Singing sleuth : three romantic mysteries

The novella collection Singing Sleuth: Three Romantic Mysteries is a vital contribution to the creative arts because it fills an artistic gap. Within creative writing, a myriad of romantic stories and police procedurals exist. However, although genre-blending has become popular, it is rare that the romance and the detective story get blended in one plot, let alone three that center on the same protagonist. However, there are many readers who appreciate a bit of romance within a gritty mystery, or vice versa, that the collection does fill a need for. What is even rarer is a story or collection that cements these two genres and also incorporates a spiritual thread. Singing Sleuth does this not only in its dialogue and characters, but in the restraint it uses. For example, unlike in secular romances, there is no sexual activity except between married couples, and even then, it is discreetly handled. Also, unlike secular mysteries or thrillers, the collection?s violence is not gratuitous or graphic. Therefore, the collection serves a special purpose for a religious audience by giving them an entertaining read without the pitfalls of action they would rather not read about. In order to write the novella collection, I conducted different types of creative research. Most of this research involved reading inspirational romance and mystery novels, as well as some novella anthologies already on the market that blend the two genres. I also took time to polish my craft in general, using books on plot, structure, and other elements to sharpen my writing. Finally, I was fortunate to be given the contact information for a retired Chicago police officer, who proved a valuable resource because my heroine is a homicide detective. Personal experience also played a major role—having been in theater and choirs for many years, I was able to write the many performing arts scenes with authenticity. As a result of my research, I was able to create a full and well-developed novella collection that seamlessly blended two opposing genres. I was also able to stretch my writing skills because until this project, I had never written a mystery and only attempted romance. The project required learning many new things, such as how law enforcement works, the complexities of romantic relationships, and how I could grow and mature as a writer. I believe the implications raised by my project are myriad. First, the existence of such a collection confirms that the genre blend of romance and police procedural can exist. Because the elements of these genres will also draw in readers despite, or perhaps because of, a spiritual thread, the implication also exists that spirituality can be entertaining and creative. However, I think the most serious implication the collection raises is that creativity knows no borders. Others have asked if such a unique collection is publishable. I believe it is, and furthermore, I believe a story like mine will help the writing world to open itself up to even more unconventional projects

Improving Pharmacy Education and Patient Centered Care Through Virtual Reality

This qualitative research explored the impact of immersive virtual reality (VR) experiences on student pharmacist knowledge, attitudes, and anticipated behaviors, when used as a supplement to traditional didactic education. Participants completed one or more simulated VR experiences role-playing a person with Alzheimer\u27s Disease, which included experiencing realistic visual and auditory disturbances, struggling with language comprehension, and displaying symptoms of aphasia. Post experience, students completed several short essay prompts. Overall, the study assessed student\u27s self-perceived empathy and anticipated changes to provision of patient care as a result of this activity. Major categories of themes that emerged included 1.) the dementia experience (communication and isolation, feeling like a burden, scared and helpless, confused, altered perception), 2.) importance of patient centered care (patient centered care, pharmacist perception, importance of caregiver care and inclusion, empathy), and 3.) resultant changes in practice (approach slowly and calmly, regimen simplicity and total medication care, monitor signs and symptoms, trust and rapport).https://dune.une.edu/cecespring2022/1014/thumbnail.jp

COVID-19 vaccine acceptance in older Syrian refugees : Preliminary findings from an ongoing study

Funding source This work was supported by ELRHA’s Research for Health in Humanitarian Crisis (R2HC) Programme, which aims to improve health outcomes by strengthening the evidence base for public health interventions in humanitarian crises. R2HC is funded by the UK Foreign, Commonwealth and Development Office (FCDO), Wellcome, and the UK National Institute for Health Research (NIHR). The views expressed herein should not be taken, in any way, to reflect the official opinion of the NRC or ELRHA. The funding agency was not involved in the data collection, analysis or interpretation.Peer reviewedPublisher PD

Dynamic changes in methadone utilisation for opioid use disorder treatment: a retrospective observational study during the COVID-19 pandemic

