishment of Oldoinyo Lengai. These themes of research are discussed in terms of the genesis of natrocarbonatite, focussing upon the notion that it may be an evolutionary feature of Oldoinyo Lengai rather than a constant eruptive product

Men and women from the STRIDE clinical trial: An assessment of stimulant abstinence symptom severity at residential treatment entry

Background and Objectives Gender‐specific factors associated with stimulant abstinence severity were examined in a stimulant abusing or dependent residential treatment sample (N = 302). Method Bivariate statistics tested gender differences in stimulant abstinence symptoms, measured by participant‐reported experiences of early withdrawal. Multivariate linear regression examined gender and other predictors of stimulant abstinence symptom severity. Results Women compared to men reported greater stimulant abstinence symptom severity. Anxiety disorders and individual anxiety‐related abstinence symptoms accounted for this difference. African American race/ethnicity was predictive of lower stimulant abstinence severity. Discussion and Conclusions Women were more sensitive to anxiety‐related stimulant withdrawal symptoms. Scientific Significance Clinics that address anxiety‐related abstinence symptoms, which more commonly occur in women, may improve treatment outcome. (Am J Addict 2015;XX:XX –XX

The need for speed! 10 ways that WhatsApp and instant messaging can enhance communication (and clinical care) in sport & exercise medicine

Editorial

Called to Unity: Language Perfection, Propagation, and Practice in France, from Louis XIII to the Third Republic

Thesis advisor: Virginia ReinburgThesis advisor: Paul SpagnoliThis investigation examines the impact of language in France from 1600 to 1900, with a particular focus on the relationship between linguistic developments and political, cultural, and social history. It traces the evolution of France from a polyglot kingdom into a linguistically-unified nation. This evolution began with the codification of written language, championed by the authorities who founded the French Academy. Written French struggled, through the seventeenth and eighteenth centuries, against a vast array of patois, regional languages, and sociolects. These created both social and geographical divides. The French Revolution marked a major (but unsuccessful) government effort to impose a national language, establishing a strong link between concepts of language and identity. Political efforts of francisation defined the nineteenth century; more importantly, social interest and dependence upon a standard idiom increased drastically. The French people adopted the national language voluntarily, integrating it firmly into their sense of identity. Even in the linguistically-exceptional region of Alsace-Lorraine, where residents rejected both French and German, local language became integral to identity. Though authorities perfected language from above, the people accepted it from below, shaping French notions of identity and creating, in effect, modern France.Thesis (BA) — Boston College, 2006.Submitted to: Boston College. College of Arts and Sciences.Discipline: History.Discipline: Romance Languages and Literature.Discipline: College Honors Program

Identification of Sonographic B-lines with Linear Transducer Predicts Elevated B-Type Natriuretic Peptide Level

Objective: This study sought to correlate the presence of pleural-based B-lines seen by emergency department ultrasound performed with the linear transducer with B-type natriuretic peptide (BNP) level in patients with suspected congestive heart failure.Methods: The study was a prospective convenience sample on adult patients in an academic, urban emergency department with over 100,000 annual patient visits. Adult patients with a BNP level ordered by the treating physician were prospectively enrolled by one of four physicians, blinded to the BNP level. The enrolling physicians included an emergency ultrasound director, two emergency ultrasound fellows, and a senior emergency medicine resident. Bedside ultrasound was performed using a 3-12 MHz linear broadband transducer in four lung fields. The serum BNP level was correlated with bilateral B-lines, defined as three or more comet-tail artifacts arising from the pleural line extending to the far field without a decrease in intensity on the right and left thorax.Results: Sixty three patients were consented and enrolled during a four-month period. Fifteen patients had the presence of bilateral B-lines. The median BNP in patients with bilateral B-lines was 1560 pg/mL (95% confidence interval (CI) 1141-3706 pg/mL), compared with 538 pg/mL (95% confidence interval 310-1917 pg/mL) in patients without B-lines. The distributions in the two groups differed significantly (p=0.0006). Based on the threshold level of BNP 500 pg/mL, the sensitivity of finding bilateral B-lines on ultrasound was 33.3% (95% CI: 0.19-0.50), and the specificity was 91.7% (95% CI: 0.73-0.99). In addition, bilateral B-lines were absent in all patients with a BNP<100 pg/mL.Conclusion: The presence of bilateral B-lines identified with the linear probe is associated with significantly higher BNP levels than patients without B-lines. In our patient population, the presence of B-lines was specific but not sensitive for BNP>500. Further research may show that it can be applied to quickly assess patients with undifferentiated dyspnea. [West J Emerg Med. 2011;12(1):102-106.