Swimming kinematics and temperature effects on spermatozoa from wild and captive shortnose sturgeon (Acipenser brevirostrum).

Computer-assisted semen analysis (CASA) and cluster analysis were used to compare spermatozoa swimming kinematics and milt quality between wild and captive shortnose sturgeon (Acipenser brevirostrum). Milt samples from 27 shortnose sturgeon were collected in May 2016 and June 2017. Of these, 19 were wild caught in the Saint John River, New Brunswick, Canada, and eight were from a captive population at the Mactaquac Biodiversity facility. The following kinematic variables were measured immediately following sperm activation (˜5 s), at 30, 60, and 180 s post-activation; average path velocity (VAP); straight-line velocity (VSL); curvilinear velocity (VCL); amplitude of lateral head displacement (ALH); beat cross frequency (BCF); straightness (STR); linearity (LIN); wobble (WOB); percent motility (MOT). Analyses were conducted at 7, 10, and 14 °C to determine potential effects of temperature on kinematics. Principal components analysis (PCA) of original kinematic variables yielded two main components, a speed/wobble component along with a movement pattern component. Hierarchical cluster analysis (HCPC) indicated there were distinct subpopulations, with composition of clusters the result of fish source (wild-caught or captive). Wild-caught fish had greater sperm densities (P = 0.0064) and sperm swimming speeds compared to captive fish (P < 0.05). Temperature had a significant effect only on captive spermatozoa, and this result was not consistent between time periods. There was no effect of hormonal manipulation on spermatozoa motility kinematics. Results indicate there are significant differences in measures of milt quality between wild and captive shortnose sturgeon, indicating an effect of rearing condition on reproductive potential, which may affect fertilization success.

Barriers to Single-Dose Levonorgestrel-Only Emergency Contraception Access in Retail Pharmacies.

OBJECTIVES: In February 2014, the Food and Drug Administration updated its regulations to make all single-dose levonorgestrel-only emergency contraception (LNG-EC) available over the counter. This study examines the availability and access to LNG-EC shortly after this policy change, and any additional barriers to obtaining LNG-EC in Colorado retail pharmacies. STUDY DESIGN: From June to July 2014, three female interviewers posing as women seeking LNG-EC conducted a telephone survey of all 633 Colorado retail pharmacies listed in The Little Blue Book (2014) phone directory. Completely accessible was defined as LNG-EC available on store shelves for purchase without presentation of an ID or prescription on the day of the call. RESULTS: Of 633 pharmacies analyzed, 85.0% (538/633) were in urban settings and 85.3% (540/633) were chain stores. Eighteen of 64 (28.1%) counties in Colorado did not have a pharmacy listed in the phone directory. Overall, 86.9% of pharmacies (550/633) had EC in stock on the day of contact but only 23.2% (147/633) of these had EC completely accessible. Of pharmacies with EC in stock, 41.6% (229/550) kept it behind the counter and 56.0% (308/550) required additional documentation to purchase. In stock and completely accessible rates were not different across rural, urban, and frontier geographic regions within the state (p = .066 and p = .905, respectively), but were significantly different across independent, chain, and 24-hour type stores (p < .001 and p = .008, respectively). In stock rates were 57.5% (42/73), 90.4% (488/540), and 100% (20/20) for independent, chain, and 24-hour stores respectively. CONCLUSIONS: Rates of completely accessible LNG-EC are low in Colorado despite high rates of availability. Behind-the-counter status and proof-of-age requirements are identified as the main sources of access restriction in Colorado.

Mobile Phone and Social Media Use of Homeless Youth in Denver, Colorado.

The purpose of this study was to investigate homeless youth mobile phone and social media use, to plan health promotion efforts. Nearly half (46.7%) of runaway/homeless youth in this sample (n = 181) owned a mobile phone and a majority of those devices were smart phones. Ownership did not vary significantly by shelter location, though regular use of Facebook was more prevalent among those in housing programs or camping, than those living on the streets. Over 90% of youth in the sample reported using Facebook. Such media use might facilitate parent, family, and health provider communications with homeless youth.

Lack of impact of direct-to-consumer advertising on the physician-patient encounter in primary care: a SNOCAP report.

PURPOSE: Direct-to-consumer advertising (DTCA) has increased tremendously during the past decade. Recent changes in the DTCA environment may have affected its impact on clinical encounters. Our objective was to determine the rate of patient medication inquiries and their influence on clinical encounters in primary care. METHODS: Our methods consisted of a cross-sectional survey in the State Networks of Colorado Ambulatory Practices and Partners, a collaboration of 3 practice-based research networks. Clinicians completed a short patient encounter form after consecutive patient encounter for one-half or 1 full day. The main outcomes were the rate of inquiries, independent predictors of inquiries, and overall impact on clinical encounters. RESULTS: One hundred sixty-eight clinicians in 22 practices completed forms after 1,647 patient encounters. In 58 encounters (3.5%), the patient inquired about a specific new prescription medication. Community health center patients made fewer inquiries than private practice patients (1.7% vs 7.2%, P<.001). Predictors of inquiries included taking 3 or more chronic medications and the clinician being female. Most clinicians reported the requested medication was not their first choice for treatment (62%), but it was prescribed in 53% of the cases. Physicians interpreted the overall impact on the visit as positive in 24% of visits, neutral in 66%, and negative in 10%. CONCLUSIONS: Patient requests for prescription medication were uncommon overall, and even more so among patients in lower income groups. These requests were rarely perceived by clinicians as having a negative impact on the encounter. Future mixed methods studies should explore specific socioeconomic groups and reasons for clinicians' willingness to prescribe these medications.

