Family Related Factors and Concurrent Heroin Use in Methadone Maintenance Treatment in China.

BackgroundThe use of heroin during Methadone Maintenance Treatment (MMT) is a challenging problem that contributes to poor treatment outcomes. Families may play an important role in addressing concurrent heroin use during MMT, especially in collectivist societies such as China.ObjectivesIn this study, we explored the relationship between family-related factors and concurrent heroin use during MMT in China.MethodsThis study was conducted at 68 MMT clinics in five provinces of China. There were 2,446 MMT clients in the analysis. Demographic information, MMT dosage, family members' heroin use status, family support of MMT, family problem, and self-reported heroin use were collected in a cross-sectional survey. The most recent urinalysis of opiate use was obtained from clinical records.ResultsOf the 2,446 participants, 533 (21.79%) self-reported heroin use in the previous seven days or had a positive urine morphine test result in the clinic record. Participants whose family member[s] used heroin were 1.59 times (95% CI: 1.17, 2.15) more likely to use concurrently during treatment. Those with family members who totally support them on the MMT were less likely to use (AOR: 0.75, 95% CI: 0.60, 0.94). Having more family problems was positively associated with concurrent heroin use (AOR: 2.01, 95% CI: 1.03, 3.93).ConclusionsThe results highlight the importance of the family's role in concurrent heroin use during MMT programs. The study's findings may have implications for family-based interventions that address concurrent heroin use

An intervention trial targeting methadone maintenance treatment providers to improve clients' treatment retention in China.

BackgroundService providers including doctors, nurses, and other healthcare professionals play an essential role in methadone maintenance treatment (MMT). This study evaluated the impact of an intervention targeting MMT providers on their clients' treatment retention.MethodsThis study was conducted in 68 MMT clinics in five provinces of China with 36 clients randomly selected from each clinic. The clinics were randomized to intervention or control condition. The MMT CARE intervention started with group sessions to enhance providers' communication skills. The trained providers were encouraged to conduct individual sessions with clients to promote treatment engagement. The outcomes, which include client retention (main outcome) and their reception of provider-delivered individual sessions (process outcome), were measured over a 24-month period.ResultsSignificantly fewer intervention clients dropped out from MMT than control clients during the study period (31% vs. 41%; p < 0.0001). Dropout hazard was significantly lower in the intervention condition compared to the control condition (HR = 0.71, 95% CI: 0.57, 0.89). More intervention clients had individual sessions than control clients (93% vs. 70%; p < 0.0001). Having individual sessions was associated with a significantly lower dropout hazard (HR = 0.30, 95% CI: 0.23, 0.40). The intervention clients had a significantly lower dropout hazard than the control clients if they started the individual sessions during the first six months (HR = 0.68, 95% CI: 0.51, 0.90).ConclusionsThe MMT CARE intervention focusing on provider capacity building has demonstrated efficacy in reducing clients' treatment dropout. This study sheds light on MMT service improvement in China and other global community-based harm reduction programs

Establishing Connections During The Age Of Telemedicine

Research presentation describing the following process: How an interprofessional team can work together to make connections with a patient through telemedicine. The essential interprofessional and telemedicine skills needed to make connections and a positive environment for the patient. What worked well and did not work well to achieve this goal.https://dune.une.edu/cecespring2021/1000/thumbnail.jp

Predicting Processing Difficulty in Chinese Syntactic Ambiguity Resolution: A Parallel Approach

No abstract

Older drivers in Australia and advanced vehicle technologies : what are their opinions? : a qualitative study

