Take-home naloxone kits: attitudes and likelihood-of-use outcomes from a European survey of potential overdose witnesses

Background: Injectable naloxone is already provided as take-home naloxone (THN), and new concentrated intranasal naloxone is now being introduced in Europe. Despite evidence of the effectiveness and cost-effectiveness of THN, little is known about the attitudes of key target populations: people who use opioids (PWUO), family/friends, and staff. We examined the acceptability of different naloxone devices (ampoule, prefilled syringe, and concentrated nasal spray) across 5 European countries. Objectives: The aim of this study was to compare THN target groups (PWUO vs. family/friends vs. staff) in their past rates of witnessed overdose and THN administration (as indicators of future use), current THN device preference, and THN carriage on the day of survey. Method: Cross-sectional survey of respondents (age ≥18) in addiction treatment, harm reduction, and recovery services in Denmark, England, Estonia, Norway, and Scotland. A purpose-developed questionnaire (59 items) was administered in the local language electronically or in a pen-and-paper format. Results: Among n = 725 participants, 458 were PWUO (63.2%), 214 staff (29.5%), and 53 (7.3%) family members. The groups differed significantly in their likelihood-of-future THN use (p < 0.001): PWUO had the highest rate of previously witnessing overdoses (352; 77.7%), and staff members reported the highest past naloxone use (62; 30.1%). Across all groups, most respondents (503; 72.4%) perceived the nasal spray device to be the easiest to use. Most reported willingness to use the spray in an overdose emergency (508; 73.5%), followed by the prefilled syringe (457; 66.2%) and ampoules (64; 38.2%). Average THN carriage was 18.6%, ranging from 17.4% (PWUO) to 29.6% (family members). Conclusion: Respondents considered the concentrated naloxone nasal spray the easiest device to use. Still, most expressed willingness to use the nasal spray as well as the prefilled syringe in an overdose emergency. Carriage rates were generally low, with fewer than 1 in 5 respondents carrying their THN kit on the day of the survey

An Infrared Census of DUST in Nearby Galaxies with Spitzer (DUSTiNGS). IV. Discovery of High-redshift AGB Analogs

The survey for DUST in Nearby Galaxies with Spitzer (DUSTiNGS) identified several candidate Asymptotic Giant Branch (AGB) stars in nearby dwarf galaxies and showed that dust can form even in very metal-poor systems (${\boldsymbol{Z}}\sim 0.008\,{Z}_{\odot }$). Here, we present a follow-up survey with WFC3/IR on the Hubble Space Telescope (HST), using filters that are capable of distinguishing carbon-rich (C-type) stars from oxygen-rich (M-type) stars: F127M, F139M, and F153M. We include six star-forming DUSTiNGS galaxies (NGC 147, IC 10, Pegasus dIrr, Sextans B, Sextans A, and Sag DIG), all more metal-poor than the Magellanic Clouds and spanning 1 dex in metallicity. We double the number of dusty AGB stars known in these galaxies and find that most are carbon rich. We also find 26 dusty M-type stars, mostly in IC 10. Given the large dust excess and tight spatial distribution of these M-type stars, they are most likely on the upper end of the AGB mass range (stars undergoing Hot Bottom Burning). Theoretical models do not predict significant dust production in metal-poor M-type stars, but we see evidence for dust excess around M-type stars even in the most metal-poor galaxies in our sample (12+\mathrm{log}({\rm{O}}/{\rm{H}})=7.26\mbox{--}7.50). The low metallicities and inferred high stellar masses (up to ~10 ${M}_{\odot }$) suggest that AGB stars can produce dust very early in the evolution of galaxies (~30 Myr after they form), and may contribute significantly to the dust reservoirs seen in high-redshift galaxies

First Neutrino Observations from the Sudbury Neutrino Observatory

The first neutrino observations from the Sudbury Neutrino Observatory are presented from preliminary analyses. Based on energy, direction and location, the data in the region of interest appear to be dominated by 8B solar neutrinos, detected by the charged current reaction on deuterium and elastic scattering from electrons, with very little background. Measurements of radioactive backgrounds indicate that the measurement of all active neutrino types via the neutral current reaction on deuterium will be possible with small systematic uncertainties. Quantitative results for the fluxes observed with these reactions will be provided when further calibrations have been completed.Comment: Latex, 7 pages, 10 figures, Invited paper at Neutrino 2000 Conference, Sudbury, Canada, June 16-21, 2000 to be published in the Proceeding

