Suburban Poverty: Barriers to Services and Injury Prevention among Marginalized Women who Use Methamphetamine

Objective: This paper aims to identify the needed healthcare and social services barriers for women living in suburban communities who are using or have used methamphetamine. Drug users are vulnerable to injury, violence and transmission of infectious diseases, and having access to healthcare has been shown to positively influence prevention and intervention among this population. Yet little is known regarding the social context of suburban drug users, their risks behaviors, and their access to healthcare.Methods: The data collection involved participant observation in the field, face-to-face interviews and focus groups. Audio-recorded in-depth life histories, drug use histories, and resource needs were collected from 31 suburban women who were former or current users of methamphetamine. The majority was drawn from marginalized communities and highly vulnerable to risk for injury and violence. We provided these women with healthcare and social service information and conducted follow-up interviews to identify barriers to these services.Results: Barriers included (1) restrictions imposed by the services and (2) limitations inherent in the women’s social, economic, or legal situations. We found that the barriers increased the women’s risk for further injury, violence and transmission of infectious diseases. Women who could not access needed healthcare and social resources typically used street drugs that were accessible and affordable to self-medicate their untreated emotional and physical pain.Conclusion: Our findings add to the literatureon how healthcare and social services are related to injury prevention. Social service providers in the suburbs were often indifferent to the needs of drug-using women. For these women, health services were accessed primarily at emergency departments (ED). To break the cycle of continued drug use, violence and injury, we suggest that ED staff be trained to perform substance abuse assessments and provide immediate referral to detoxification and treatment facilities. Policy change is needed for EDs to provide the care and linkages to treatment that can prevent future injuries and the spread of infectious diseases. [West J Emerg Med. 2011;12(3):284-292.

Drug Use Trajectory Patterns among Older Drug Users

To better understand patterns of drug use trajectories over time, it is essential to have standard measures of change. Our goal here is to introduce measures we developed to quantify change in drug use behaviors. A secondary goal is to provide effective visualizations of these trajectories for applied use. We analyzed data from a sample of 92 older drug users (ages 45 to 65) to identify transition patterns in drug use trajectories across the life course. Data were collected for every year since birth using a mixed methods design. The community-drawn sample of active and former users were 40% female, 50% African American, and 60% reporting some college or greater. Their life histories provided retrospective longitudinal data on the diversity of paths taken throughout the life course and changes in drug use patterns that occurred over time. Bayesian analysis was used to model drug trajectories displayed by innovative computer graphics. The mathematical techniques and visualizations presented here provide the foundation for future models using Bayesian analysis. In this paper we introduce the concepts of transition counts, transition rates and relapse/remission rates, and we describe how these measures can help us better understand drug use trajectories. Depicted through these visual tools, measurements of discontinuous patterns provide a succinct view of individual drug use trajectories. The measures we use on drug use data will be further developed to incorporate contextual influences on the drug trajectory and build predictive models that inform rehabilitation efforts for drug users. Although the measures developed here were conceived to better examine drug use trajectories, the applications of these measures can be used with other longitudinal datasets

Race–Gender Differences in the Impact of History of Heavy Drinking on Current Alcohol Consumption during the Transition to Adulthood

American youth transitioning to adulthood consume more alcohol than in any other period of the life course. This high level of consumption can result in serious consequences, including lost productivity, death and disability, sexual assault, and addiction. Nevertheless, relatively little is known, especially by race and gender, about how prior history of heavy drinking (e.g., in late adolescence) impacts drinking in young adulthood. Utilizing data from the National Longitudinal Survey of Youth (1994-2004) for African Americans, Latinos, and Whites (N = 2,300), we found that Whites and Latinos drink more than African Americans, and men report drinking more than women. However, accounting for a history of heavy drinking introduces considerable variation in current drinking patterns by race–gender status. A history of heavy drinking more than doubles the number of drinks consumed by African American women, putting their drinking levels on par with African American men and White women and raising their level of drinking above Latinas. Further, African American women\u27s probability of heavy drinking becomes indistinguishable from that of African American men and White women, once accounting for a prior history of binge drinking. For Latinas with a history of heavy drinking, the probability of being a current binge drinker is equal to Latinos and White men and higher than African Americans and White women

Packed Ultra-wideband Mapping Array (PUMA): A Radio Telescope for Cosmology and Transients

