Rates of Synthetic Cannabinoid Use in Adolescents Admitted to a Treatment Facility.

OBJECTIVE: Many forms of synthetic marijuana are available in the United States for recreational use. Although the composition of these synthetic forms is unclear, consumption has been on the rise among adolescents. The objective of this study is to understand the usage rates and identify the reasons and risk factors for synthetic cannabinoid use. METHODS: We recruited 637 adolescents (aged 13 to 17 years) admitted to the Children's Recovery Center, Norman, Oklahoma, from August 11, 2014, to March 30, 2016, for the study. Descriptive statistics and Pearson χ² test were used to analyze the data. Logistic regression and adjusted odds ratio (OR) were performed to determine the risk factors for synthetic marijuana use. RESULTS: The mean age of synthetic cannabinoid users was 16 years. Increased prevalence of synthetic marijuana use was observed in 16- to 17-year-old adolescent males, in the white population, and in individuals living in urban areas. Synthetic marijuana was preferred by subjects over the regular form, as it is less expensive, produces a better high, is undetectable on drug tests, and is perceived as legal. Male sex (OR = 2.63, P < .0001), aged 16 to 17 years (OR = 1.99, P < .0001), and residing in an urban locality (OR = 1.57, P = .05) were identified as risk factors for consuming synthetic marijuana. Adolescents who use synthetic marijuana are more at risk of having substance use disorder (OR = 11.87, P < .0001) than those who do not. CONCLUSIONS: Synthetic marijuana use is increasing in the adolescent age group and could potentially have a negative impact on the health of teenagers. Hence, enforcing strict laws against synthetic marijuana use and promoting awareness programs targeting adolescents would be beneficial.​.

Relationship of American Indian blood quantum with osteoporosis risk: a cross-sectional study of American Indian women in Oklahoma.

Information regarding the prevalence and risk of osteoporosis among American Indian (AI) women is limited. This study showed that with increasing AI blood quantum, the prevalence of osteoporosis at the hip based on BMD T-scores decreased and this appeared to be independent of other risk factors. INTRODUCTION: This study was designed to investigate the effects of AI blood quantum (BQ) on osteoporosis prevalence and risk in a cohort of AI women in Oklahoma. METHODS: Women (n = 301), aged 50 years and older, were recruited to participate in the Oklahoma American Indian Women's Osteoporosis Study. Baseline bone density, fracture history, bone biochemical markers, and potential risk factors were assessed. Participants were stratified by AI BQ into BQ1 ≤ 25%, BQ2 = 25-49%, BQ3 = 50-74%, and BQ4 = 75-100%. The effects of BQ on the prevalence and risk of osteoporosis were evaluated. RESULTS: Based on T-scores, one in approximately eight women in the study was osteoporotic at one or more sites. The prevalence of osteoporosis decreased (p < 0.05) with increasing BQ, especially at the hip, trochanteric, and intertrochanter regions. No differences in bone-specific alkaline phosphatase and C-telopeptide were observed across BQ that could account for the differences in bone density. 25-OH vitamin D decreased with increasing BQ, but mean for each BQ1-4 was > 40 ng/mL. Fracture history did not differ across BQ, and though 52% of the population consumed less than the RDA for calcium, no effect of BQ was observed. CONCLUSIONS: In this cohort of women who identified as AI, greater Indian BQ was associated with a decrease in the prevalence of osteoporosis.

Comparing Access to Laser Capsulotomy Performed by Optometrists and Ophthalmologists in Oklahoma by Calculated Driving Distance and Time.

PURPOSE: To quantify Medicare beneficiary proximity to his or her yttrium-aluminum-garnet (YAG) laser capsulotomy-providing ophthalmologist and optometrist in Oklahoma by calculating driving distances and times. DESIGN: Cross-sectional cohort study using 2014 Oklahoma Medicare 100% and 5% data sets and Google Maps distance and travel time application programming interfaces. PARTICIPANTS: U.S. fee-for-service Medicare beneficiaries and Oklahoma ophthalmologist and optometrist laser capsulotomy providers. METHODS: The 2014 Medicare Provider Utilization and Payment Limited 100% and 5% datasets from the Centers for Medicare and Medicaid (CMS) were obtained to identify the office street addresses of Oklahoma ophthalmologists and optometrists who submitted claims to Medicare for a YAG laser capsulotomy, and the county addresses of the corresponding Medicare beneficiaries who received the laser capsulotomy. The shortest travel distances and travel times between the beneficiary and the laser provider were calculated by using Google Maps distance and travel time application programming interfaces. MAIN OUTCOME MEASURES: Beneficiary driving distances and times to his or her YAG laser capsulotomy-providing Oklahoma ophthalmologist and optometrist. RESULTS: In 2014, 90 (57%) of 157 Oklahoma ophthalmologists and 65 (13%) of 506 Oklahoma optometrists submitted a total of 7521 and 3751 YAG laser capsulotomy claims to Medicare, respectively. By using the Medicare Limited 5% dataset, there was no difference in driving distance between beneficiaries who received a laser capsulotomy from an ophthalmologist (median, 39 miles; interquartile range [IQR], 13-113 miles) compared with an optometrist (median, 46 miles; IQR, 13-125 miles; P = 0.93) or in driving time to an ophthalmologist (median, 47 minutes; IQR, 19-110 minutes) compared with an optometrist (median, 50 minutes; IQR, 17-117 minutes; P = 0.76). CONCLUSIONS: For Medicare beneficiaries, there was no difference in geographic access to YAG laser capsulotomy whether performed by an Oklahoma ophthalmologist or optometrist as determined by calculated driving distances and times.

