Primary Prevention of Prescription Drug Misuse Among Culturally and Linguistically Diverse Suburban Communities.

Comprehensive strategies for prescription drug misuse must reach culturally and linguistically diverse suburban populations to effectively combat the ongoing opioid epidemic. The purpose of this study was to conduct a community needs assessment and inform the development and implementation of culturally appropriate primary prevention strategies for community-based interventions, specifically related to medication disposal practices. Three data collection techniques were utilized: key informant interviews (n = 4), intercept surveys (n = 71), and focus group discussions (n = 8; 61 participants). To accommodate linguistically diverse subpopulations, surveys and focus groups were available in English, Spanish, Arabic, Russian, and Hindi. Participants were overwhelmingly female (survey: 70%/FGD: 84%), ethnic minorities (survey: 61%/FGD: 66%), and, on average, middle-aged [survey: 52 years (SD: 19)/FGD: 54 (15)]. Approximately one in three survey respondents (30%) had heard of drug-take back events, and one in ten (10%) had participated. Non-English speakers were less likely to both perceive a community problem with prescription drugs (ß = - .35; p < .001) and be aware of take-back opportunities (ß = - .23; p = .038). Focus group participants expressed confusion about appropriate medication disposal methods, identifying potential sources of conflicting information. Recent media coverage and political events have heightened stigma towards non-English speaking and non-native peoples, increasing their fear of law enforcement and other perceived threats. To encourage community engagement in take-back events, we identified multiple ways, such as multilingual materials and marketing campaigns, which may help marginalized suburban subpopulations feel less threatened and more included in prescription drug misuse prevention activities.

Sodium perchlorate disrupts development and affects metamorphosis- and growth-related gene expression in tadpoles of the wood frog (Lithobates sylvaticus).

Numerous endocrine disrupting chemicals can affect the growth and development of amphibians. We investigated the effects of a targeted disruption of the endocrine axes modulating development and somatic growth. Wood frog (Lithobates sylvaticus) tadpoles were exposed for 2weeks (from developmental Gosner stage (Gs) 25 to Gs30) to sodium perchlorate (SP, thyroid inhibitor, 14mg/L), estradiol (E2, known to alter growth and development, 200nM) and a reduced feeding regime (RF, to affect growth and development in a chemically-independent manner). All treatments experienced developmental delay, and animals exposed to SP or subjected to RF respectively reached metamorphic climax (Gs42) approximately 11(±3) and 17(±3) days later than controls. At Gs42, only SP-treated animals showed increased weight and snout-vent length (P<0.05) relative to controls. Tadpoles treated with SP had 10-times higher levels of liver igf1 mRNA after 4days of exposure (Gs28) compared to controls. Tadpoles in the RF treatment expressed 6-times lower levels of liver igf1 mRNA and 2-times higher liver igf1r mRNA (P<0.05) at Gs30. Tadpoles treated with E2 exhibited similar developmental and growth patterns as controls, but had increased liver igf1 mRNA levels at Gs28, and tail igf1r at Gs42. Effects on tail trß mRNA levels were detected in SP-treated tadpoles at Gs42, 40days post-exposure, suggesting that the chemical inhibition of thyroid hormone production early in development can have long-lasting effects. The growth effects observed in the SP-exposed animals suggest a relationship between TH-dependent development and somatic growth in L. sylvaticus tadpoles.

Treatment of HIV in outpatients with schizophrenia, schizoaffective disorder and bipolar disease at two county clinics.

Despite a high prevalence of HIV in patients with serious mental health disorders, there is little information in the literature regarding details of their HIV treatment. The objective of this paper is to assess factors associated with the success of HIV therapy in people with schizophrenia, schizoaffective, and bipolar disease. The methods used are retrospective, post-study chart review, and clinician questionnaire at two HIV county clinics. Forty-nine (4.8%) study patients were identified, 51% of whom achieved an undetectable HIV viral load. These patients tended to have less drug use (42% vs. 68%), more ongoing psychiatric visits (70% vs. 58%) and were more apt to take psychiatric medicines (70% vs. 40%) than patients with detectable HIV viral loads. Both groups had many missed appointments. We were surprised to find that many patients were successful with HIV treatment despite substance abuse, uncontrolled psychiatric symptoms, and lack of psychiatric care. Missing clinic appointments had little influence on treatment outcome.

Formative research to address vaccine hesitancy in Tajikistan.

INTRODUCTION: Incomplete childhood vaccination is associated with caregiver vaccine hesitancy, conceptualized by "3 Cs": high complacency, low confidence, and low convenience. To expand on existing evidence drawn primarily from the Americas and Europe, and develop culturally appropriate interventions, this research explored drivers of vaccine hesitancy in the Central Asian country of Tajikistan. METHODS: In twelve diverse districts, clinic-based immunization record abstraction identified purposive samples of children who were up-to-date (N = 300) or not (N = 300) on all first year vaccines. Using a modified case-control design, the structured face-to-face in-home survey of 600 caregivers compared knowledge, attitudes and practices regarding childhood vaccination by up-to-date status. Socio-demographic and psychological factors associated with hesitancy were identified, using a 22-item vaccine hesitancy scale, with subscales measuring complacency, confidence, and convenience. Overall contribution of vaccine hesitancy to up-to-date status was modeled, adjusting for other significant covariates. RESULTS: Caregivers of not up-to-date children were more likely to report their child's health as poor, and report many logistical barriers to vaccination. Knowledge of vaccine-preventable illnesses was low, and complacency regarding vaccination was high among not up-to-date caregivers. In final multivariable models of predisposing, enabling and reinforcing influences on vaccination status, urban children, those with transportation and employed mothers were more likely to be up-to-date, while not up-to-date children included those born at home, seen as having fair or poor health, or reportedly told by clinicians to avoid immunization. Reinforcing factors included having a "vaccine passport", receiving useful information from medical providers, and believing that vaccine-preventable illnesses are serious and that most in their community are vaccinated. Additionally, vaccine hesitancy was negatively associated with up-to-date status (odds ratio 0.15, 95% C.I. 0.08, 0.26). CONCLUSIONS: Results confirm that in this traditional culture, there is a strong need for tailored communication campaigns to address vaccine hesitancy, while continuing to address systems-level barriers.

Structure-activity studies of 7-heteroaryl-3-azabicyclo[3.3.1]non-6-enes: a novel class of highly potent nicotinic receptor ligands.

The potential for nicotinic ligands with affinity for the α4ß2 or α7 subtypes to treat such diverse diseases as nicotine addiction, neuropathic pain, and neurodegenerative and cognitive disorders has been exhibited clinically for several compounds while preclinical activity in relevant in vivo models has been demonstrated for many more. For several therapeutic programs, we sought nicotinic ligands with various combinations of affinity and function across both subtypes, with an emphasis on dual α4ß2-α7 ligands, to explore the possibility of synergistic effects. We report here the structure-activity relationships (SAR) for a novel series of 7-heteroaryl-3-azabicyclo[3.3.1]non-6-enes and characterize many of the analogues for activity at multiple nicotinic subtypes.