Is Primary Care Providers’ Trust in Socially Marginalized Patients Affected by Race?

Interpersonal trust plays an important role in the clinic visit. Clinician trust in the patient may be especially important when prescribing opioid analgesics because of concerns about misuse. Previous studies have found that non-white patients are perceived negatively by clinicians.To examine whether clinicians' trust in patients differed by patients' race/ethnicity in a socially marginalized cohort.Cross-sectional study of patient-clinician dyads.169 HIV infected indigent patients recruited from the community and their 61 primary care providers (PCPs.)The Physician Trust in Patients Scale (PTPS), a validated scale that measures PCPs' trust in patients.The mean PTPS score was 43.2 (SD 10.8) out of a possible 60. Reported current illicit drug use and prescription opioid misuse were similar across patients' race or ethnicity. However, both patient illicit drug use and patient non-white race/ethnicity were associated with lower PTPS scores. In a multivariate model, non-white race/ethnicity was independently associated with PTPS scores 6.3 points lower than whites (95% CI: -9.9, -2.7). Current illicit drug use was associated with PTSP scores 5.5 lower than no drug use (95% CI -8.5, -2.5).In a socially marginalized cohort, non-white patients were trusted less than white patients by their PCPs, despite similar rates of illicit drug use and opioid analgesic misuse. The effect was independent of illicit drug use. This finding may reflect unconscious stereotypes by PCPs and may underlie disparities in chronic pain management

Potential Agronomic Benefits of Wood Ash Application on Reclaimed Surface Mined Lands

Wood ash is a by-product generated by paper companies, lumber manufacturing plants and utilities that bum wood products, bark and papermill sludge as a means of disposal and/or energy production. Large quantities of wood ash are generated by these industries since wood generally contains 6 to 10% ash. Most of these ashes are landfilled or discarded in lagoons. However, the increasing expense of landfill disposal has led to increased interest in the land application of industry generated wood ash

Green Infrastructure in Coastal Landscapes: Ecological Design, Hydrological Function, and Sustainable Land Use Goals

2012 S.C. Water Resources Conference - Exploring Opportunities for Collaborative Water Research, Policy and Managemen

The COS-Dwarfs Survey: The Carbon Reservoir Around sub-L* Galaxies

We report new observations of circumgalactic gas from the COS-Dwarfs survey, a systematic investigation of the gaseous halos around 43 low-mass z $\leq$ 0.1 galaxies using background QSOs observed with the Cosmic Origins Spectrograph. From the projected 1D and 2D distribution of C IV absorption, we find that C IV absorption is detected out to ~ 0.5 R$_{vir}$ of the host galaxies. The C IV absorption strength falls off radially as a power law and beyond 0.5 R$_{vir}$, no C IV absorption is detected above our sensitivity limit of ~ 50-100 m$\AA$. We find a tentative correlation between detected C IV absorption strength and star formation, paralleling the strong correlation seen in highly ionized oxygen for L~L* galaxies by the COS-Halos survey. The data imply a large carbon reservoir in the CGM of these galaxies, corresponding to a minimum carbon mass of $\gtrsim$ 1.2$\times 10^6$ $M_\odot$ out to ~ 110 kpc. This mass is comparable to the carbon mass in the ISM and more than the carbon mass currently in stars of these galaxies. The C IV absorption seen around these sub-L* galaxies can account for almost two-thirds of all $W_r$> 100 m$\AA$ C IV absorption detected at low z. Comparing the C IV covering fraction with hydrodynamical simulations, we find that an energy-driven wind model is consistent with the observations whereas a wind model of constant velocity fails to reproduce the CGM or the galaxy properties.Comment: 18 Pages, 11 Figures, ApJ 796 13

Resolving a puzzling anomaly in the spin-coupled generalized valence bond description of benzene