Consumption of a calcium and vitamin D-fortified food product does not affect iron status during initial military training: a randomised, double-blind, placebo-controlled trial.

Ca/vitamin D supplementation maintains bone health and decreases stress fracture risk during initial military training (IMT); however, there is evidence that Ca may negatively affect the absorption of other critical micronutrients, particularly Fe. The objective of this randomised, double-blind, placebo-controlled trial was to determine whether providing 2000 mg/d Ca and 25 µg/d vitamin D in a fortified food product during 9 weeks of military training affects Fe status in young adults. Male (n 98) and female (n 54) volunteers enrolled in US Army basic combat training (BCT) were randomised to receive a snack bar with Ca/vitamin D (n 75) or placebo (snack bar without Ca/vitamin D; n 77) and were instructed to consume 2 snack bars/d between meals throughout the training course. Circulating ionised Ca was higher (P0·05) in markers of Fe status between placebo and Ca/vitamin D groups. Collectively, these data indicate that Ca/vitamin D supplementation through the use of a fortified food product consumed between meals does not affect Fe status during IMT.

Survey of upper extremity injuries among martial arts participants.

PURPOSE: To survey participants at various experience levels of different martial arts (MA) about upper extremity injuries sustained during training and fighting. MATERIALS: A 21-s question survey was designed and utilised. The survey was divided into four groups (Demographics, Injury Description, Injury Mechanism, and Miscellaneous information) to gain knowledge about upper extremity injuries sustained during martial arts participation. Chi-square testing was utilised to assess for significant associations. RESULTS: Males comprised 81% of respondents. Involvement in multiple forms of MA was the most prevalent (38%). The hand/wrist was the most common area injured (53%), followed by the shoulder/upper arm (27%) and the forearm/elbow (19%). Joint sprains/muscle strains were the most frequent injuries reported overall (47%), followed by abrasions/bruises (26%). Dislocations of the upper extremity were reported by 47% of participants while fractures occurred in 39%. Surgeries were required for 30% of participants. Females were less likely to require surgery and more likely to have shoulder and elbow injuries. Males were more likely to have hand injuries. Participants of Karate and Tae Kwon Do were more likely to have injuries to their hands, while participants of multiple forms were more likely to sustain injuries to their shoulders/upper arms and more likely to develop chronic upper extremity symptoms. With advanced level of training the likelihood of developing chronic upper extremity symptoms increases, and multiple surgeries were required. Hand protection was associated with a lower risk of hand injuries. CONCLUSION: Martial arts can be associated with substantial upper extremity injuries that may require surgery and extended time away from participation. Injuries may result in chronic upper extremity symptoms. Hand protection is important for reducing injuries to the hand and wrist.

Take home lead exposure in children of oil field workers.

Childhood lead poisoning is a major, preventable environmental health problem. While residential lead-based paint and lead contaminated dust and soil are the most common sources of childhood lead poisoning, children can also be at risk if they live with an adult with a job or hobby that involves exposure to lead. Currently, the Oklahoma Childhood Lead Poisoning Prevention Program (OCLPPP) has a small number of cases of "take home" lead exposure in children of oil field workers. These workers may come in contact with a threading compound, "pipe dope" that can contain large amounts of lead. Workers handling this product may be exposed to lead by not following safety instructions. Additionally workers may not be provided the facilities to shower and change out of the contaminated clothing before leaving the work location. The OCLPPP recommends employers and worksites should consider effective alternative options like lead free biodegradable pipe dopes or dope free connections to prevent workers and their families from adverse health effects associated with lead.

Micronutrient intakes in two US populations of older adults: lipid research clinics program prevalence study findings.