Correlates of substance use among homeless youths in eight cities.

Homeless youths (N = 684) in eight cities participated in this study to understand the rates and correlates of substance use. Rates of lifetime and recent substance use ranged from 66% to 90%. Variability in lifetime and recent substance use was partially explained by being white (ages 14-17); ever attempting suicide (ages 14-17); not being African American (lifetime substance use) or Hispanic (ages 18-24); being male (ages 18-24); identifying as lesbian, gay, or bisexual (ages 18-24); using substances with a parent; beginning substance use at a young age; and having a family history of a substance problem.

Direct-to-consumer pharmaceutical advertising: physician and public opinion and potential effects on the physician-patient relationship.

BACKGROUND: Previous studies have shown that direct-to-consumer (DTC) pharmaceutical advertising can influence consumer behavior and that many physicians have negative views of these advertisements. Physician and public opinions about these advertisements and how they may affect the physician-patient relationship are not well established. METHODS: Mail survey of 523 Colorado physicians and 261 national physicians and telephone survey of 500 Colorado households asking respondents to rate their agreement with statements about DTC advertising. RESULTS: Most physicians tended to view DTC advertisements negatively, indicating that such advertisements rarely provide enough information on cost (98.7%), alternative treatment options (94.9%), or adverse effects (54.8%). Most also believed that DTC advertisements affected interactions with patients by lengthening clinical encounters (55.9%), leading to patient requests for specific medications (80.7%), and changing patient expectations of physicians' prescribing practices (67.0%). Only 29.0% of public respondents agreed that DTC advertising is a positive trend in health care and 28.6% indicated that advertisements make them better informed about medical problems; fewer indicated that advertisements motivated them to seek care (10.5%) or led them to request specific medications from their physicians (13.3%). CONCLUSIONS: Most physicians have negative views of DTC pharmaceutical advertising and see several potential effects of these advertisements on the physician-patient relationship. Many public respondents have similarly negative views, and only a few agree that they change their expectations of or interactions with physicians. While these advertisements may be influencing only a few consumers, it seems that the impact on physicians and their interactions with patients may be significant.

Echinacea and truth in labeling.

BACKGROUND: Echinacea sales represent 10% of the dietary supplement market in the United States, but there is no guarantee as to the content, quality, variability, or contamination in Echinacea preparations. OBJECTIVE: To qualitatively and quantitatively assess the contents of Echinacea-only preparations available in a retail setting. METHODS: One of each single-herb Echinacea preparations that were available in August 2000 was obtained from several stores in the Denver, Colo, area. Thin-layer chromatography (TLC) was used to determine species and measure quantity. From this information, accuracy of species labeling and comparison of constituent to labeled content were assessed. The samples were stratified by whether they were labeled as standardized, and the standardized and nonstandardized samples were compared by ratio of constituent to labeled content. RESULTS: Of the samples, 6 (10%) of 59 preparations contained no measurable Echinacea. The assayed species content was consistent with labeled content in 31 (52%) of the samples. Of the 21 standardized preparations, 9 (43%) met the quality standard described on the label. Labeled milligrams were weakly associated with measured constituent (r = 0.35; P =.02). CONCLUSIONS: Echinacea from retail stores often does not contain the labeled species. A claim of "standardization" does not mean the preparation is accurately labeled, nor does it indicate less variability in concentration of constituents of the herb.

Physician and public opinions on quality of health care and the problem of medical errors.

BACKGROUND: The 1999 Institute of Medicine report on medical errors proposed major changes to the health care system and gained widespread media attention, yet there is limited information on physician or public opinion regarding recommendations from that report. METHODS: Mail survey of 1000 Colorado physicians (n = 594) and 1000 national physicians (n = 304), and telephone survey of 500 Colorado households to assess agreement with several proposals and conclusions from the 1999 Institute of Medicine report. RESULTS: Most physicians believed that reduction of medical errors should be a national priority (69.7% of Colorado physicians). However, physicians were much less likely than the public to believe that quality of care is a problem (29.1% vs 67.6%; P<.001) or that a national agency is needed to address the problem of medical errors (24.1% vs 59.8%; P<.001). Uniformly, physicians believed that fear of medical malpractice is a barrier to reporting of errors and that greater legal safeguards are necessary for a mandatory reporting system to be successful. Nearly all physicians (92.9%) believed that more training in how to handle medical errors is needed, and 60.1% agreed that it is difficult to differentiate errors due to negligence from unintended errors. CONCLUSIONS: There appears to be widespread concern among physicians regarding medical errors, but only a minority in this survey believed that the problem is as significant as the Institute of Medicine and the public believe it to be. Our results suggest that physicians see several barriers to successful error reduction including difficulty defining errors, the need for more training in handling errors, and fear of malpractice litigation. Addressing these barriers will be a necessary step to increasing physician support for many of the changes proposed by the Institute of Medicine.