Supporting Children Impacted by Parental Addiction: A Toolkit for Kinship Caregivers

Kinship caregiving has become increasingly common in the United States, specifically due to parental substance use disorder. These kinship caregivers (KC) have unique needs that are largely unmet. Often, there is no comprehensive resource for KCs specific to their community. KC’s greatest needs are financial, legal, and mental health assistance, as well as educational information about care of children for the kinship caregivers. The objective of this project was to develop a KC resource toolkit to meet priority needs within the community. The project design utilized an EBP framework and followed a community-based participatory research approach. Project leads worked with a local non-profit organization (NPO) in a mid-sized midwestern city to inform the project from September 2021 to June 2022. Consultation with social work, addiction medicine, and law enforcement professionals as well as kinship caregivers with lived experience who were also partners within the NPO were completed throughout the process of creating the resource toolkit. Using evidence-based information, the toolkit was created with continuous input from professionals as well as persons with lived experience, over a period of six months. Project leads, working in collaboration with the NPO and professionals within the community, attempted to recruit kinship caregivers from within community settings. The Caregiver Toolkit Survey (CTS) was developed to measure usefulness of the KC toolkit as perceived by KC. The CTS was administered at baseline and distributed to KC for completion 2 – 4 weeks after baseline. A second survey was developed and administered to professional stakeholders to obtain professional perspectives on the usefulness of the toolkit. Data was collected between March 15, 2022, and May 15, 2022. The main findings indicate that professionals all agreed or strongly agreed that the toolkit will help caregivers understand the needs of children impacted by parental SUD. The results of the surveys will assist in modifying the toolkit for future use within the community. This project offers a starting point for others who wish to create an evidence-based toolkit for KC

Without Fear or Favor, Since 1929

A letter to SNC parents about the student newspaper, St. Norbert Times, in 2013

Complex host-pathogen coevolution in the Apterostigma fungus-growing ant-microbe symbiosis

BACKGROUND: The fungus-growing ant-microbe symbiosis consists of coevolving microbial mutualists and pathogens. The diverse fungal lineages that these ants cultivate are attacked by parasitic microfungi of the genus Escovopsis. Previous molecular analyses have demonstrated strong phylogenetic congruence between the ants, the ants-cultivated fungi and the garden pathogen Escovopsis at ancient phylogenetic levels, suggesting coevolution of these symbionts. However, few studies have explored cophylogenetic patterns between these symbionts at the recent phylogenetic levels necessary to address whether these parasites are occasionally switching to novel hosts or whether they are diversifying with their hosts as a consequence of long-term host fidelity. RESULTS: Here, a more extensive phylogenetic analysis of Escovopsis lineages infecting the gardens of Apterostigma ants demonstrates that these pathogens display patterns of phylogenetic congruence with their fungal hosts. Particular clades of Escovopsis track particular clades of cultivated fungi, and closely-related Escovopsis generally infect closely-related hosts. Discordance between host and parasite phylogenies, however, provides the first evidence for occasional host-switches or acquisitions of novel infections from the environment. CONCLUSION: The fungus-growing ant-microbe association has a complex coevolutionary history. Though there is clear evidence of host-specificity on the part of diverse Escovopsis lineages, these pathogens have switched occasionally to novel host fungi. Such switching is likely to have profound effects on how these host and parasites adapt to one another over evolutionary time scales and may impact how disease spreads over ecological time scales

Modeling and comparing dependencies in multivariate risk portfolios

In this paper we investigate multivariate risk portfolios where the risks are dependent. By providing some natural models for risk portfolios with the same marginal distributions we are able to compare two portfolios with different dependence structure with respect to their stoploss premiums. In particular some comparison results for portfolios with twopoint distributions are obtained. The analysis is based on the concept of the so called supermodular ordering. We also give some numerical results which indicate that dependencies in risk portfolios can have a severe impact on the stoploss premium. In fact we show that the effect of dependencies can grow beyond any given bound

