Patient Perspectives on Medication Assisted Therapy in Vermont

Introduction. Medication-Assisted Therapy (MAT) for opioid addiction has dramatically increased in Vermont, supported by a novel statewide system that integrates specialty treatment centers ( Hubs ) with primary care office-based opioid therapy ( Spokes ). In 2010, Vermont had the highest per capita buprenorphine use in the US. Previous studies of patient perspectives of MAT have identified social barriers, rigid program rules, and concerns about withdrawal and relapse as common causes of treatment failure. Our goal was to elicit patient perspectives on barriers and enablers of successful MAT to further inform system refinement. Methods. An interview guide was developed based on previous literature as well as discussions with program leadership, staff and clinicians, and community stakeholders. Responses were organized using thematic content analysis with consensus across seven interviewers and two analysts. The interviews were conducted with 44 patients enrolled in MAT at two Hub sites in Burlington, VT in October 2016. Results. The median age of subjects was 34 years, 34% were employed at least part-time, and 72% were female. Half reported a mental health condition and 20% reported chronic pain. Barriers included transportation (25%), lack of stable housing, and stigma (41%). Enablers included feeling supported (82% felt well-supported; 52% felt supported by healthcare professionals). Subjects expressed high confidence in the treatment system and high self-efficacy for sobriety. Conclusions. Patients in MAT have complex medical, mental health, social, personal, and work lives. A comprehensive system that addresses this wide range of domains is critical to achieving optimal outcomes.https://scholarworks.uvm.edu/comphp_gallery/1245/thumbnail.jp

Origin of volatiles in the Main Belt

We propose a scenario for the formation of the Main Belt in which asteroids incorporated icy particles formed in the outer Solar Nebula. We calculate the composition of icy planetesimals formed beyond a heliocentric distance of 5 AU in the nebula by assuming that the abundances of all elements, in particular that of oxygen, are solar. As a result, we show that ices formed in the outer Solar Nebula are composed of a mix of clathrate hydrates, hydrates formed above 50 K and pure condensates produced at lower temperatures. We then consider the inward migration of solids initially produced in the outer Solar Nebula and show that a significant fraction may have drifted to the current position of the Main Belt without encountering temperature and pressure conditions high enough to vaporize the ices they contain. We propose that, through the detection and identification of initially buried ices revealed by recent impacts on the surfaces of asteroids, it could be possible to infer the thermodynamic conditions that were present within the Solar Nebula during the accretion of these bodies, and during the inward migration of icy planetesimals. We also investigate the potential influence that the incorporation of ices in asteroids may have on their porosities and densities. In particular, we show how the presence of ices reduces the value of the bulk density of a given body, and consequently modifies its macro-porosity from that which would be expected from a given taxonomic type.Comment: Accepted for publication in MNRA

A Portable Wireless Particulate Sensor System for Continuous Real-Time Environmental Monitoring

Airborne particulate matter has been shown to be associated with morbidity and mortality, and may interfere with certain sensitive experiment. Understanding the levels and movements of particulate matter in an enclosed space can lead to a reduction in the impact of this material on health and experimental results. A system of environmental sensors including particulate matter, selected gasses, humidity, temperature, and pressure can be used to assist in tracking air movement, providing real-time mapping of potential contaminants as they move through a space. In this paper we present a system that is capable of sensing these environmental factors, collecting data from multiple dispersed nodes and presenting the aggregated information in real-time. The highly modular system is based on a flexible and scalable framework developed for use in aircraft cabin environments. Use of this framework enables the deployment of a custom suite of sensors with minimal development effort. Individual nodes communicate using a self-organizing mesh network and can be powered from a variety of sources, bringing a high level of flexibility in the arrangement and distribution of the sensor array. Sensor data is transmitted to a coordinator node, which then passes the time-correlated information to a server-hosted database through a choice of wired or wireless networks. Presentation software is used to either monitor the real-time data stream, or to extract records of interest from the database. A reference implementation has been created for the National Institutes of Health consisting of a custom optical particle counter and off-the-shelf sensors for CO2, CO, temperature, humidity, pressure, and acoustic noise. The total environmental sensing system provides continuous, real-time data in a readable format that can be used to analyze ambient air for events of interest

Children's at Home: Pilot Study Assessing Dedicated Social Media for Parents of Adolescents with Neurofibromatosis Type 1.

The aim of this pilot study was to evaluate Children's at Home (C@H), a dedicated social media website for parents of adolescents with neurofibromatosis type 1 (NF1). The interventional study included two phases: (1) creating video intervention/prevention assessment (VIA) visual narratives about having an adolescent with NF1 and (2) interacting on C@H, a secure, medically moderated social media website. C@H was evaluated qualitatively at three time points. At enrollment (T0, N = 17), participants reported needing C@H to break their isolation, connect with other families, and receive accurate information, advice, and support from others facing similar challenges. At T1, after creating VIA during 6 months (N = 13, 145 videos), participants mostly valued the opportunity to speak about the challenges they face with NF1 and their journey since diagnosis. At T2, after interacting on C@H for 7 weeks (N = 10, two sign-ins/week/parent), participants reported connecting with other parents of children with NF1 for the first time, valuing the "real faces" and emotions of other parents with shared experiences providing a sense of normalcy. Qualitative analysis suggested that C@H decreased feelings of isolation, provided relief to talk about NF1 without having to explain it, provided new knowledge about NF1 and the opportunity to address non-medical issues of NF1 never discussed in clinic, and helped participants with putting their lives into perspective. C@H allowed parents of adolescents with NF1 to overcome previous isolation and connect for the first time. Innovative applications of social media dedicated to those who care for children with chronic conditions can provide peer-to-peer support, shared experience, and reliable medical information

The comet Halley dust and gas environment

Quantitative descriptions of environments near the nucleus of comet P /Halley have been developed to support spacecraft and mission design for the flyby encounters in March, 1986. To summarize these models as they exist just before the encounters, we review the relevant data from prior Halley apparitions and from recent cometary research. Orbital elements, visual magnitudes, and parameter values and analysis for the nucleus, gas and dust are combined to predict Halley's position, production rates, gas and dust distributions, and electromagnetic radiation field for the current perihelion passage. The predicted numerical results have been useful for estimating likely spacecraft effects, such as impact damage and attitude perturbation. Sample applications are cited, including design of a dust shield for spacecraft structure, and threshold and dynamic range selection for flight experiments. We expect that the comet's activity may be more irregular than these smoothly varying models predict, and that comparison with the flyby data will be instructive.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/43774/1/11214_2004_Article_BF00175326.pd

Finding Fidelity : Advancing Audiovisual Analysis using Software

Specialised software for the analysis of qualitative data has been in development for the last thirty years. However, its adoption is far from widespread. Additionally, qualitative research itself is evolving, from projects that utilised small, text-based data sets to those which involve the collection, management, and analysis of enormous quantities of multimedia data or data of multiple types. Software has struggled to keep up with these changes for several reasons: 1. meeting the needs of researchers is complicated by the lack of documentation and critique by those who are implementing software use and 2. audiovisual data is particularly challenging due to the multidimensionality of data and substantial variety in research project aims and output requirements. This article discusses the history of Computer Assisted Qualitative Data AnalysiS (CAQDAS) as it relates to audiovisual data, and introduces the term "fidelity" as a conceptual mechanism to match software tools and researcher needs. Currently available software tools are examined and areas found lacking are highlighted