Objectives: Opioid use disorder (OUD) is a major public health concern in the USA, resulting in high rates of overdose and other negative outcomes. Methadone, an OUD treatment, has been shown to be effective in reducing the risk of overdose and improving overall health and quality of life. This study analysed the distribution of methadone for the treatment of OUD across the USA over the past decade and through the COVID-19 pandemic. Design: Retrospective observational study using secondary data analysis of the Drug Enforcement Administration and Medicaid Databases. Setting: USA. Participants: Patients who were dispensed methadone at US opioid treatment programmes (OTPs). Primary and secondary outcome measures: The primary outcomes were the overall pattern in methadone distribution and the number of OTPs in the USA per year. The secondary outcome was Medicaid prescriptions for methadone. Results: Methadone distribution for OUD has expanded significantly over the past decade, with an average state increase of +96.96% from 2010 to 2020. There was a significant increase in overall distribution of methadone to OTP from 2010 to 2020 (+61.00%, p\u3c0.001) and from 2015 to 2020 (+26.22%, p\u3c0.001). However, the distribution to OTPs did not significantly change from 2019 to 2021 (-5.15%, p=0.491). There was considerable state-level variation in methadone prescribing to Medicaid patients with four states having no prescriptions. Conclusions: There have been dynamic changes in methadone distribution for OUD. Furthermore, pronounced variation in methadone distribution among states was observed, with some states having no OTPs or Medicaid coverage. New policies are urgently needed to increase access to methadone treatment, address the opioid epidemic in the USA and reduce overdose deaths

An analysis of patterns of distribution of buprenorphine in the United States using ARCOS, Medicaid, and Medicare databases

Opioid overdose remains a problem in the United States despite pharmacotherapies, such as buprenorphine, in the treatment of opioid use disorder. This study characterized changes in buprenorphine use. Using the Drug Enforcement Administration\u27s ARCOS, Medicaid, and Medicare claims databases, patterns in buprenorphine usage in the United States from 2018 to 2020 were analyzed by examining percentage changes in total grams distributed and changes in grams per 100 K people in year-to-year usage based on ZIP code and state levels. For ARCOS from 2018 to 2019 and 2019 to 2020, total buprenorphine distribution in grams increased by 16.2% and 12.6%, respectively. South Dakota showed the largest statewide percentage increase in both 2018–2019 (66.1%) and 2019–2020 (36.7%). From 2018 to 2019, the ZIP codes ND-577 (156.4%) and VA-222 (−82.1%) had the largest and smallest percentage changes, respectively. From 2019 to 2020, CA-932 (250.2%) and IL-603 (−36.8%) were the largest and smallest, respectively. In both 2018–2019 and 2019–2020, PA-191 had the second highest increase in grams per 100K while OH-452 was the only ZIP code to remain in the top three largest decreases in grams per 100K in both periods. Among Medicaid patients in 2018, there was a nearly 2000-fold difference in prescriptions per 100k Medicaid enrollees between Kentucky (12 075) and Nebraska (6). Among Medicare enrollees in 2018, family medicine physicians and other primary care providers were the top buprenorphine prescribers. This study not only identified overall increases in buprenorphine availability but also pronounced state-level differences. Such geographic analysis can be used to discern which public policies and regional factors impact buprenorphine access

Impacts of phosphorus concentration and light intensity on river periphyton biomass and community structure

Periphyton growth rate has been identified as the key process that leads to river eutrophication. Effort has focused on reducing phosphorus concentrations to control periphyton biomass, but other factors, such as light, are also important. Within-stream flume mesocosms were deployed in the River Lambourn, UK, to investigate how light intensity and phosphorus concentrations affect periphyton biomass and community structure. Soluble reactive phosphorus (SRP) concentrations were tripled in some flumes, and decreased in others by dosing of FeCl3. Increasing SRP concentrations from the ambient concentration of 49 µg L-1 to 155 µg L-1 had no effect on biomass, but community composition (by flow cytometry) shifted from diatom to cyanobacterial dominance. Reducing light levels (equivalent to riparian tree shading) decreased biomass by 40 %, showing that the biofilms were light limited at SRP concentration ≥ 49 µg L-1. Periphyton were phosphorus / light co-limited when SRP concentrations were reduced to 33 µg L-1. Further reductions in SRP concentration (23 µg L-1) resulted in phosphorus limitation of periphyton biomass and increased dominance of diatoms and chlorophytes within the biofilm. Reducing light intensity through providing riparian tree shading could be an important management tool to reduce periphyton biomass and improve ecological status