Model Pratice Building: Baseline Evaluation Findings

This report presents the key findings based on data from baseline qualitative interviews and retrospective data collected from December 2007 to September 2009. The evaluation found grantees reported much success implementing their project. In particular, increasing project visibility and buy-in within their communities were areas where grantees felt they made significant progress.https://openscholarship.wustl.edu/cphss/1050/thumbnail.jp

Application of nanoscale zero valent iron (NZVI) for groundwater remediation in Europe

Purpose: Nanoscale zero valent iron (NZVI) is emerging as a new option for the treatment of contaminated soil and groundwater targeting mainly chlorinated organic contaminants (e.g., solvents, pesticides) and inorganic anions or metals. The purpose of this article is to give a short overview of the practical experience with NZVI applications in Europe and to present a comparison to the situation in the USA. Furthermore, the reasons for the difference in technology use are discussed. Method: The results in this article are based on an extensive literature review and structured discussions in an expert workshop with experts from Europe and the USA. The evaluation of the experiences was based on a SWOT (strength, weakness, opportunity, threat) analysis. Result: There are significant differences in the extent and type of technology used between NZVI applications in Europe and the USA. In Europe, only three full-scale remediations with NZVI have been carried out so far, while NZVI is an established treatment method in the USA. Bimetallic particles and emulsified NZVI, which are extensively used in the USA, have not yet been applied in Europe. Economic constraints and the precautionary attitude in Europe raise questions regarding whether NZVI is a cost-effective method for aquifer remediation. Challenges to the commercialization of NZVI include mainly non-technical aspects such as the possibility of a public backlash, the fact that the technology is largely unknown to consultants, governments and site owners as well as the lack of long-term experiences. Conclusion: Despite these concerns, the results of the current field applications with respect to contaminant reduction are promising, and no major adverse impacts on the environment have been reported so far. It is thus expected that these trials will contribute to promoting the technology in Europ

Assessment of liver fibrosis and associated risk factors in HIV-infected individuals using transient elastography and serum biomarkers

Background: Liver fibrosis in human immunodeficiency virus (HIV)-infected individuals is mostly attributable to co-infection with hepatitis B or C. The impact of other risk factors, including prolonged exposure to combined antiretroviral therapy (cART) is poorly understood. Our aim was to determine the prevalence of liver fibrosis and associated risk factors in HIV-infected individuals based on non-invasive fibrosis assessment using transient elastography (TE) and serum biomarkers (Fibrotest [FT]). Methods: In 202 consecutive HIV-infected individuals (159 men; mean age 47 ± 9 years; 35 with hepatitis-C-virus [HCV] co-infection), TE and FT were performed. Repeat TE examinations were conducted 1 and 2 years after study inclusion. Results: Significant liver fibrosis was present in 16% and 29% of patients, respectively, when assessed by TE (≥ 7.1 kPa) and FT (> 0.48). A combination of TE and FT predicted significant fibrosis in 8% of all patients (31% in HIV/HCV co-infected and 3% in HIV mono-infected individuals). Chronic ALT, AST and γ-GT elevation was present in 29%, 20% and 51% of all cART-exposed patients and in 19%, 8% and 45.5% of HIV mono-infected individuals. Overall, factors independently associated with significant fibrosis as assessed by TE (OR, 95% CI) were co-infection with HCV (7.29, 1.95-27.34), chronic AST (6.58, 1.30-33.25) and γ-GT (5.17, 1.56-17.08) elevation and time on dideoxynucleoside therapy (1.01, 1.00-1.02). In 68 HIV mono-infected individuals who had repeat TE examinations, TE values did not differ significantly during a median follow-up time of 24 months (median intra-patient changes at last TE examination relative to baseline: -0.2 kPa, p = 0.20). Conclusions: Chronic elevation of liver enzymes was observed in up to 45.5% of HIV mono-infected patients on cART. However, only a small subset had significant fibrosis as predicted by TE and FT. There was no evidence for fibrosis progression during follow-up TE examinations