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

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

Remarks on Andrew Lang's World Trade Law After Neo-Liberalism

No abstract available