‘You’re just chopped off at the end’: Retired servicemen’s identity work struggles in the military to civilian transition

Promoting positive transition to retirement and cultural adaption for ex-service personnel has been identified as a priority for both social-science research and for public health policy in the UK. The Royal British Legion (RBL) aims to provide support to service and retired service personnel, but to date the transition to retirement experiences of older (60-plus) ex- service personnel remain under-researched. In this article, we employ a symbolic interactionist theoretical framework to examine older servicemen’s experiences and identity challenges post-retirement from the British armed forces. Data were collected primarily through semi-structured, focus-group interviews with 20 former servicemen. Here, we focus specifically upon the challenges encountered by these ex-servicemen in the retirement transition from military to civilian life, a time of identity flux of sociological interest. To navigate this period of identity change and challenge, many participants constructed a ‘modified military self’ through involvement with the RBL as a key social support network. For many retired personnel the RBL offered a form of identification and group identity that resonated strongly with earlier experiences of comradeship in the military

Clostridium difficile Ribotype 027, Toxinotype III, the Netherlands

Outbreaks due to Clostridium difficile polymerase chain reaction (PCR) ribotype 027, toxinotype III, were detected in 7 hospitals in the Netherlands from April 2005 to February 2006. One hospital experienced at the same time a second outbreak due to a toxin A–negative C. difficile PCR ribotype 017 toxinotype VIII strain. The outbreaks are difficult to control

Children's travel to school—the interaction of individual, neighbourhood and school factors

The increase in average distance from home to secondary school over recent decades has been accompanied by a significant growth in the proportion of pupils travelling to school by motorized means as opposed to walking or cycling. More recently this switch in travel mode has received considerable attention as declining levels of physical activity, growing car dependence and the childhood obesity “crisis” have pushed concerns about the health of future generations up the public health agenda, particularly in the U.S., but also in the UK and Europe. This has led to a proliferation of international studies researching a variety of individual, school and spatial characteristics associated with children's active travel to school which has been targeted by some governments as a potential silver bullet to reverse the trend. However, to date national pupil census data, which comprises annual data on all English pupils, including a mode of travel to school variable, has been under-utilised in the analysis of how pupils commute to school. Furthermore, methodologically, the grouped nature of the data with pupils clustered within both schools and residential neighbourhoods has often been ignored - an omission which can have considerable consequences for the statistical estimation of the model. The research presented here seeks to address both of these points by analysing pupil census data on all 26,709 secondary pupils (aged 11-16) who attended schools in Sheffield, UK during the 2009-10. Individual pupil data is grouped within school, and neighbourhood, within a cross-classified multilevel model of active versus motorised modes of commuting to school. The results support the findings of other research that distance to school is key, but find that sociospatial clustering within neighbourhoods and schools are also critical. A further finding is that distance to school varies significantly by ethnicity, with white British pupils travelling the shortest distance of all ethnic groups. The implications of these findings for education and transport policy are discussed

Algebraic Bethe ansatz method for the exact calculation of energy spectra and form factors: applications to models of Bose-Einstein condensates and metallic nanograins

In this review we demonstrate how the algebraic Bethe ansatz is used for the calculation of the energy spectra and form factors (operator matrix elements in the basis of Hamiltonian eigenstates) in exactly solvable quantum systems. As examples we apply the theory to several models of current interest in the study of Bose-Einstein condensates, which have been successfully created using ultracold dilute atomic gases. The first model we introduce describes Josephson tunneling between two coupled Bose-Einstein condensates. It can be used not only for the study of tunneling between condensates of atomic gases, but for solid state Josephson junctions and coupled Cooper pair boxes. The theory is also applicable to models of atomic-molecular Bose-Einstein condensates, with two examples given and analysed. Additionally, these same two models are relevant to studies in quantum optics. Finally, we discuss the model of Bardeen, Cooper and Schrieffer in this framework, which is appropriate for systems of ultracold fermionic atomic gases, as well as being applicable for the description of superconducting correlations in metallic grains with nanoscale dimensions. In applying all of the above models to physical situations, the need for an exact analysis of small scale systems is established due to large quantum fluctuations which render mean-field approaches inaccurate.Comment: 49 pages, 1 figure, invited review for J. Phys. A., published version available at http://stacks.iop.org/JPhysA/36/R6

Computerized ICU Data Management Pitfalls and Promises

journal articleBiomedical Informatic