County and Demographic Differences in Drug Arrests and Controlled Substance Use in Maine

. Introduction: The Diversion Alert Program (DAP) was established to curb misuse of drugs and help identify people who may need treatment for substance use disorder (SUD). Law enforcement compiled arrest data into a database accessible by health care providers. Our objectives were to identify regional and demographic differences in drug use and misuse in Maine. Methods: All arrests (N = 11 234) reported to the DAP from 2013 to 2018 were examined by county and arrestee demographics, and classified into families (opioids, stimulants, sedatives). The Drug Enforcement Administration’s Automation of Reports and Consolidated Orders System (ARCOS) tracks the distribution of controlled pharmaceuticals (Schedule II-III). Opioids were converted to oral morphine milligram equivalents (MMEs). County and zip-code maps were constructed. Results: The most arrests per capita occurred in Androscoggin, Knox, and Cumberland Counties. Opioids were the most common drug class in arrests in all counties except Aroostook County, where stimulants were most common. Medical distribution of opioids varied. Although buprenorphine doubled, many prescription opioids (eg, hydrocodone, fentanyl, oxymorphone) exhibited large (\u3e 50%) reductions in distribution. Methadone was the predominant opioid statewide (56.4% of total MMEs), although there were sizable differences between regions (Presque Isle = 8.6%, Bangor = 78.9%). Amphetamine distribution increased by 67.9%. Discussion: The DAP, a unique pharmacoepidemiological resource, revealed a 6-fold difference in drug arrests by county. Regional differences in methadone may be due to heterogeneities in methadone clinic distribution. Conclusions: The decrease in most prescription opioids, but increase in prescription stimulants, may warrant continued monitoring to improve public health

VBP15, a glucocorticoid analogue, is effective at reducing allergic lung inflammation in mice

Asthma is a chronic inflammatory condition of the lower respiratory tract associated with airway hyperreactivity and mucus obstruction in which a majority of cases are due to an allergic response to environmental allergens. Glucocorticoids such as prednisone have been standard treatment for many inflammatory diseases for the past 60 years. However, despite their effectiveness, long-term treatment is often limited by adverse side effects believed to be caused by glucocorticoid receptor-mediated gene transcription. This has led to the pursuit of compounds that retain the anti-inflammatory properties yet lack the adverse side effects associated with traditional glucocorticoids. We have developed a novel series of steroidal analogues (VBP compounds) that have been previously shown to maintain anti-inflammatory properties such as NFκB-inhibition without inducing glucocorticoid receptor-mediated gene transcription. This study was undertaken to determine the effectiveness of the lead compound, VBP15, in a mouse model of allergic lung inflammation. We show that VBP15 is as effective as the traditional glucocorticoid, prednisolone, at reducing three major hallmarks of lung inflammation--NFκB activity, leukocyte degranulation, and pro-inflammatory cytokine release from human bronchial epithelial cells obtained from patients with asthma. Moreover, we found that VBP15 is capable of reducing inflammation of the lung in vivo to an extent similar to that of prednisone. We found that prednisolone--but not VBP15 shortens the tibia in mice upon a 5 week treatment regimen suggesting effective dissociation of side effects from efficacy. These findings suggest that VBP15 may represent a potent and safer alternative to traditional glucocorticoids in the treatment of asthma and other inflammatory diseases.Supported in part by grants from the NIH (1R41HL104939-01B; 1K26RR032082; 1P50AR060836-01; 1U54HD071601; 2R24HD050846-06, R01 HL033152- 25), DOD grants (W81XWH-11-1-0330; W81XWH-11-1-0782; W81XWH-10-1-0659; W81XWH-11-1-0809; W81XWH-09-1-0599) a translational research grant from MDA, pilot grant from Parent Project Muscular Dystrophy (PPMD), and a contribution from the Clark Family Foundation