Your search

BACKGROUND: Naloxone is an opioid antagonist that can reverse an opioid overdose. Increased opioid-related mortality rates led to greater distribution of naloxone without a prescription and administration of naloxone by laypersons. This study fills a gap in knowledge of naloxone experiences among active users of opioids living in suburban communities. PURPOSE: The purpose of this article is to provide nurse practitioners with an in-depth understanding of current naloxone use practices among people who experience overdose events. The specific aims are to compare access to naloxone in diverse suburban towns, to examine administration differences across settings, and to understand perspectives on naloxone experiences from people who are actively using opioids. METHODOLOGICAL ORIENTATION: The data for this analysis were drawn from an ethnographic study in the suburban towns around Atlanta, Georgia; Boston, Massachusetts; and New Haven, Connecticut. Short surveys and in-depth interviews were collected. Inductive methods were used to compare data across settings. SAMPLE: The sample of 106 included 48% female, 62% White, 24% African American/Black, 13% more than one race, and 21% Hispanic/Latinx. The mean age was 41.35 years. CONCLUSIONS: Differences between study settings in access to naloxone, administration frequency, and delivery systems were found. Findings suggest more education and training is needed in overdose prevention and harm reduction intervention. Studies on delivery systems need to address the increase in fentanyl-related overdoses. IMPLICATIONS FOR PRACTICE: Nurse practitioners can help to target distribution of naloxone in local communities, facilitate collaboration with harm reduction services, and provide evidence-based education and training to laypersons. Copyright © 2020 American Association of Nurse Practitioners.

Background: Non-motor symptoms (NMS) are common in Parkinson's disease (PD), but their relationships to nigrostriatal degeneration remain largely unexplored. Methods: We evaluated 18 NMS scores covering 5 major domains in relation to concurrent and future dopamine transporter (DAT) imaging in 344 PD patients from the Parkinson's Progression and Markers Initiative (PPMI). We standardized NMS assessments into z-scores for side-by-side comparisons. Patients underwent sequential DaTSCAN imaging at enrollment and at months 12, 24, and 48. Specific binding ratios (SBR) were calculated using the occipital lobe reference region. We evaluated the association of striatal DAT binding at the four time points with each baseline NMS using mixed-effects regression models. Results: Multiple baseline NMS were significantly associated with DAT binding at baseline and at follow-up scans. REM sleep behavior disorder (RBD) symptoms showed the strongest association – mean striatal SBR declined with increasing RBD symptom z-score (average of time-point-specific slopes per unit change in z-score: βAVG = −0.083, SE = 0.017; p < 0.0001). In addition, striatal DAT binding was linearly associated with increasing baseline z-scores: positively for the memory (βAVG=0.055, SE = 0.022; p = 0.01) and visuospatial (βAVG=0.044, SE = 0.020; p = 0.03) cognitive domains, and negatively for total anxiety (βAVG= −0.059, SE = 0.018; p = 0.001). Striatal DAT binding showed curvilinear associations with odor identification, verbal discrimination recognition, and autonomic dysfunction z-scores (p = 0.001, p = 0.0009, and p = 0.0002, respectively). Other NMS were not associated with DAT binding. Conclusions: Multiple NMS, RBD symptoms in particular, are associated with nigrostriatal dopaminergic changes in early PD. © 2020 Elsevier Ltd

Retweeting is an important way of information propagation on Twitter. In this paper, we investigate the sentiment correlation between regular tweets and retweets. We anticipate our investigation sheds a light on how the sentiment of regular tweets impacts the retweets of different sentiments. We propose a method for measuring the sentiment of tweets. We categorize the Twitter users into different groups by different norms, which are the follower count, the betweenness connectivity, a combination of follower count and betweenness centrality,and the amount of tweets. Then, we calculate the sentiment correlation for different groups to examine the influential factors for retweeting a message with a certain sentiment.We find that the users with higher betweenness centrality and higher tweets amount tend to exhibit a higher sentiment correlation. The users with medium-level followers_count show the highest sentiment correlation compared to the low-level and high-level followers_count. After combining the two factors of followers_count and betweenness centrality, we discover that specifically at low-level betweenness centrality the users with medium-level followers_count have the highest sentiment correlation. Our last observation is that the difference for correlation coefficients exists between different types of users. Our study on the sentiment correlation provides instructional information for modeling information propagation in human society. © 2020, Springer-Verlag GmbH Austria, part of Springer Nature.

