Cannabis use among hospitalised adolescents before and after decriminalisation in South Africa

Background: Cannabis is the most widely used substance worldwide, and its use is much higher among adolescents. However, adolescents are at higher risk of negative sequelae secondary to this use, including the possible development of mental disorders. On 31 March 2017, the South African High Court ruled that cannabis use by an adult in a private dwelling should be decriminalised. Aim: This study aimed to determine the clinical profile of adolescents who use cannabis, who use, who present to a tertiary hospital in Cape Town, South Africa, before and after the high court ruling in 2017. Setting: Folder review of adolescents admitted at Groote Schuur Hospital (GSH) in the Emergency Psychiatric Unit. Methods: This study was a retrospective folder review of adolescents admitted from April 2015 to March 2019. Results: Cannabis was the most commonly used substance in the study, with increased use seen post-ruling. The most common frequency of cannabis use reported was daily. A significantly higher proportion of patients who used cannabis pre-ruling had psychotic disorder (p  0.001) and cannabis use disorder (p = 0.01). Post-ruling, the results were statistically significant (p  0.001) for both. Conclusion: The study showed an increasing prevalence of cannabis use in adolescents admitted with mental illness after the high court ruling in 2017. This study also demonstrates that adolescents remain a vulnerable population to the effects of cannabis and highlights the need for further research. Contribution: The findings of this study call for more focussed adolescent interventions and services

Addressing and Inspiring Vaccine Confidence in Black, Indigenous, and People of Color During the Coronavirus Disease 2019 Pandemic

During the coronavirus disease 2019 (COVID-19) pandemic, we have witnessed profound health inequities suffered by Black, Indigenous, and People of Color (BIPOC). These manifested as differential access to testing early in the pandemic, rates of severe disease and death 2-3 times higher than white Americans, and, now, significantly lower vaccine uptake compared with their share of the population affected by COVID-19. This article explores the impact of these COVID-19 inequities (and the underlying cause, structural racism) on vaccine acceptance in BIPOC populations, ways to establish trustworthiness of healthcare institutions, increase vaccine access for BIPOC communities, and inspire confidence in COVID-19 vaccines

Research Priorities for Childhood Apraxia of Speech: A Long View

This article introduces the Journal of Speech, Language, and Hearing Research Special Issue: Selected Papers From the 2022 Apraxia Kids Research Symposium. The field of childhood apraxia of speech (CAS) has developed significantly in the past 15 years, with key improvements in understanding of basic biology including genetics, neuroscience, and computational modelling; development of diagnostic tools and methods; diversity of evidence-based interventions with increasingly rigorous experimental designs; and understanding of impacts beyond impairment-level measures. Papers in this special issue not only review and synthesize the some of the substantial progress to date but also present novel findings addressing critical research gaps and adding to the overall body of knowledge. A second aim of this prologue is to report the current research needs in CAS, which arose from symposium discussions involving researchers, clinicians, and Apraxia Kids community members (including parents of children with CAS). Four primary areas of need emerged from discussions at the symposium. These were: (a) What questions should we ask? (b) Who should be in the research? (c) How do we conduct the research? and (d) How do we move from research to practice? Across themes, symposium attendees emphasized the need for CAS research to better account for the diversity of people with CAS and improve the timeliness of implementation of high-level evidence-based practice across the lifespan. It is our goal that the articles and prologue discussion in this special issue provide an appreciation of advancements in CAS research and an updated view of the most pressing needs for future research

Kinetics, mechanisms and ionic liquids in the uptake of n-butylamine onto low molecular weight dicarboxylic acids

Atmospheric particles adversely affect visibility, health, and climate, yet the kinetics and mechanisms of particle formation and growth are poorly understood. Multiphase reactions between amines and dicarboxylic acids (diacids) have been suggested to contribute. In this study, the reactions of n-butylamine (BA) with solid C3-C8 diacids were studied at 296 ± 1 K using a Knudsen cell interfaced to a quadrupole mass spectrometer. Uptake coefficients for amines on the diacids with known geometric surface areas were measured at initial amine concentrations from (3-50) × 1011 cm-3. Uptake coefficients ranged from 0.7 ± 0.1 (2σ) for malonic acid (C3) to <10-6 for suberic acid (C8), show an odd-even carbon number effect, and decrease with increasing chain length within each series. Butylaminium salts formed from evaporation of aqueous solutions of BA with C3, C5 and C7 diacids (as well as C8) were viscous liquids, suggesting that ionic liquids (ILs) form on the surface during the reactions of gas phase amine with the odd carbon diacids. Predictions from the kinetic multi-layer model of aerosol surface and bulk chemistry (KM-SUB) were quantitatively consistent with uptake occurring via dissolution of the underlying diacid into the IL layer and reaction with amine taken up from the gas phase. The butylaminium salts formed from the C4 and C6 diacids were solids, and their uptake coefficients were smaller. These experiments and kinetic modeling demonstrate the unexpected formation of ILs in a gas-solid reaction, and suggest that ILs should be considered under some circumstances in atmospheric processes

Language discordance as a marker of disparities in cerebrovascular risk and stroke outcomes: A multi-center Canadian study

Background: Differences in ischemic stroke outcomes occur in those with limited English proficiency. These health disparities might arise when a patient's spoken language is discordant from the primary language utilized by the health system. Language concordance is an understudied concept. We examined whether language concordance is associated with differences in vascular risk or post-stroke functional outcomes, depression, obstructive sleep apnea and cognitive impairment. Methods: This was a multi-center observational cross-sectional cohort study. Patients with ischemic stroke/transient ischemic attack (TIA) were consecutively recruited across eight regional stroke centers in Ontario, Canada (2012 – 2018). Participants were language concordant (LC) if they spoke English as their native language, ESL if they used English as a second language, or language discordant (LD) if non-English speaking and requiring translation. Results: 8156 screened patients. 6,556 met inclusion criteria: 5067 LC, 1207 ESL and 282 LD. Compared to LC patients: (i) ESL had increased odds of diabetes (OR = 1.28, p = 0.002), dyslipidemia (OR = 1.20, p = 0.007), and hypertension (OR = 1.37, p<0.001) (ii) LD speaking patients had an increased odds of having dyslipidemia (OR = 1.35, p = 0.034), hypertension (OR = 1.37, p<0.001), and worse functional outcome (OR = 1.66, p<0.0001). ESL (OR = 1.88, p<0.0001) and LD (OR = 1.71, p<0.0001) patients were more likely to have lower cognitive scores. No associations were noted with obstructive sleep apnea (OSA) or depression. Conclusions: Measuring language concordance in stroke/TIA reveals differences in neurovascular risk and functional outcome among patients with limited proficiency in the primary language of their health system. Lower cognitive scores must be interpreted with caution as they may be influenced by translation and/or greater vascular risk. Language concordance is a simple, readily available marker to identify those at risk of worse functional outcome. Stroke systems and practitioners must now study why these differences exist and devise adaptive care models, treatments and education strategies to mitigate barriers influenced by language discordance