Prospectively surveying health-related quality of life and symptom relief in a lot-based sample of medical cannabis-using patients in urban Washington State reveals managed chronic illness and debility.

OBJECTIVES: To characterize health-related quality of life (HRQoL) in medical cannabis patients. METHODS: Short Form 36 (SF-36) Physical Health Component Score and Mental Health Component Score (MCS) surveys as well has CDC (Centers for Disease Control) HRQoL-14 surveys were completed by 37 qualified patients. RESULTS: Mean SF-36 PCS and MCS, normalized at 50, were 37.4 and 44.2, respectively. Eighty percent of participants reported activity/functional limitations secondary to impairments or health problems. Patients reported using medical cannabis to treat a wide array of symptoms across multiple body systems with relief ratings consistently in the 7-10/10 range. CONCLUSION: The HRQoL results in this sample of medical cannabis-using patients are comparable with published norms in other chronically ill populations. Data presented provide insight into medical cannabis-using patients' self-rated health, HRQoL, disease incidences, and cannabis-related symptom relief.

Aging in place, age specific migration and natural decrease.

"This analysis of regional demographic change evaluates the roles of 'aging in place' and of age-specific migration on the geographic pattern of the advent of natural decrease in the United States. The spread of natural decrease is projected on the basis of recent births and deaths, in the absence of migration. Age-specific migration data for Oregon and Washington are used to develop a typology of counties that can be used in turn to modify the probable timing of natural decrease."

Age-specific migration and regional diversity.

"This author examines patterns of age-specific migration between 1980 and 1990 for a small, growing region, the Pacific Northwest of the U.S.A., with the purpose of assessing the degree of geographic diversity in experience. A simple typology of the expected spatial and structural pattern of age-specific migration is proposed. Cluster analysis is used to group counties on the basis of age-specific rates of net migration. Even this fairly small region is found to exemplify most of the patterns that might be expected to occur in the nation as a whole."

Population redistribution within metropolitan regions in the 1980s: core, satellite, and exurban growth.

"This paper evaluates the hypothesis that the growth experiences of core parts of metropolitan areas [in the United States] tend to predict the growth of satellite, exurban, and even more distant non-metropolitan areas. Particular attention is paid to evidence of spillover of growth into adjacent smaller metropolises and smaller cities, and to the hypothesis that spillover is especially marked in areas of rapid growth, growth restrictions, and housing price inflation. The hypotheses are supported by 1980-1990 patterns of change, as is the continuing attractiveness of exurban and non-metropolitan environmental amenities."

Intra metropolitan demographic structure: a Seattle example.

"Internal urban variation in demographic character (births, deaths, fertility, natural increase, net migration) is analyzed in relation to age of persons, age of housing, ownership, distance from the CBD [central business district], race, household type and size. A descriptive analysis of maps of these characteristics is followed by simple statistical tests of relations among the variables, in particular distance from the city center. Predictable and strong patterns of spatial structure are consonant with expectations from economic, social, geographic and political urban theory." Data concern King County, Washington, for the period 1980-1985, (the city of Seattle) and are from local sources, including the Puget Sound Council of Governments.

Migration regions and population redistribution.

"Gross and net migration flows among...[U.S.] states for 1975-80 were used to define migration regions, or groups of states with similar patterns of net interchange. This typology may be characterized as a transition from a northeastern 'core' which lost to all other regions to a northwestern 'periphery' which gained from all other regions. Florida and California were found to have an important role in redistributing population. The typology was also valid for all age groups and across racial and ethnic categories. The typology remained meaningful when the 1975-80 data were compared to 1965-70 and 1980-85 data, despite great volatility in net migration and significant change in the placement of many states." Data are taken primarily from the 1980 census.

Attribute preferences and the non-metropolitan migration decision.

PIP: The factors affecting the decision to migrate to rural or small-town areas in the Pacific Northwest of the United States are examined using data from interviews undertaken in 72 households. The primary factors identified were negative views about cities and positive attitudes toward the social and environmental characteristics of the rural areas of current residence.^ieng

Use of propranolol for provoked and unprovoked episodes of rage.

The use of propranolol to treat unprovoked rage episodes in brain-damaged patients has recently been reported. The authors report three cases that indicate a role for its use in the treatment of overall aggressiveness in brain-damaged or mentally retarded patients.

The future for mental health in primary health care programs.

Our largely separate mental health system has developed in relationship to a health care system oriented toward specialization and solo practice. Now the health care system is moving in the direction of primary care and group and organizational practice. New forms of mental health delivery are needed to maximize the potential of these new health care programs for mental health services. The author describes these new integrated programs which bring mental health providers into the primary health care programs for direct services as well as consultation. Issues discussed include mutual roles, changes in services, the referral process, and provider relationships. The advantages of such integrated programs include decreased stigma, increased prevention through earlier detection and referral, increased family orientation, greater coordination of care, and less duplication.

The coordination of mental health services at the neighborhood level.

The neighborhood health center is becoming a major locus of mental health care delivery. Because of their strategic position at the neighborhood level, mental health care systems in the comprehensive health center locus have been able to develop linkages with both general health and community mental health systems to provide a broad continuum of coordinated health and mental health care. Four models identified in a survey of 19 neighborhood mental health programs are described. The authors suggest that persistent problems in coordination of care between neighborhood mental health and other caregiving systems would be considerably alleviated by a fiscal reimbursement scheme that rewarded integration rather than fragmentation of care.