Background: Our pilot study has demonstrated improvements in health outcomes through participation in a new sport, light volleyball (LVB), among older adults. In response to the promising results of the LVB pilot study and the priority of allocating resources to the prevention of age-related fitness degradation by the Hong Kong (HKG) government, the present study aims to investigate the effectiveness of a LVB intervention on physical and psychological health attributes among older adults at a larger scale in HKG. Methods/design: This study will apply both quantitative and qualitative methods with a large sample (approximately 315 participants). We will adopt a randomized controlled trial (RCT) design to further evaluate the effectiveness of a LVB intervention on health outcomes against a comparison group, Tai Chi (TC), and a control group (C). Older adults will be eligible to join the intervention if they are (a) aged 65 years and above; (b) living in the community independently; (c) absent of diagnosed cognitive impairment; (d) not regular participants in a structured PA program for two years preceding the study; and (e) able to achieve a passing score on the Timed-up-and-go test (TUG) and Abbreviated Mental Test (AMT). About 315 participants will be randomly assigned into 3 groups in 1:1:1 ratio. LVB group participants will receive 16-week LVB program; TC group will utilize a simplified 24-form Yang Style TC, and C group participants will be instructed to maintain their normal daily activity and join regular non-exercise social gatherings. Measurements will be collected before and after the intervention, and 6 months and 12 months after completion of the intervention. Discussion: This intervention, if effective, will enhance older adult's physical and psychological health, and provide the data and evidence to support policymaking in relation to future PA promotion for older adults. Trial registration number: ChiCTR1900026657. © 2020 The Author(s).

Health education and promotion researchers and practitioners are committed to eliminating health disparities, and the Society for Public Health Education (SOPHE) has continuously supported this effort through its journals, professional development, annual conferences, and advocacy. The COVID-19 pandemic elucidated inequities directly caused by racism and other social determinants of health. In order to achieve health equity, we need to become antiracist in our research, practice, and advocacy work by standing united against racist policies and practices. I invite us all to heed the call to action on these five points: place racism on the agenda, practice cultural humility, claim your privilege and eliminate microaggressions, utilize strategies that promote inclusion and equity, and embrace your inner leader and activist. Just as SOPHE as an organization pivoted its annual conference from on ground to virtual in March 2020, so can we be innovative and brave as professionals to face the hard work and dedication needed to become antiracist., (C)2020Sage Publications

The mechanisms responsible for aspiration are relatively unknown in patients recovering from acute respiratory failure (ARF) who required mechanical ventilation. Though many conditions may contribute to swallowing dysfunction, alterations in laryngeal structure and swallowing function likely play a role in the development of aspiration. At four university-based tertiary medical centers, we conducted a prospective cohort study of ARF patients who required intensive care and mechanical ventilation for at least 48 h. Within 72 h after extubation, a Fiberoptic Flexible Endoscopic Evaluation of Swallowing (FEES) examination was performed. Univariate and multivariable analyses examined the relationship between laryngeal structure and swallowing function abnormalities. Aspiration was the primary outcome, defined as a Penetration- Aspiration Scale (PAS) score of 6 or greater. Two other salient signs of dysphagia—spillage and residue—were secondary outcomes. A total of 213 patients were included in the final analysis. Aspiration was detected in 70 patients (33%) on at least one bolus. The most commonly aspirated consistency was thin liquids (27%). In univariate analyses, several abnormalities in laryngeal anatomy and structural movement were significantly associated with aspiration, spillage, and residue. In a multivariable analysis, the only variables that remained significant with aspiration were pharyngeal weakness (Odds ratio = 2.57, 95%CI = 1.16–5.84, p = 0.019) and upper airway edema (Odds ratio = 3.24, 95%CI = 1.44–7.66, p = 0.004). These results demonstrated that dysphagia in ARF survivors is multifactorial and characterized by both anatomic and physiologic abnormalities. These findings may have important implications for the development of novel interventions to treat dysphagia in ARF survivors. Clinical Trials Registration ClinicalTrials.gov Identifier: NCT02363686, Aspiration in Acute Respiratory FailureSurvivors. © 2020, Springer Science+Business Media, LLC, part of Springer Nature.

Alzheimer's Disease (AD) is a neurodegenerative disease that causes complications with thinking capability, memory and behavior. AD is a major public health problem among the elderly in developed and developing countries. With the growth of AD around the world, there is a need to further expand our understanding of the roles different clinical measurements can have in the diagnosis of AD. In this work, we propose a machine learning-based technique to distinguish control subjects with no cognitive impairments, AD subjects, and subjects with mild cognitive impairment (MCI), often seen as precursors of AD. We utilized several machine learning (ML) techniques and found that Gradient Boosting Decision Trees achieved the highest performance above 84% classification accuracy. Also, we determined the importance of the features (clinical biomarkers) contributing to the proposed multi-class classification system. Further investigation on the biomarkers will pave the way to introduce better treatment plan for AD patients. © 2020 The authors and IOS Press.

Objective: To examine health behaviors associated with overweight/obesity by race/ethnicity at a diverse urban college. Participants: 270 undergraduates (77.0% female; 26.7% non-Hispanic white) and median body mass index (BMI) of 23.1 kg/m2. Methods: A questionnaire about health-related behaviors as part of the “Get Fruved” project was used to measure health behaviors (sugar sweetened beverage (SSB), fruit and vegetable consumption, physical activity, stress, and sleep) by race/ethnicity. Multivariable logistic regression was used to assess the adjusted odds of engaging in positive health-related behaviors. Results: Non-Hispanic black and Hispanic students were 64% and 59% less likely to consume lower amounts of SSB. Hispanic students were 83% and 81% less likely to meet vegetable and fruit recommendations. Non-Hispanic black and other (including biracial) had reduced odds of meeting vegetable recommendations (AOR = 0.18 and 0.28). Conclusions: Disparities in SSB, fruit, and vegetable consumption represent potential intervention targets to improve health behaviors among racial/ethnic minorities. © 2020 Taylor & Francis Group, LLC.

