315 research outputs found
Opioid initiation and injection transition in rural northern New England: A mixed-methods approach
BACKGROUND: In rural northern New England, located in the northeastern United States, the overdose epidemic has accelerated with the introduction of fentanyl. Opioid initiation and transition to opioid injection have been studied in urban settings. Little is known about opioid initiation and transition to injection drug use in rural northern New England.
METHODS: This mixed-methods study characterized opioid use and drug injection in 11 rural counties in Massachusetts, Vermont, and New Hampshire between 2018 and 2019. People who use drugs completed audio computer-assisted self-interview surveys on substance use and risk behaviors (n = 589) and shared personal narratives through in-depth interviews (n = 22). The objective of the current study is to describe initiation of opioid use and drug injection in rural northern New England.
RESULTS: Median age of first injection was 22 years (interquartile range 18-28 years). Key themes from in-depth interviews that led to initiating drug injection included normalization of drug use in families and communities, experiencing trauma, and abrupt discontinuation of an opioid prescription. Other factors that led to a transition to injecting included lower cost, increased effect/ rush, greater availability of heroin/ fentanyl, and faster relief of withdrawal symptoms with injection.
CONCLUSIONS: Trauma, normalization of drug use, over-prescribing of opioids, and abrupt discontinuation challenge people who use drugs in rural northern New England communities. Inadequate opioid tapering may increase transition to non-prescribed drug use. The extent and severity of traumatic experiences described highlights the importance of enhancing trauma-informed care in rural areas
Tribute to Professor Doug Rendleman
A tribute to Professor Doug Rendleman, who served on the faculty of the Washington and Lee University School of Law from 1988 to 2020. Rendleman became Professor of Law, Emeritus in 2020
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Houselessness and syringe service program utilization among people who inject drugs in eight rural areas across the USA: A cross-sectional analysis
Background: Research conducted in urban areas has highlighted the impact of housing instability on people who inject drugs (PWID), revealing that it exacerbates vulnerability to drug-related harms and impedes syringe service program (SSP) use. However, few studies have explored the effects of houselessness on SSP use among rural PWID. This study examines the relationship between houselessness and SSP utilization among PWID in eight rural areas across 10 states. Methods: PWID were recruited using respondent-driven sampling for a cross-sectional survey that queried self-reported drug use and SSP utilization in the prior 30 days, houselessness in the prior 6 months and sociodemographic characteristics. Using binomial logistic regression, we examined the relationship between experiencing houselessness and any SSP use. To assess the relationship between houselessness and the frequency of SSP use, we conducted multinomial logistic regression analyses among participants reporting any past 30-day SSP use. Results: Among 2394 rural PWID, 56.5% had experienced houselessness in the prior 6 months, and 43.5% reported past 30-day SSP use. PWID who had experienced houselessness were more likely to report using an SSP compared to their housed counterparts (adjusted odds ratio [aOR] = 1.24 [95% confidence intervals [CI] 1.01, 1.52]). Among those who had used an SSP at least once (n = 972), those who experienced houselessness were just as likely to report SSP use two (aOR = 0.90 [95% CI 0.60, 1.36]) and three times (aOR = 1.18 [95% CI 0.77, 1.98]) compared to once. However, they were less likely to visit an SSP four or more times compared to once in the prior 30 days (aOR = 0.59 [95% CI 0.40, 0.85]). Conclusion: This study provides evidence that rural PWID who experience houselessness utilize SSPs at similar or higher rates as their housed counterparts. However, housing instability may pose barriers to more frequent SSP use. These findings are significant as people who experience houselessness are at increased risk for drug-related harms and encounter additional challenges when attempting to access SSPs.</p
Feeding the rural tourism strategy? Food and notions of place and identity
The humble rural cuisine has now been thrust at the forefront of economic
development strategies. This conceptual paper is a contribution to a growing critical
awareness of the operations of the food industry and helps to foster a critical understanding
of how, if at all, local food and its associated culture can help sustain rural tourism
particularly and rural communities generally. It is inspired by literature about the
international political economy of food and the many experiences of local food development,
and is aware of the contrast between the structure of the industry and the hopes associated
with its practice on the ground. The paper thus argues that, beyond the glamour and hype,
there are those who gain, as well as those who lose, from the current food fad. While it
explains the causes of the contemporary craze with food, the paper also interrogates the
naı¨ve expectations often placed in food as a motor of rural development, and as the panacea
for struggling rural communities. The empirical data on which this chapter is based are
drawn from 18 short chapters explaining the history of various “traditional dishes” from the
islands of the broad North Atlantic that feature in a recent food publication.peer-reviewe
Dark Energy from structure: a status report
The effective evolution of an inhomogeneous universe model in any theory of
gravitation may be described in terms of spatially averaged variables. In
Einstein's theory, restricting attention to scalar variables, this evolution
can be modeled by solutions of a set of Friedmann equations for an effective
volume scale factor, with matter and backreaction source terms. The latter can
be represented by an effective scalar field (`morphon field') modeling Dark
Energy.
