Ensuring safe access to medication for palliative care while preventing prescription drug abuse: innovations for American inner cities, rural areas, and communities overwhelmed by addiction

This article proposes and develops novel components of community-oriented programs for creating and affording access to safe medication dispensing centers in existing retail pharmacies and in permanent or travelling pharmacy clinics that are guarded by assigned or off-duty police officers. Pharmacists at these centers would work with police, medical providers, social workers, hospital administrators, and other professionals in: planning and overseeing the safe storage of controlled substance medications in off-site community safe-deposit boxes; strengthening communication and cooperation with the prescribing medical provider; assisting the prescribing medical provider in patient monitoring (checking the state prescription registry, providing pill counts and urine samples); expanding access to lower-cost, and in some cases, abuse-resistant formulations of controlled substance medications; improving transportation access for underserved patients and caregivers to obtain prescriptions; and integrating community agencies and social networks as resources for patient support and monitoring. Novel components of two related community-oriented programs, which may be hosted outside of safe medication dispensing centers, are also suggested and described: (1) developing medication purchasing cooperatives (ie, to help patients, families, and health institutions afford the costs of medications, including tamper-or abuse-resistant/deterrent drug formulations); and (2) expanding the role of inner-city methadone maintenance treatment programs in palliative care (ie, to provide additional patient monitoring from a second treatment team focusing on narcotics addiction, and potentially, to serve as an untapped source of opioid medication for pain that is less subject to abuse, misuse, or diversion)

Evaluation of Bird Response to Propane Exploders in an Airport Environment

Bird-aircraft collisions (bird-strikes) cause serious safety hazards to aircraft, costing civilian aviation at least $496 million annually in the U.S. Non-lethal bird-frightening devices, such as propane exploders, are commonly used to deter birds from airport environments. We conducted a study during August - October 2004 to determine the efficacy of propane exploders utilized with and without concurrent lethal reinforcement activities for altering bird behavior at John F. Kennedy International Airport in Queens, New York. Two groups of 8 propane exploders each were deployed on the airfield. One group of propane exploders was set to “off” (control), whereas the other group was programmed to activate at 15-minute intervals (treatment). This pattern was reversed each week for a 12-week period. In addition, lethal control activities to reduce gull-aircraft collisions were conducted during August and September 2004. We conducted bird observations associated with propane exploders during the lethal control program (8-week period) and following the end of the program (4-week period). The number of bird flocks (≥1 birds) that were within 150 m of treatment (n = 432) and control (n = 442) propane exploders was similar. Simultaneous lethal control activities at the airport did not alter the effectiveness of the propane exploders. Birds responded (e.g., altered flight path) on 3 of 21 (14.3%) occasions when a bird flock was within 150 m of a treatment propane exploder that activated. Our findings suggest propane exploders used in this manner in this airport environment do not significantly alter birds behavior or reduce the threat of bird-strikes. Future research is needed to evaluate techniques such as motion-activated propane exploders to enhance the effectiveness of this tool to reduce wildlife hazards at airports

Comparing Effects of Nutrients on Algal Biomass in Streams in Two Regions with Different Disturbance Regimes and with Applications for Developing Nutrient Criteria

Responses of stream algal biomass to nutrient enrichment were studied in two regions where differences in hydrologic variability cause great differences in herbivory. Around northwestern Kentucky (KY) hydrologic variability constrains invertebrate biomass and their effects on algae, but hydrologic stability in Michigan (MI) streams permits accrual of high herbivore densities and herbivory of benthic algae. Multiple indicators of algal biomass and nutrient availability were measured in 104 streams with repeated sampling at each site over a 2−month period. Many measures of algal biomass and nutrient availability were positively correlated in both regions, however the amount of variation explained varied with measures of biomass and nutrient concentration and with region. Indicators of diatom biomass were higher in KY than MI, but were not related to nutrient concentrations in either region. Chl   a and % area of substratum covered by Cladophora were positively correlated to nutrient concentrations in both regions. Cladophora responded significantly more to nutrients in MI than KY. Total phosphorus (TP) and total nitrogen (TN) explained similar amounts of variation in algal biomass, and not significantly more variation in biomass than dissolved nutrient concentrations. Low N:P ratios in the benthic algae indicated N as well as P may be limiting their accrual. Most observed responses in benthic algal biomass occurred in nutrient concentrations between 10 and 30 μg TP  l −1 and between 400 and 1000 μg TN l −1 .Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/42905/1/10750_2005_Article_1611.pd

Subjective Perceptions of Financial Strain by Home Care Patients Initiating Palliative Radiation for Recurrent Cancer: Do Older Adults Accomodate More to Objective Family Financial Stress?

