RESUMEN
Inland waters are one of the largest natural sources of methane (CH4), a potent greenhouse gas, but emissions models and estimates were developed for solute-poor ecosystems and may not apply to salt-rich inland waters. Here we combine field surveys and eddy covariance measurements to show that salinity constrains microbial CH4 cycling through complex mechanisms, restricting aquatic emissions from one of the largest global hardwater regions (the Canadian Prairies). Existing models overestimated CH4 emissions from ponds and wetlands by up to several orders of magnitude, with discrepancies linked to salinity. While not significant for rivers and larger lakes, salinity interacted with organic matter availability to shape CH4 patterns in small lentic habitats. We estimate that excluding salinity leads to overestimation of emissions from small Canadian Prairie waterbodies by at least 81% ( ~ 1 Tg yr-1 CO2 equivalent), a quantity comparable to other major national emissions sources. Our findings are consistent with patterns in other hardwater landscapes, likely leading to an overestimation of global lentic CH4 emissions. Widespread salinization of inland waters may impact CH4 cycling and should be considered in future projections of aquatic emissions.
RESUMEN
HIV-associated neurocognitive disorders (HAND) remain a major challenge for people with HIV in the antiretroviral therapy era. Cocaine use may trigger/exacerbate HAND among African American (AA) adults, especially women. Between 2018 and 2019, 922 adults, predominantly AAs, with/without HIV and with/without cocaine use in Baltimore, Maryland, were enrolled in a study investigating the association of HIV and cocaine use with neurocognitive impairment (NCI). Neurocognitive performance was assessed with the NIH Toolbox Cognition Battery (NIHTB-CB). NCI was considered to be present if the fully adjusted standard score for at least two cognitive domains was 1.0 standard deviation below the mean. Although the overall analysis showed HIV and female sex were associated with NCI, the associations were dependent on cocaine use. Neither HIV [adj prevalence ratio (PR): 1.12, confidence interval (95% CI): 0.77-1.64] nor female sex (adj PR: 1.07, 95% CI: 0.71-1.61) was associated with NCI among cocaine nonusers, while both HIV (adj PR: 1.39, 95% CI: 1.06-1.81) and female sex (adj PR: 1.53, 95% CI: 1.18-1.98) were associated with NCI in cocaine users. HIV was associated with two NIHTB-CB measures overall. In addition, HIV was associated with a lower dimensional change card sort score (an executive function measure) in cocaine users and not in nonusers. Cognitive performance was poorer in female than in male cocaine users. The adverse effect of HIV on cognitive performance predominantly affected cocaine users. However, cocaine use may moderate the impact of HIV and female sex on cognitive performance, highlighting the importance of reducing cocaine use in NCI prevention among the AA population.
Asunto(s)
Trastornos Relacionados con Cocaína , Cocaína , Infecciones por VIH , Adulto , Humanos , Masculino , Femenino , Infecciones por VIH/complicaciones , Infecciones por VIH/epidemiología , Infecciones por VIH/psicología , VIH , Negro o Afroamericano , Trastornos Relacionados con Cocaína/complicaciones , Trastornos Relacionados con Cocaína/epidemiología , Trastornos Relacionados con Cocaína/psicología , Pruebas NeuropsicológicasRESUMEN
The threat generated by the COVID-19 pandemic has triggered sudden institutional changes in an effort to reduce viral spread. Restrictions on group gatherings and in-person engagement have increased the demand for remote service delivery. These restrictions have also affected the delivery of court-mandated interventions. However, much of the literature has focused on populations that voluntarily seek out face-to-face medical care or mental health services, whereas insufficient attention has been paid to telehealth engagement of court-mandated populations. This article draws on data gathered on an NIH/NIDA-funded study intervention implemented with juvenile justice-involved youths of Haitian heritage in Miami-Dade County, Florida, during the COVID-19 public health crisis. We explore the process of obtaining consent, technological access issues, managing privacy, and other challenges associated with remote delivery of family-based therapy to juvenile justice-involved youth. Our aim is to provide some insights for consideration by therapists, healthcare workers, advocates, researchers, and policymakers tasked with finding alternative and safer ways to engage nontraditional populations in health services. The clinical trial registration number is NCT03876171.
Asunto(s)
COVID-19/epidemiología , Terapia Familiar , Telemedicina , Adolescente , COVID-19/prevención & control , Florida , Haití , Humanos , Rol Judicial , Delincuencia Juvenil/prevención & control , Pandemias , Psicología del Adolescente , Servicio Social , Trastornos Relacionados con Sustancias/prevención & controlRESUMEN
Both clinical and street-based encounters with people who misuse drugs have led the authors to examine the relationship between misuse of drugs and narcissism. Widely accepted criteria for diagnosing Substance Use Disorder (SUD) suggest parallels between narcissistic traits (e.g. invulnerability to consequences and lack of empathy for others) and the characteristics of drug abusers. Because narcissism as a concept has a long and somewhat confusing history, we first reviewed its origins in the psychoanalytic tradition of psychiatry and its exegesis into current clinical concepts in order to arrive at a set of attributes that may be useful when applied to problems of drug abuse. This process required extensive review of the literature on narcissism and its interactions with the literature on drug abuse. This process led to an understanding that positive self-concept may exemplify a variety of socially beneficial narcissism, but that at the other end of narcissism's continuum of traits may be found exploitative and non-empathetic traits. Furthermore, the negative traits of narcissism, as they may arise in adolescence along with drug use, can support an individual's ongoing dependence on drugs, especially if narcissism and drug use persist into adulthood. Our investigation of narcissism and drug use revealed, through in-depth interviewing, that some drug users employ drugs and alcohol to feed their self-concepts of superiority over other people. Our findings suggest that treatment for drug abuse cannot proceed assuming that drug users have low self-concepts. Rather, their continued use of drugs may emanate from a narcissistic sense of superiority.