The present work provides an overview over the Dark Energy debate in
connection with the impact of inhomogeneities, and formulates strategies for a
comprehensive quantitative evaluation of backreaction effects both in
theoretical and observational cosmology. We recall the basic steps of a
description of backreaction effects in relativistic cosmology that lead to
refurnishing the standard cosmological equations, but also lay down a number of
challenges and unresolved issues in connection with their observational
interpretation.
The present status of this subject is intermediate: we have a good
qualitative understanding of backreaction effects pointing to a global
instability of the standard model of cosmology; exact solutions and
perturbative results modeling this instability lie in the right sector to
explain Dark Energy from inhomogeneities. It is fair to say that, even if
backreaction effects turn out to be less important than anticipated by some
researchers, the concordance high-precision cosmology, the architecture of
current N-body simulations, as well as standard perturbative approaches may all
fall short in correctly describing the Late Universe.Comment: Invited Review for a special Gen. Rel. Grav. issue on Dark Energy, 59
pages, 2 figures; matches published versio
Stellar structure and compact objects before 1940: Towards relativistic astrophysics
Since the mid-1920s, different strands of research used stars as "physics
laboratories" for investigating the nature of matter under extreme densities
and pressures, impossible to realize on Earth. To trace this process this paper
is following the evolution of the concept of a dense core in stars, which was
important both for an understanding of stellar evolution and as a testing
ground for the fast-evolving field of nuclear physics. In spite of the divide
between physicists and astrophysicists, some key actors working in the
cross-fertilized soil of overlapping but different scientific cultures
formulated models and tentative theories that gradually evolved into more
realistic and structured astrophysical objects. These investigations culminated
in the first contact with general relativity in 1939, when J. Robert
Oppenheimer and his students George Volkoff and Hartland Snyder systematically
applied the theory to the dense core of a collapsing neutron star. This
pioneering application of Einstein's theory to an astrophysical compact object
can be regarded as a milestone in the path eventually leading to the emergence
of relativistic astrophysics in the early 1960s.Comment: 83 pages, 4 figures, submitted to the European Physical Journal
Expression and Characterization of Drosophila Signal Peptide Peptidase-Like (sppL), a Gene That Encodes an Intramembrane Protease
Intramembrane proteases of the Signal Peptide Peptidase (SPP) family play important roles in developmental, metabolic and signaling pathways. Although vertebrates have one SPP and four SPP-like (SPPL) genes, we found that insect genomes encode one Spp and one SppL. Characterization of the Drosophila sppL gene revealed that the predicted SppL protein is a highly conserved structural homolog of the vertebrate SPPL3 proteases, with a predicted nine-transmembrane topology, an active site containing aspartyl residues within a transmembrane region, and a carboxy-terminal PAL domain. SppL protein localized to both the Golgi and ER. Whereas spp is an essential gene that is required during early larval stages and whereas spp loss-of-function reduced the unfolded protein response (UPR), sppL loss of function had no apparent phenotype. This was unexpected given that genetic knockdown phenotypes in other organisms suggested significant roles for Spp-related proteases
A review of elliptical and disc galaxy structure, and modern scaling laws
A century ago, in 1911 and 1913, Plummer and then Reynolds introduced their
models to describe the radial distribution of stars in `nebulae'. This article
reviews the progress since then, providing both an historical perspective and a
contemporary review of the stellar structure of bulges, discs and elliptical
galaxies. The quantification of galaxy nuclei, such as central mass deficits
and excess nuclear light, plus the structure of dark matter halos and cD galaxy
envelopes, are discussed. Issues pertaining to spiral galaxies including dust,
bulge-to-disc ratios, bulgeless galaxies, bars and the identification of
pseudobulges are also reviewed. An array of modern scaling relations involving
sizes, luminosities, surface brightnesses and stellar concentrations are
presented, many of which are shown to be curved. These 'redshift zero'
relations not only quantify the behavior and nature of galaxies in the Universe
today, but are the modern benchmark for evolutionary studies of galaxies,
whether based on observations, N-body-simulations or semi-analytical modelling.
For example, it is shown that some of the recently discovered compact
elliptical galaxies at 1.5 < z < 2.5 may be the bulges of modern disc galaxies.Comment: Condensed version (due to Contract) of an invited review article to
appear in "Planets, Stars and Stellar
Systems"(www.springer.com/astronomy/book/978-90-481-8818-5). 500+ references
incl. many somewhat forgotten, pioneer papers. Original submission to
Springer: 07-June-201
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Remarks on Andrew Lang's World Trade Law After Neo-Liberalism
No abstract available
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