Background: There is limited research on older drivers’ perspectives on advanced vehicle technologies (AVTs). This study investigates what older drivers know and understand about AVTs in the current vehicle market, and identifies what motivates older drivers to use or not use AVTs. Method: Older drivers (≥65 years) living in New South Wales, Australia completed semi-structured telephone interviews guided by the Car Technology Acceptance Model. All interviews were audio-recorded and transcribed verbatim. Content analysis and deductive-inductive thematic analysis were completed on each transcript independently by two researchers, with all themes presented to the investigative team, discussed until consensus was reached. Participant recruitment were ceased after thematic saturation. Results: 24 participants (mean age: 74.5 years; 13 males, 11 females) were interviewed. Eleven different AVTs were mentioned by participants. Attitudes towards these AVTs impacted how much participants understood how these technologies worked. These attitudes and motivation of technology usage could be explained by four major themes; (1) AVTs help with safety but overall responsibility remains with the driver, (2) Lack of clear information and instructions make AVTs look confusing, (3) AVTs need to be more user-friendly for older adults, and (4) Expensive out-of-pocket costs stop AVT usage. Conclusions: Despite understanding the safety benefits of simple, standard AVTs, older drivers perceive barriers that hinder their use of more complicated technologies. Increased consultations to make AVTs more acceptable to older adults are needed. In conjunction, more resources and options aimed at helping older adults better understand and access AVTs need to be developed

Foxc1 is required by pericytes during fetal brain angiogenesis

Summary Brain pericytes play a critical role in blood vessel stability and blood–brain barrier maturation. Despite this, how brain pericytes function in these different capacities is only beginning to be understood. Here we show that the forkhead transcription factor Foxc1 is expressed by brain pericytes during development and is critical for pericyte regulation of vascular development in the fetal brain. Conditional deletion of Foxc1 from pericytes and vascular smooth muscle cells leads to late-gestation cerebral micro-hemorrhages as well as pericyte and endothelial cell hyperplasia due to increased proliferation of both cell types. Conditional Foxc1 mutants do not have widespread defects in BBB maturation, though focal breakdown of BBB integrity is observed in large, dysplastic vessels. qPCR profiling of brain microvessels isolated from conditional mutants showed alterations in pericyte-expressed proteoglycans while other genes previously implicated in pericyte–endothelial cell interactions were unchanged. Collectively these data point towards an important role for Foxc1 in certain brain pericyte functions (e.g. vessel morphogenesis) but not others (e.g. barriergenesis)

A sample return mission to Ceres

The goal of Project GAUSS (Genesis of Asteroids and evolUtion of the Solar System) is to return samples from the dwarf planet Ceres. Ceres is the most accessible candidate of ocean worlds and the largest reservoir of water in the inner Solar System. It shows active volcanism and hydrothermal activities in recent history. Recent evidence for the existence of a subsurface ocean on Ceres and the complex geochemistry suggest past habitability and even the potential for ongoing habitability. GAUSS will return samples from Ceres with the aim of answering the following top-level scientific questions: What is the origin of Ceres and what does this imply for the origin of water and other volatiles in the inner Solar System? What are the physical properties and internal structure of Ceres? What do they tell us about the evolutionary and aqueous alteration history of dwarf planets? What are the astrobiological implications of Ceres? Is it still habitable today? What are the mineralogical connections between Ceres and our current collections of carbonaceous meteorites

IRS2 mutations linked to invasion in pleomorphic invasive lobular carcinoma

Pleomorphic invasive lobular carcinoma (PILC) is an aggressive variant of invasive lobular breast cancer that is associated with poor clinical outcomes. Limited molecular data are available to explain the mechanistic basis for PILC behavior. To address this issue, targeted sequencing was performed to identify molecular alterations that define PILC. This sequencing analysis identified genes that distinguish PILC from classic ILC and invasive ductal carcinoma by the incidence of their genomic changes. In particular, insulin receptor substrate 2 (IRS2) is recurrently mutated in PILC, and pathway analysis reveals a role for the insulin receptor (IR)/insulin-like growth factor-1 receptor (IGF1R)/IRS2 signaling pathway in PILC. IRS2 mutations identified in PILC enhance invasion, revealing a role for this signaling adaptor in the aggressive nature of PILC