The University Archives has determined that this item is of continuing value to OSU's history.Francoeur, Richard B., Ph.D., Ph.D., University of Pittsburgh, Assistant Professor, Columbia University School of Social Work - "Subjective Perceptions of Financial Strain by Home Care Patients Initiating Palliative Radiation for Recurrent Cancer: Do Older Adults Accommodate More to Objective Family Financial Stress?"The Ohio State University College of Social Wor

Synergies vs. Clustering Only of Depressive Symptoms in Diabetes and Co-Occurring Conditions: Symmetric Indicators with Asymmetric, Bidirectional Influences in MIMIC Models

I extend multiple indicators multiple causes (MIMIC) models to unveil unbiased, asymmetric, bidirectional influences using indicators of the same items within variable-defined subgroups. The strategy discerns (1) item-variation in interaction (and derivative) terms that capture synergies and cluster together (formative or causal indicators) from (2) item-variation in duplicate terms when items lack synergy and cluster together only (reflective or effect indicators). An item may reveal either or both influences. These symmetric indicators yield estimates of (1) the unique variation and synergy of each formative indicator within the structural model portion of the MIMIC model (based on moderated regression) and (2) the remaining shared variation in the reflective indicator within the measurement model portion (based on confirmatory factor analysis). I reveal two patterns of comorbidity in disease subgroups of a specific co-occurring condition across a community sample of older adults and in age and gender subsamples. First, as structural model indicators, depressive symptoms may display different synergies as they cluster within a disease subgroup of diabetes and a specific co-occurring condition. As measurement model indicators, depressive symptoms capture non-synergistic clustering within the disease subgroup. Second, diabetes may mediate the co-occurring condition when depressive symptoms lack synergies but cluster within the disease subgroup. Researchers should distinguish both comorbidity patterns, which have different implications. I offer insights for adaptive modeling, conceptualizing and screening symptom clusters, metabolomics, and economic or social monitoring

FORAGING ECOLOGY OF FOUR GULL SPECIES AT A COASTAL–URBAN INTERFACE

Coastal urban environments provide a potentially diverse source of food for gulls, including items of marine, terrestrial, and anthropogenic origin. Our objective was to examine variation in the diet and use of feeding habitat of four species of gulls, the Laughing (Leucophaeus atricilla), Herring (Larus argentatus), Great Blackbacked (L. marinus), and Ring-billed (L. delawarensis), at a coastal–urban interface. We necropsied, identified the sex and age class, and quantified the stomach contents of 1053 Laughing, 249 Herring, 67 Great Black-backed, and 31 Ring-billed Gulls collected near the New York City metropolitan area in 2003 and 2004. Great Black-backed Gulls specialized on marine foods, whereas Ring-billed Gulls were generalists. Laughing Gulls and Herring Gulls favored marine foods and foraged in marine habitats but also used terrestrial and anthropogenic food sources. We found evidence that demographics influenced the gulls’ choice of diet and use of feeding habitat. Laughing Gulls and Herring Gulls switched their use of feeding habitats at various stages of breeding, exploiting terrestrial prey and feeding habitats most during chick rearing. Interspecific and intraspecific differences in the four species’ diet and use of feeding habitat apparently allow for their coexistence at this coastal–urban interface

Arthropods of a semi-natural grassland in an urban environment: the John F. Kennedy International Airport, New York

Semi-natural grassland habitat fragments, such as those found on airports, might be important for arthropod conservation and biodiversity in urban ecosystems. The objectives of this study were to: (1) describe the arthropod communities present within the grasslands on the John F. Kennedy International Airport and (2) assess spatial and temporal variation in those arthropod communities. We collected arthropods using a vacuum sampler during 2003 and using sweep-net collection methods during 2003 and 2004. During 2003, a total of 1,467 arthropods, representing 17 orders and 68 families were found in vacuum samples. A total of 3,784 arthropods, representing 12 orders and 94 families were collected in sweep-net samples during 2003. In 2004, a total of 3,281 arthropods, representing 12 orders and 85 families were collected in sweepnet samples. Hemiptera, Orthoptera, and Diptera were the most abundant taxa, accounting for 47, 18, and 14% of all arthropods captured, respectively. We found evidence of spatial and temporal variation in arthropod abundance, in particular as noted by fluctuations in Orthoptera: Acrididae and Hemiptera: Auchenorrhyncha. Hemipteran family diversity was also influenced by habitat type. Grassland habitats on airfields, although influenced by anthropogenic factors (e.g., mowing), have the potential to provide abundant and diverse arthropod communities and might serve as a refugium for such species within urban ecosystems