Dietary intakes of several minerals and vitamins were assessed in two US sub-populations of older men and women between 60 and 80 years as part of the Lipid Research Clinics Program Prevalence Study conducted in the mid-1980s prior to widespread fortification. Dietary intakes were analyzed from 24-hour recalls using the Minnesota Nutrition Coding Center. Descriptive statistics on the two diverse sub-populations were generated for the elderly subjects at the two clinic sites, southern California and Oklahoma. Regression analyses of specific micronutrients were performed while controlling for several variables, namely, age, sex, clinic (region), education, Body Mass Index (BMI), alcohol consumption, and smoking status. Compared to current (1999-2004) Estimated Average Requirements (EARs) and Adequate Intakes (AIs) for three micronutrients without EARs for the US and Canada, several micronutrients were consumed at or close to their EAR values. Exceptions include intakes of vitamin A, vitamin E, folic acid, potassium and calcium which were very low; intakes of thiamin, riboflavin, niacin, and vitamin C were low but closer to the published EAR or AI values. High intakes approaching cut-offs for practically all subjects were found for both groups of elders at the two clinic sites for iron, phosphorus, and sodium. In general, California elderly had somewhat better consumption patterns for the vitamins, but the Oklahomans, males at least, had higher overall mineral intakes. The micronutrient deficits found in this small study suggest that most elderly US citizens were likely to be deficient in five micronutrients and marginally insufficient in four others in the mid-1980s and, despite even greater fortification currently, elderly intakes seem not to have improved substantially since the 1980s, except for subjects who are regular multi-supplement users.

Widespread risks of dental fluorosis in cotton rats (Sigmodon hispidus) residing on petrochemical waste sites.

Fluoride has been identified as a ubiquitous contaminant of soils where petrochemical wastes have been disposed. The purpose of this study was to assess how widespread toxicity risks are to resident vertebrates from chronic exposure to fluoride in the soil of petrochemical-contaminated waste sites. In total, 573 wild cotton rats (Sigmodon hispidus) were examined. The rats that were seasonally collected from 12 contaminated and 12 ecologically matched reference sites across Oklahoma over a 3-yr period. The risks of cotton rats exposed to fluoride were analyzed by means of gross examination, histopathology, and scanning electron microscopy of rat incisors. Cotton rats from reference sites showed no pathologic changes in incisors (98%). In comparison, 46% of cotton rats from contaminated sites had various degrees of dental lesions. The prevalence and severity of dental lesions in cotton rats from contaminated sites were significantly influenced by season. There was a 45% increase in prevalence and a 65% increase in severity of dental lesions from summer to winter. This study demonstrated that cotton rats are very sensitive biomonitors for assessing toxicity risks from soils contaminated with fluoride and that such assessments should consider seasonal influences.

Characteristics of American-Indian clients seeking inpatient treatment for substance abuse.

OBJECTIVE: The current study was conducted as a preliminary examination of substance use and some of its correlates in nonreservation-residing American Indians. METHOD: A group of 522 American-Indian (AI) subjects (473 men) were compared with two sets of geographic controls: (1) an equal number of African Americans (AA) and (2) an equal number of European Americans (EA). All received treatment in the same facilities over the same time period. RESULTS: Contrary to expectations, the ethnic/racial groups were remarkably similar on a number of alcohol use variables, including the amount consumed in the 6 months prior to treatment and the number of previous treatments. Among those self-reporting as problem drinkers, there were group differences in the age of first drink (AA mean = 13.54, AI mean = 12.24 and EA mean = 11.71) and first drunk (AA mean = 15.80, AI mean = 14.23 and EA mean = 14.08) and the number of alcohol-related problems (AA mean = 7.52, AI mean = 8.49 and EA mean = 8.46). On these measures, AI and EA subjects did not differ whereas AA subjects reported a later age of onset and fewer negative consequences. EA and AI male subjects reported marijuana as their most frequently used "other" drug, whereas AA male subjects listed stimulants as their primary drugs. Regardless of ethnic/racial group, women did not differ on their drug(s) of choice, reporting stimulants as the most frequently abused drug (after accounting for alcohol use). CONCLUSIONS: This preliminary study is remarkable for the observed similarities among groups. Future studies using more rigorous sampling are needed to provide clarification of this preliminary study.

Control of Psoroptes cuniculi in captive white-tailed deer with ivermectin-treated corn.

Psoroptes cuniculi, the ear mite of domestic rabbits, was collected from captive white-tailed deer (Odocoileus virginianus). This is the first report of rabbit ear mite infestations in white-tailed deer in Oklahoma or Texas (USA). In addition to moderate infestations in their ears, two 4-yr-old bucks, two 3-yr-old does, and seven 4-yr-old does showed patchy areas of alopecia along the sides and brisket. Both bucks also had patchy areas of alopecia around the base of antlers. Ear mites were eradicated from all deer except from one doe by providing ivermectin-treated corn to the deer at a rate of 1,000 g (equivalent to 200 mcg/kg of ivermectin)/day/deer for several days. The ear mite infestation in the one doe was eradicated by intramuscularly injection with ivermectin at 400 mcg/kg. After treatment with the ivermectin and eradication of the mites, the alopecia improved and eventually was eliminated. The ivermectin-treated corn also controlled all internal nematode parasites in the deer.

Incidence of sacroiliac joint dysfunction and low back pain in fit college students.

The incidence of low back pain and sacroiliac joint dysfunction and their relationship was studied in a sample of physically fit college students. An incidence of 26.5% was found for low back pain, while an incidence of 19.3% was found for sacroiliac joint dysfunction. This study found no significant relationship between sacroiliac joint dysfunction and low back pain.