Characteristics of Unintentional Prescription Drug Poisoning Admissions Clark County, Nevada 2009-2013

Prescription drug abuse has been the fastest growing drug problem in the United States in recent years, and is the second most commonly abused category of illegal and illicit drugs, after marijuana (SAMHSA, 2013; Carnevale, 2011). Reducing the morbidity and mortality associated with prescription drug abuse in challenging because multiple factors contribute to the problem. Prescribing behaviors and the lack of education among providers and pharmacists along with inadequate counseling and monitoring of patients prescribed pain medication are important factors (Machikanti, 2007; Okie, 2010). Patients\u27 misuse or abuse, diversion or the sharing or sell of pills, and doctor shopping are also contribute to the problem (Okie, 2010). Where they exist, prescription drug monitoring programs are underfunded and ineffective, and there are no established national prescription monitoring programs (Manchikanti, 2007) or substance abuse treatment guidelines for prescription pain relievers. Additionally, nonmedical use, including diversion, is deviant behavior driven by a range of physical, mental and social health problems. Gilson and Kreis suggest that the problem can be effectively mitigated by the development of novel opioid formulations that reduce non medical use, improvements in prescription drug monitoring programs and a better, more accurate understanding of the problem (Gilson and Kreis, 2009). Implementing strategies that target populations at greatest risk requires collaboration among local, state, federal, tribal health entities along with community partners. Further defining populations at greatest risk is critical for development and implementation of effective interventions (JAMA, 2012). This study aims to contribute to the understanding of the problem by describing the characteristics of persons who experienced an unintentional drug poisoning admission Clark County, Nevada between 2009 and 2013. This research will help to better define the population that might benefit from targeted risk reduction education and monitoring to prevent continued drug seeking and use behaviors that may lead to continued morbidity and eventual mortality

Europeanization and secessionist conflicts: concepts and theories

Die Verfasser fragen nach dem Potenzial der EU zur Lösung der Konflikte in den geteilten Staaten an ihrer Peripherie. Eine dritte Governance-Ebene schafft neue institutionelle Optionen einer Konfliktlösung und schafft neue Anreize, die zu einer Redefinition der Interessen und Identitäten der an Sezessionskonflikten beteiligten Parteien führen können. Unter Europäisierung wird ein Prozess verstanden, der von europäischen Institutionen - vor allem der EU - eingeleitet und unterstützt wird, indem das Endergebnis eines Konflikts mit einer gewissen Integration der Konfliktparteien in europäische Strukturen verknüpft wird. Konditionalität und Sozialisation als Konfliktlösungsmechanismen der Europäisierung können nicht intendierte Folgen zeitigen, die das Ziel der Konfliktlösung unterminieren können. (ICEÜbers)'This chapter explores the potential of the EU to bring about conflict settlement and conflict resolution in the divided states on its periphery through its multi-level framework and capacity for foreign policy action. A third level of governance provides new institutional options for conflict settlement and creates new incentives that may lead to a redefinition of the interests and identities of the parties involved in a secessionist conflict. Europeanization is defined as a process which is activated and encouraged by European institutions, primarily the European Union, by linking the final outcome of the conflict to a certain degree of integration of the parties involved in it into European structures. The Europeanization mechanisms of conditionality and socialization aimed at conflict settlement may have unintended effects which can undermine the objective of conflict resolution.' (author's abstract

A survey in natural forest ecosystems of Vietnam reveals high diversity of both new and described Phytophthora taxa including P. ramorum