PUMA is a proposal for an ultra-wideband, low-resolution and transit interferometric radio telescope operating at $200-1100\,\mathrm{MHz}$. Its design is driven by six science goals which span three science themes: the physics of dark energy (measuring the expansion history and growth of the universe up to $z=6$), the physics of inflation (constraining primordial non-Gaussianity and primordial features) and the transient radio sky (detecting one million fast radio bursts and following up SKA-discovered pulsars). We propose two array configurations composed of hexagonally close-packed 6m dish arrangements with 50% fill factor. The initial 5,000 element 'petite array' is scientifically compelling, and can act as a demonstrator and a stepping stone to the full 32,000 element 'full array'. Viewed as a 21cm intensity mapping telescope, the program has the noise equivalent of a traditional spectroscopic galaxy survey comprised of 0.6 and 2.5 billion galaxies at a comoving wavenumber of $k=0.5\,h\mathrm{Mpc}^{-1}$ spanning the redshift range $z = 0.3 - 6$ for the petite and full configurations, respectively. At redshifts beyond $z=2$, the 21cm technique is a uniquely powerful way of mapping the universe, while the low-redshift range will allow for numerous cross-correlations with existing and upcoming surveys. This program is enabled by the development of ultra-wideband radio feeds, cost-effective dish construction methods, commodity radio-frequency electronics driven by the telecommunication industry and the emergence of sufficient computing power to facilitate real-time signal processing that exploits the full potential of massive radio arrays. The project has an estimated construction cost of 55 and 330 million FY19 USD for the petite and full array configurations. Including R&D, design, operations and science analysis, the cost rises to 125 and 600 million FY19 USD, respectively.Comment: 10 pages + references, 3 figures, 3 tables; project white paper submitted to the Astro2020 decadal survey; further details in updated arXiv:1810.0957

Atmospheric Acetaldehyde: Importance of Air-Sea Exchange and a Missing Source in the Remote Troposphere.

We report airborne measurements of acetaldehyde (CH3CHO) during the first and second deployments of the National Aeronautics and Space Administration (NASA) Atmospheric Tomography Mission (ATom). The budget of CH3CHO is examined using the Community Atmospheric Model with chemistry (CAM-chem), with a newly-developed online air-sea exchange module. The upper limit of the global ocean net emission of CH3CHO is estimated to be 34 Tg a-1 (42 Tg a-1 if considering bubble-mediated transfer), and the ocean impacts on tropospheric CH3CHO are mostly confined to the marine boundary layer. Our analysis suggests that there is an unaccounted CH3CHO source in the remote troposphere and that organic aerosols can only provide a fraction of this missing source. We propose that peroxyacetic acid (PAA) is an ideal indicator of the rapid CH3CHO production in the remote troposphere. The higher-than-expected CH3CHO measurements represent a missing sink of hydroxyl radicals (and halogen radical) in current chemistry-climate models

Scleroderma and related disorders: 223. Long Term Outcome in a Contemporary Systemic Sclerosis Cohort

Background: We have previously compared outcome in two groups of systemic sclerosis (SSc) patients with disease onset a decade apart and we reported data on 5 year survival and cumulative incidence of organ disease in a contemporary SSc cohort. The present study examines longer term outcome in an additional cohort of SSc followed for 10 years. Methods: We have examined patients with disease onset between years 1995 and 1999 allowing for at least 10 years of follow-up in a group that has characteristics representative for the patients we see in contemporary clinical practice. Results: Of the 398 patients included in the study, 252 (63.3%) had limited cutaneous (lc) SSc and 146 (36.7%) had diffuse cutaneous (dc) SSc. The proportion of male patients was higher among the dcSSc group (17.1% v 9.9%, p = 0.037) while the mean age of onset was significantly higher among lcSSc patients (50 ± 13 v 46 ± 13 years ± SD, p = 0.003). During a 10 year follow-up from disease onset, 45% of the dcSSc and 21% of the lcSSc subjects developed clinically significant pulmonary fibrosis, p < 0.001. Among them approximately half reached the endpoint within the first 3 years (23% of dcSSc and 10% of lcSSc) and over three quarters within the first 5 years (34% and 16% respectively). There was a similar incidence of pulmonary hypertension (PH) in the two subsets with a steady rate of increase over time. At 10 years 13% of dcSSc and 15% of lcSSc subjects had developed PH (p=0.558), with the earliest cases observed within the first 2 years of disease. Comparison between subjects who developed PH in the first and second 5 years from disease onset demonstrated no difference in demographic or clinical characteristics, but 5-year survival from PH onset was better among those who developed this complication later in their disease (49% v 24%), with a strong trend towards statistical significance (p = 0.058). Incidence of SSc renal crisis (SRC) was significantly higher among the dcSSc patients (12% v 4% in lcSSc, p = 0.002). As previously observed, the rate of development of SRC was highest in the first 3 years of disease- 10% in dcSSc and 3% in lcSSc. All incidences of clinically important cardiac disease developed in the first 5 years from disease onset (7% in dcSSc v 1% in lcSSc, p < 0.001) and remained unchanged at 10 years. As expected, 10-year survival among lcSSc subjects was significantly higher (81%) compared to that of dcSSc patients (70%, p = 0.006). Interestingly, although over the first 5 years the death rate was much higher in the dcSSc cohort (16% v 6% in lcSSc), over the following years it became very similar for both subsets (14% and 13% between years 5 and 10, and 18% and 17% between years 10 and 15 for dcSSc and lcSSc respectively). Conclusions: Even though dcSSc patients have higher incidence for most organ complications compared to lcSSc subjects, the worse survival among them is mainly due to higher early mortality rate. Mortality rate after first 5 years of disease becomes comparable in the two disease subsets. Disclosure statement: The authors have declared no conflicts of interes

Opera and Hypnosis: Victor Maurel’s Experiments with Verdi’s Otello

One day in his private home on the avenue Bugeaud, in Paris’s sixteenth arrondissement, the famous baritone Victor Maurel hosted a meeting which combined music with hypnotism of a young woman