Lessons learned from a peri-urban needle exchange

<p>Abstract</p> <p>Background</p> <p>Injection drug users continue to be at high risk of HIV and HCV. Research has shown that needle exchange programs (NEP) decrease injection frequency, reduce syringe reuse, and reduce needle sharing, though some results have been mixed.</p> <p>Methods</p> <p>This evaluation of a small, peri-urban, legal NEP near Ypsilanti, Michigan describes the operation of the NEP and its clients. It uses interviews conducted with NEP participants between 2003 and 2006, describing the population served by the program, and draws on limited comparisons between matched baseline and follow-up measures as well as aggregate baseline and follow-up comparisons.</p> <p>Results</p> <p>The HIV/AIDS Resource Center (HARC) Harm Reduction NEP serves a diverse population from a wide geographical area. NEP participants at follow-up reused their syringes significantly fewer times before getting new ones, were significantly less likely to report giving another IDU a previously used syringe, and were more likely to clean their skin with alcohol either before or after injecting than the baseline comparison group.</p> <p>Conclusions</p> <p>The limited data presented here suggest that a NEP can be an effective method of harm reduction even in low-volume, non-urban settings and are an important venue for intervention in peri-urban areas.</p

Long-range orbitofrontal and amygdala axons show divergent patterns of maturation in the frontal cortex across adolescence.

The adolescent transition from juvenile to adult is marked by anatomical and functional remodeling of brain networks. Currently, the cellular and synaptic level changes underlying the adolescent transition are only coarsely understood. Here, we use two-photon imaging to make time-lapse observations of long-range axons that innervate the frontal cortex in the living brain. We labeled cells in the orbitofrontal cortex (OFC) and basolateral amygdala (BLA) and imaged their axonal afferents to the dorsomedial prefrontal cortex (dmPFC). We also imaged the apical dendrites of dmPFC pyramidal neurons. Images were taken daily in separate cohorts of juvenile (P24-P28) and young adult mice (P64-P68), ages where we have previously discovered differences in dmPFC dependent decision-making. Dendritic spines were pruned across this peri-adolescent period, while BLA and OFC afferents followed alternate developmental trajectories. OFC boutons showed no decrease in density, but did show a decrease in daily bouton gain and loss with age. BLA axons showed an increase in both bouton density and daily bouton gain at the later age, suggesting a delayed window of enhanced plasticity. Our findings reveal projection specific maturation of synaptic structures within a single frontal region and suggest that stabilization is a more general characteristic of maturation than pruning

Mapping the Literature on Parent-Child Language across Activity Contexts:A Scoping Review

Linguistic interactions between parents and their children are frequently studied to investigate how children acquire language. From observations, researchers have identified interaction strategies that foster children’s language development. In turn, interventions to support children’s early language skills employ styles of interaction derived from these observations. However, researchers have not often considered how the activity context selected forobservation may affect the language used, or whether these contexts reflect children’s diverse experiences.The aim of this scoping review was to explore the breadth of literature about language use across a range of activities. Included studies described linguistic outputs of parents and typically developing children (aged 1;0 to 5;11 years) and activity context(s). Searches were conducted in PsycInfo, Medline, CINAHL, ERIC-ProQuest and Google Scholar. From 16,718 records, 59 studies were retained. Studies were charted according to the population included, linguistic outputs recorded, activity contexts studied and the methodological design. To allow for comparison of results across activity contexts, five thematic categories were identified: play activities, book reading, naturalistic routines, media and methodological implications. Challenges for future research are discussed, including ways to ensure the ecological validity of findings by coupling naturalistic language recordings with data collected during diverse everyday activity contexts

Identification of symptom domains in ulcerative colitis that occur frequently during flares and are responsive to changes in disease activity

<p>Abstract</p> <p>Background</p> <p>Ulcerative colitis disease activity is determined by measuring symptoms and signs. Our aim was to determine which symptom domains are frequent and responsive to change in the evaluation of disease activity, which are those defined by three criteria: 1) they occur frequently during flares; 2) they improve during effective therapy for ulcerative colitis; and 3) they resolve during remission.</p> <p>Methods</p> <p>Twenty-eight symptom domains, 16 from standard indices and 12 novel domains identified by ulcerative colitis patient focus groups, were evaluated. Sixty subjects with ulcerative colitis were surveyed, rating each symptom on the three criteria with a 100 mm Visual Analogue Scale. Frequent and responsive symptoms were defined <it>a priori </it>as those whose median Visual Analogue Scale rating for all 3 criteria was significantly greater than 50.</p> <p>Results</p> <p>Thirteen of the 28 symptom domains were identified as both frequent in ulcerative colitis flares and responsive to changes in disease activity. Seven of these 13 symptom domains were novel symptoms derived from ulcerative colitis patient focus groups including stool mucus, tenesmus, fatigue, rapid postprandial bowel movements, and inability to differentiate liquid or gas from solid stool when rectal urgency occurs. Ten of the 16 symptom domains from standard indices were either infrequent or unresponsive to changes in disease activity.</p> <p>Conclusion</p> <p>Only some of the symptoms of ulcerative colitis that are important to patients are included in standard indices, and several symptoms currently measured are not frequent or responsive to change in ulcerative colitis patients. Development of survey measures of these symptom domains could significantly improve the assessment of disease activity in ulcerative colitis.</p

Development of a Multicenter Interventional Cardiology Database: The Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2) Experience

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72219/1/j.1540-8183.2002.tb01072.x.pd

Enhancing Participation of Older Women in Surgical Trials

Older participants are often excluded from clinical trials, precluding a representative sample

GRB 090417B and its Host Galaxy: A Step Towards an Understanding of Optically-Dark Gamma-Ray Bursts

GRB 090417B was an unusually long burst with a T_90 duration of at least 2130 s and a multi-peaked light curve at energies of 15-150 keV. It was optically dark and has been associated with a bright star-forming galaxy at a redshift of 0.345 that is broadly similar to the Milky Way. This is one of the few cases where a host galaxy has been clearly identified for a dark gamma-ray burst and thus an ideal candidate for studying the origin of dark bursts. We find that the dark nature of GRB 090417B cannot be explained by high redshift, incomplete observations, or unusual physics in the production of the afterglow. Assuming the standard relativistic fireball model for the afterglow we find that the optical flux is at least 2.5 mag fainter than predicted by the X-ray flux. The Swift/XRT X -ray data are consistent with the afterglow being obscured by a dense, localized sheet of dust approximately 30-80 pc from the burst along the line of sight. Our results suggest that this dust sheet imparts an extinction of A_V >~ 12 mag, which is sufficient to explain the missing optical flux. GRB 090417B is an example of a gamma-ray burst that is dark due to the localized dust structure in its host galaxy.Comment: Accepted for publication in Ap