In an earlier study of benzene, Small and Head-Gordon found that the spin-coupled generalized valence bond (SCGVB) wave function for the π system predicted a distorted (non-D6h) geometry, one with alternating CC bond lengths. However, the variations in the energy were very small and the predictions were made using a very small basis set (STO-3G). We re-examined this prediction using a much larger basis set (aug-cc-pVTZ) to determine the dependence of the energy of benzene on the distortion angle, ΔθCXC (ΔθCXC = 0° corresponds to the D6h structure). We also found a distorted geometry with the optimum ΔθCXC being 0.31° with an energy 0.040 kcal mol⁻¹ lower than that for the D6h structure. In the optimum geometry, adjacent CC bond lengths are 1.3861 Å and 1.4004 Å. Analysis of the SCGVB wave function led us to conclude that the cause of the unusual non-D6h geometry predicted by the SCGVB calculations seems to be a result of the interaction between the Kekulé and Dewar components of the full SCGVB wave function. The addition of doubly ionic configurations to the SCGVB wave function leads to the prediction of a D6h geometry for benzene and a dependence on ΔθCXC essentially the same as that predicted by the complete active space self-consistent field wave function

The COS-Halos Survey: Physical Conditions and Baryonic Mass in the Low-Redshift Circumgalactic Medium

We analyze the physical conditions of the cool, photoionized (T $\sim 10^4$ K) circumgalactic medium (CGM) using the COS-Halos suite of gas column density measurements for 44 gaseous halos within 160 kpc of $L \sim L^*$ galaxies at $z \sim 0.2$. These data are well described by simple photoionization models, with the gas highly ionized (n$_{\rm HII}$/n$_{\rm H} \gtrsim 99\%$) by the extragalactic ultraviolet background (EUVB). Scaling by estimates for the virial radius, R$_{\rm vir}$, we show that the ionization state (tracked by the dimensionless ionization parameter, U) increases with distance from the host galaxy. The ionization parameters imply a decreasing volume density profile n$_{\rm H}$ = (10$^{-4.2 \pm 0.25}$)(R/R$_{\rm vir})^{-0.8\pm0.3}$. Our derived gas volume densities are several orders of magnitude lower than predictions from standard two-phase models with a cool medium in pressure equilibrium with a hot, coronal medium expected in virialized halos at this mass scale. Applying the ionization corrections to the HI column densities, we estimate a lower limit to the cool gas mass M$_{\rm CGM}^{\rm cool} > 6.5 \times 10^{10}$ M$_{\odot}$ for the volume within R $<$ R$_{\rm vir}$. Allowing for an additional warm-hot, OVI-traced phase, the CGM accounts for at least half of the baryons purported to be missing from dark matter halos at the 10$^{12}$ M$_{\odot}$ scale.Comment: 19 pages, 12 Figures, and a 37-page Appendix with 36 additional figures. Accepted to ApJ June 21 201

Hydrogen and Metal Line Absorption Around Low-Redshift Galaxies in Cosmological Hydrodynamic Simulations

We study the physical conditions of the circum-galactic medium (CGM) around z=0.25 galaxies as traced by HI and metal line absorption, using cosmological hydrodynamic simulations that include galactic outflows. Using lines of sight targeted at impact parameters from 10 kpc to 1 Mpc around galaxies with halo masses from 10^11-10^13 M_solar, we study the physical conditions and their variation with impact parameter b and line-of-sight velocity delta v in the CGM as traced by HI, MgII, SiIV, CIV, OVI, and NeVIII absorbers. All ions show a strong excess of absorption near galaxies compared to random lines of sight. The excess continues beyond 1 Mpc, reflecting the correlation of metal absorption with large-scale structure. Absorption is particularly enhanced within about v<300 km/sec and roughly 300 kpc of galaxies (with distances somewhat larger for the highest ion), approximately delineating the CGM; this range contains the majority of global metal absorption. Low ions like MgII and SiIV predominantly arise in denser gas closer to galaxies and drop more rapidly with b, while high ions OVI and NeVIII trace more diffusely distributed gas with a comparatively flat radial profile; CIV is intermediate. All ions predominantly trace T~10^4-4.5 K photo-ionised gas at all b, but when hot CGM gas is present (mostly in larger halos), we see strong collisionally-ionised OVI and NeVIII at b <= 100 kpc. Larger halo masses generally produce more absorption, though overall the trends are not as strong as that with impact parameter. These findings arise using our favoured outflow scalings as expected for momentum-driven winds; with no winds, the CGM gas remains mostly unenriched, while our outflow model with a constant velocity and mass loading factor produce hotter, more widely dispersed metals.Comment: 26 pages, 15 figures, published in MNRAS. Updates to citations from previous versio