In 2016 and 2017, surveys of Phytophthora diversity were performed in 25 natural and semi-natural forest stands and 16 rivers in temperate and subtropical montane and tropical lowland regions of Vietnam. Using baiting assays from soil samples and rivers and direct isolations from naturally fallen leaves, 13 described species, five informally designated taxa and 21 previously unknown taxa of Phytophthora were isolated from 58 of the 91 soil samples (63.7%) taken from the rhizosphere of 52 of the 64 woody plant species sampled (81.3%) in 20 forest stands (83.7%), and from all rivers: P. capensis, P. citricola VII, VIII, IX, X and XI, P. sp. botryosa-like 2, P. sp. meadii-like 1 and 2, P. sp. tropicalis-like 2 and P. sp. multivesiculata-like 1 from Phytophthora major phylogenetic Clade 2; P. castaneae and P. heveae from Clade 5; P. chlamydospora, P. gregata, P. sp. bitahaiensis-like and P. sp. sylvatica-like 1, 2 and 3 from Clade 6; P. cinnamomi (Pc), P. parvispora, P. attenuata, P. sp. attenuata-like 1, 2 and 3 and P. ×heterohybrida from Clade 7; P. drechsleri, P. pseudocryptogea, P. ramorum (Pr) and P. sp. kelmania from Clade 8, P. macrochlamydospora, P. sp. ×insolita-like, P. sp. ×kunnunara-like, P. sp. ×virginiana-like s.l. and three new taxa, P. sp. quininea-like, P. sp. ×Grenada 3-like and P. sp. ×Peru 4-like, from Clade 9; and P. sp. gallica-like 1 and 2 from Clade 10. The A1 and A2 mating types of both Pc and Pr co-occurred. The A2 mating type of Pc was associated with severe dieback of montane forests in northern Vietnam. Most other Phytophthora species, including Pr, were not associated with obvious disease symptoms. It is concluded that (1) Vietnam is within the center of origin of most Phytophthora taxa found including Pc and Pr, and (2) Phytophthora clades 2, 5, 6, 7, 8, 9, and 10 are native to Indochina.info:eu-repo/semantics/publishedVersio

Locomotor activity in Aedes aegypti with different insecticide resistance profiles

OBJECTIVE: To evaluate locomotor activity in four field populations of Ae. aegypti with different insecticide resistance profiles from the state of São Paulo for two years. METHODS: This study comprised the susceptible Rockefeller strain and four populations from São Paulo, Brazil: two considered populations with “reduced susceptibility” to pyrethroids (Campinas and Marília), and two “resistant populations” (Santos and Ribeirão Preto). First, 2016 and 2017 eggs from these five populations were hatched in laboratory. Virgin females underwent experiments under laboratory conditions at 25°C, with 12:12h light/dark (LD) photoperiod; 24-hour individual activity was recorded using a locomotor activity monitor (LAM). RESULTS: In females from 2016 field populations, both resistant populations showed significant more locomotor activity than the two reduced susceptibility populations and the Rockefeller strain (p < 0.05). As for females from 2017 field populations, reduced susceptibility populations showed a significant increased locomotor activity than the Rockefeller strain, but no significant difference when compared to Santos resistant population (p > 0.05). CONCLUSIONS: Our results indicate that insecticide-resistant Ae. aegypti populations show increased locomotor activity, which may affect the transmission dynamics of their arboviruses

Dietary interventions with dietitian involvement in adults with chronic kidney disease: A systematic review

Background A comprehensive evidence base is needed to support recommendations for the dietetic management of adults with chronic kidney disease (CKD). The present study aimed to determine the effect of dietary interventions with dietitian involvement on nutritional status, well‐being, kidney risk factors and clinical outcomes in adults with CKD. Methods Cochrane Central Register of Controlled Trials, CINAHL, MEDLINE, PsycINFO and EMBASE.com were searched from January 2000 to November 2019. Intentional weight loss and single nutrient studies were excluded. Risk of bias was assessed using the Cochrane risk‐of‐bias tool. Effectiveness was summarised using the mean difference between groups for each outcome per study. Results Twelve controlled trials (1906 participants) were included. High fruit and vegetable intake, as well as a multidisciplinary hospital and community care programme, slowed the decline in glomerular filtration rate in adults with stage 3–4 CKD. Interventions addressing nutrition‐related barriers increased protein and energy intake in haemodialysis patients. A Mediterranean diet and a diet with high n‐3 polyunsaturated fatty acids improved the lipid profile in kidney transplant recipients. Conclusions A limited number of studies suggest benefits as a result of dietary interventions that are delivered by dietitians and focus on diet quality. We did not identify any studies that focussed on our primary outcome of nutritional status or studies that examined the timing or frequency of the nutritional assessment. This review emphasises the need for a wider body of high‐quality evidence to support recommendations on what and how dietetic interventions are delivered by dietitians for adults with CKD.Output Status: Forthcoming/Available Onlin