Therapist and computer‐based brief interventions for drug use within a randomized controlled trial: effects on parallel trajectories of alcohol use, cannabis use and anxiety symptoms

Background and AimsDespite their high comorbidity, the effects of brief interventions (BI) to reduce cannabis use, alcohol use and anxiety symptoms have received little empirical attention. The aims of this study were to examine whether a therapist‐delivered BI (TBI) or computer‐guided BI (CBI) to address drug use, alcohol consumption (when relevant) and HIV risk behaviors, relative to enhanced usual care (EUC), was associated with reductions in parallel trajectories of alcohol use, cannabis use and anxiety symptoms, and whether demographic characteristics moderated reductions over time.DesignLatent growth curve modeling was used to examine joint trajectories of alcohol use, cannabis use and anxiety symptoms assessed at 3, 6 and 12 months after baseline enrollment.SettingHurley Medical Center Emergency Department (ED) in Flint, MI, USA.ParticipantsThe sample was 780 drug‐using adults (aged 18–60 years; 44% male; 52% black) randomly assigned to receive either a TBI, CBI or EUC through the HealthiER You study.Interventions and comparatorED‐delivered TBI and CBIs involved touchscreen‐delivered and audio‐assisted content. The TBI was administered by a Master’s‐level therapist, whereas the CBI was self‐administered using a virtual health counselor. EUC included a review of health resources brochures in the ED.MeasurementsAssessments of alcohol use (10‐item Alcohol Use Disorders Identification Test), cannabis use (past 30‐day frequency) and anxiety symptoms (Brief Symptom Inventory‐18) occurred at baseline and 3‐, 6‐ and 12‐month follow‐up.FindingsTBI, relative to EUC, was associated with significant reductions in cannabis use [B = –0.49, standard error (SE) = 0.20, P < 0.05) and anxiety (B = –0.04, SE = 0.02, P < 0.05), but no main effect for alcohol use. Two of 18 moderation tests were significant: TBI significantly reduced alcohol use among males (B = –0.60, SE = 0.19, P < 0.01) and patients aged 18–25 years in the TBI condition showed significantly greater reductions in cannabis use relative to older patients (B = –0.78, SE = 0.31, P < 0.05). Results for CBI were non‐significant.ConclusionsEmergency department‐based therapist‐delivered brief interventions to address drug use, alcohol consumption (when relevant) and HIV risk behaviors may also reduce alcohol use, cannabis use and anxiety over time, accounting for the overlap of these processes.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/152851/1/add14781.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/152851/2/add14781_am.pd

Autonomous in situ calibration of ion‐sensitive field effect transistor pH sensors

Ion‐sensitive field effect transistor‐based pH sensors have been shown to perform well in high frequency and long‐term ocean sampling regimes. The Honeywell Durafet is widely used due to its stability, fast response, and characterization over a large range of oceanic conditions. However, potentiometric pH monitoring is inherently complicated by the fact that the sensors require careful calibration. Offsets in calibration coefficients have been observed when comparing laboratory to field‐based calibrations and prior work has led to the recommendation that an in situ calibration be performed based on comparison to discrete samples. Here, we describe our work toward a self‐calibration apparatus integrated into a SeapHOx pH, dissolved oxygen, and CTD sensor package. This Self‐Calibrating SeapHOx is capable of autonomously recording calibration values from a high quality, traceable, primary reference standard: equimolar tris buffer. The Self‐Calibrating SeapHOx\u27s functionality was demonstrated in a 6‐d test in a seawater tank at Scripps Institution of Oceanography (La Jolla, California, U.S.A.) and was successfully deployed for 2 weeks on a shallow, coral reef flat (Lizard Island, Australia). During the latter deployment, the tris‐based self‐calibration using 15 on‐board samples exhibited superior reproducibility to the standard spectrophotometric pH‐based calibration using \u3e 100 discrete samples. Standard deviations of calibration pH using tris ranged from 0.002 to 0.005 whereas they ranged from 0.006 to 0.009 for the standard spectrophotometric pH‐based method; the two independent calibration methods resulted in a mean pH difference of 0.008. We anticipate that the Self‐Calibrating SeapHOx will be capable of autonomously providing climate quality pH data, directly linked to a primary seawater pH standard, and with improvements over standard calibration techniques

Motivational Interviewing to Promote Self-Management

Motivational interviewing is an empathetic approach for facilitating behavior change. Clinicians can use this approach to support individuals with chronic health conditions to identify opportunities for behavior change and develop a plan for working toward their goals, recognizing the importance of self-management. The aim of this chapter is to provide a description of motivational interviewing, highlighting how this approach can be used to promote self-management. This chapter (a) provides a brief overview of motivational interviewing, (b) presents evidence about the effectiveness of motivational interviewing, (c) discusses how motivational interviewing can be used in practice with an emphasis on its use to promote self-management for individuals with chronic health conditions, and (d) summarizes key considerations when using motivational interviewing to promote self-management for individuals with chronic health conditions