To better explain daily fluctuations in physical activity and sedentary behavior, investigations of motivation are turning from social cognitive frameworks to those centered on affect, emotion and automaticity, such as the Affect and Health Behavior Framework (AHBF), Integrated Framework and Affective-Reflective Theory (ART). This shift has necessitated: (a) re-examination of older theories and their constructs, such as drives, needs and tensions and (b) an inspection of competing theories from other fields that also attempt to explain dynamic changes in health behaviors. The Dynamical Model of Desire, Elaborated Intrusion Theory and others commonly share with AHBF the idea that human behavior is driven strongly by desires and/or the similar concepts of wants, urges, and cravings. These affectively-charged motivation states (ACMS) change quickly and may better explain physical activity behavior from one moment to the next. Desires for movement predominantly derive from negative but also positive reinforcement. Data from clinical populations with movement dysfunction or psychiatric disorders provides further evidence of these drivers of movement. Those with Restless Legs Syndrome, akathisia, tic disorders and exercise dependence all report strong urges to move and relief when it is accomplished. Motor control research has identified centers of the brain responsible for wants and urges for muscular movement. Models elaborated herein differentiate between wants, desires, urges and cravings. The WANT model (Wants and Aversions for Neuromuscular Tasks) conceptualizes desires for movement and rest as varying by magnitude, approach or avoidance-orientation (wants versus aversions) and as occupying independent dimensions instead of opposite ends of the same axis. For instance, one hypothetically might be in a state of both high desire for movement and rest simultaneously. Variations in motivation states to move and rest may also be associated with various stress states, like freezing or fight and flight. The first validated instrument to measure feelings of desire/want for movement and rest, the CRAVE Scale (Cravings for Rest and Volitional Energy Expenditure) is already shedding light on the nature of these states. With these advances in theory, conceptual modeling and instrumentation, future investigations may explore the effects of desires and urges for movement and sedentary behavior in earnest. Copyright © 2020 Stults-Kolehmainen, Blacutt, Bartholomew, Gilson, Ash, McKee and Sinha.

Food waste has become an area of increasing concern in recent years, since unsustainable food waste practices have been associated with a range of adverse environmental, economic and societal impacts. Food waste is a multi-sectoral issue and must be addressed as such, by ensuring policymakers, practitioners, and consumers are equipped with the relevant knowledge and understanding of the importance of sustainable food waste practices. By exploring current attitudes and understanding of this topic amongst consumers, a lack of education about the importance of this issue has been identified as a barrier to carrying out sustainable practices at the household level, along with excess packaging, cultural norms of overconsumption and inappropriate social marketing. In contrast, a number of enablers, including social pressures, access to appropriate facilities and encouragement from media advertisements appear to have been highly influential in infringing on the consciousness of consumers. Investigating these enablers and barriers has allowed a number of potential interventions to be identified, with the intention of addressing this issue using a multifaceted approach and encouraging society to carry out sustainable food waste practices in the future. © 2020

Connecticut Literary Anthology features thirty-six Connecticut poets and prose writers from across the Nutmeg State. The 2020 Anthology is published by the Central Connecticut State University English Department. The writers in the inaugural anthology share themes amplified by current events, but not the context. Stories of family, economic in- equality, sexual violence, social justice, culture wars, lost love, aging, and gender—they’re all in here. And mangoes. Everyone loves mangoes. Featured writers: Janet L. Bannister, Charles V. Belson, Susan Cinoman, Ginny Lowe Connors, Jason Courtmanche, Catherine DeNunzio, Joanie DiMartino, Catherine DeNunzio, Meghan Evans, Maura Faulise, Kathryn Fitzpatrick, Beth Gibbs, Cecilia Gigliotti, Nichole Gleisner, Sitara Gnanaguru, Emi Gonzalez, José B. González, Benjamin S. Grossberg, Avery Jenkins, B. Fulton Jennes, Sarah Darer Littman, Kiran Masroor, Melissa McEwen, Claudia McGhee, Nancy McMillan, Jean P. Moore, Steven Ostrowski, Makenzie Ozycz, Aimee Pozorski, Kara Molway Russell, Vivian Shipley, Amy Sisson, Katherine A. Szpekman, Wendy Terry, Mika Taylor, Marina Tinone, Jason Wilkins. Praise for Anthology: "It feels like we have become unglued from one another since March of 2020; masked strangers passing each other in anonymity. But this anthology glues us back together and helps us find ways to heal and talk with one another. Important stories are told, and we should heed them." —Lisa Comstock, Director for Connecticut Center for the Book