A Screening Tool to Enhance Clinical Trial Participation at a Community Center Involved in a Radiation Oncology Disparities Program

A simple screening tool was used to enhance clinical trial participation at a community radiation oncology center involved in a National Cancer Institute–funded disparities program but lacking on site clinical trials personnel

Seasonal changes in seawater calcium and alkalinity in the Sargasso Sea and across the Bermuda carbonate platform

Ocean acidification may shift coral reefs from a state of net ecosystem calcification (+NEC) to net ecosystem dissolution (–NEC). Changes in NEC are typically inferred from either measured or calculated total alkalinity (TA) or the dissolved calcium (Ca) to salinity ratio relative to a reference value. The alkalinity anomaly technique has historically been the primary method to estimate NEC due to the greater analytical challenges and uncertainty associated with dissolved Ca measurements in seawater. However, this method assumes that changes in salinity-normalized TA are exclusively the result of calcification and dissolution processes. In many cases, this assumption is valid, but in some environments additional processes can significantly influence seawater TA (e.g., nutrient fluxes and redox processes). Seawater Ca is unaffected or less sensitive to these processes, and therefore, Ca and TA anomalies can be used to estimate absolute or relative changes in NEC with greater confidence. Here, we present a two-year time series of monthly seawater Ca and TA measurements across the Bermuda carbonate platform and the nearby Bermuda Atlantic Time-series Study (BATS) location offshore. High precision Ca measurements (±6 μmol kg −1) were conducted using an improved spectrophotometric titration system and showed mostly good agreement with changes in TA over the same spatial and temporal scales. Ca and TA measurements across the Bermuda platform showed seasonal fluctuations relative to offshore waters, with +NEC during summer months and near-zero or possible –NEC (net dissolution) during winter months. These seasonal patterns were most pronounced at the inshore locations with the longest residence times (10+ days), which allow stronger biogeochemical signals to develop relative to the offshore source water. Although obtaining high accuracy and precision Ca measurements remains challenging, parallel measurements of Ca and TA from both inshore and offshore waters over a multi-annual timescale could strengthen the validity of predictions for when and where a reef system, such as the Bermuda platform, may shift from +NEC to –NEC. </p

Acidity across the interface from the ocean surface to sea spray aerosol.

Aerosols impact climate, human health, and the chemistry of the atmosphere, and aerosol pH plays a major role in the physicochemical properties of the aerosol. However, there remains uncertainty as to whether aerosols are acidic, neutral, or basic. In this research, we show that the pH of freshly emitted (nascent) sea spray aerosols is significantly lower than that of sea water (approximately four pH units, with pH being a log scale value) and that smaller aerosol particles below 1 μm in diameter have pH values that are even lower. These measurements of nascent sea spray aerosol pH, performed in a unique ocean-atmosphere facility, provide convincing data to show that acidification occurs "across the interface" within minutes, when aerosols formed from ocean surface waters become airborne. We also show there is a correlation between aerosol acidity and dissolved carbon dioxide but no correlation with marine biology within the seawater. We discuss the mechanisms and contributing factors to this acidity and its implications on atmospheric chemistry

The Sea Spray Chemistry and Particle Evolution Study (SeaSCAPE): Overview and Experimental Methods

Marine aerosols strongly influence climate through their interactions with solar radiation and clouds. However, significant questions remain regarding the influences of biological activity and seawater chemistry on the flux, chemical composition, and climate-relevant properties of marine aerosols and gases. Wave channels, a traditional tool of physical oceanography, have been adapted for large-scale ocean-atmosphere mesocosm experiments in the laboratory. These experiments enable the study of aerosols under controlled conditions which isolate the marine system from atmospheric anthropogenic and terrestrial influences. Here, we present an overview of the 2019 Sea Spray Chemistry and Particle Evolution (SeaSCAPE) study, which was conducted in an 11,800 L wave channel which was modified to facilitate atmospheric measurements. The SeaSCAPE campaign sought to determine the influence of biological activity in seawater on the production of primary sea spray aerosols, volatile organic compounds (VOCs), and secondary marine aerosols. Notably, the SeaSCAPE experiment also focused on understanding how photooxidative aging processes transform the composition of marine aerosols. In addition to a broad range of aerosol, gas, and seawater measurements, we present key results which highlight the experimental capabilities during the campaign, including the phytoplankton bloom dynamics, VOC production, and the effects of photochemical aging on aerosol production, morphology, and chemical composition. Additionally, we discuss the modifications made to the wave channel to improve aerosol production and reduce background contamination, as well as subsequent characterization experiments. The SeaSCAPE experiment provides unique insight into the connections between marine biology, atmospheric chemistry, and climate-relevant aerosol properties, and demonstrates how an ocean-atmosphere-interaction facility can be used to isolate and study reactions in the marine atmosphere in the laboratory under more controlled conditions