Asunto(s)
Abuso de Medicamentos , Consumidores de Drogas , Adolescente , Adulto , Empatía , Humanos , Narcisismo , AutoimagenRESUMEN
Draining of geographically isolated (no defined inlet or outlet) freshwater mineral soil wetlands has likely converted areas that acted historically as important P sinks to sources of P. To explore the role of wetland drainage on nonpoint-source P pollution, differences in the chemical characteristics and P sorption parameters of drained and intact wetlands were investigated in a small watershed situated in the Prairie Pothole Region of southwestern Manitoba, Canada. Chemical characteristics and P sorption parameters varied across landscape positions, particularly for landscape positions that were submerged. Intact wetlands had slightly higher concentrations of organic and total P relative to drained wetlands, which is indicative of their P trapping capacity. More importantly, the maximum P sorption capacity and P buffering capacity of intact wetlands were 3.6 (1752 vs. 492 mg kg) and 17 (1394 vs. 84 L kg) times greater than those in drained wetlands. Conversely, equilibrium P concentrations and bioavailable P concentrations in drained wetlands were an order of magnitude greater than those in intact prairie wetlands. Our study suggests that intact prairie wetlands may be effective sinks for P. As a result, prairie wetlands may play an important role in mitigating nonpoint-source pollution. Conversely, our findings suggest that drained prairie wetlands are potentially a high risk for P export and should be treated as important critical source areas within prairie watersheds.
Asunto(s)
Pradera , Fósforo/análisis , Contaminantes del Agua/análisis , Humedales , Canadá , Suelo , Movimientos del AguaRESUMEN
Ibogaine may be effective for transitioning opioid and cocaine dependent individuals to sobriety. American and European self-help groups provided public testimonials that ibogaine alleviated drug craving and opioid withdrawal symptoms after only a single dose administration. Preclinical studies in animal models of addiction have provided proof-of-concept evidence in support of these claims. However, the purported therapeutic benefits of ibogaine are based on anecdotal reports from a small series of case reports that used retrospective recruitment procedures. We reviewed clinical results from an open label case series (N = 191) of human volunteers seeking to detoxify from opioids or cocaine with medical monitoring during inpatient treatment. Whole blood was assayed to obtain pharmacokinetic measures to determine the metabolism and clearance of ibogaine. Clinical safety data and adverse events (AEs) were studied in male and female subjects. There were no significant adverse events following administration of ibogaine in a dose range that was shown to be effective for blocking opioid withdrawal symptoms in this study. We used multi-dimensional craving questionnaires during inpatient detoxification to test if ibogaine was effective in diminishing heroin and cocaine cravings. Participants also completed standardized questionnaires about their health and mood before and after ibogaine treatment, and at program discharge. One-month follow-up data were reviewed where available to determine if ibogaine's effects on drug craving would persist outside of an inpatient setting. We report here that ibogaine therapy administered in a safe dose range diminishes opioid withdrawal symptoms and reduces drug cravings. Pharmacological treatments for opioid dependence include detoxification, narcotic antagonists and long-term opioid maintenance therapy. Our results support product development of single oral dose administration of ibogaine for the treatment of opioid withdrawal during medically supervised detoxification to transition drug dependent individuals to abstinence.
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BACKGROUND: HIV infection is prevalent among substance abusers. The effects of specific illicit drugs on HIV disease progression have not been established. We evaluated the relationship between substances of abuse and HIV disease progression in a cohort of HIV-1-positive active drug users. METHODS: A prospective, 30-month, longitudinal study was conducted on 222 HIV-1 seropositive drug users in Miami, FL. History of illicit drug, alcohol, and medication use, CD4+ cell count, and viral load were performed every 6 months. RESULTS: Crack-cocaine users were 2.14 times [95% confidence interval (CI): 1.08 to 4.25, P = 0.029] more likely to present a decline of CD4 to Asunto(s)
Trastornos Relacionados con Cocaína/complicaciones
, Cocaína Crack/efectos adversos
, Infecciones por VIH/complicaciones
, Adulto
, Alcoholismo
, Terapia Antirretroviral Altamente Activa
, Recuento de Linfocito CD4
, Cannabis
, Estudios de Cohortes
, Progresión de la Enfermedad
, Femenino
, Infecciones por VIH/tratamiento farmacológico
, Heroína
, Humanos
, Estudios Longitudinales
, Masculino
, Persona de Mediana Edad
, Estudios Prospectivos
, Trastornos Relacionados con Sustancias/complicaciones
, Carga Viral
RESUMEN
Co-use of illicit drugs, in particular cocaine and alcohol, is common among HIV-1(+) men and women of different ethnic groups. We compared cohorts of alcohol and cocaine co-users HIV-1(+) African American women and in cohorts of drug-free, or methamphetamine users HIV-1(+) men. We monitored clinical cellular immune parameters at repeated regular intervals. We found that significant inverse correlations between (CD8+)CD38+ cells and subpopulations of CD4+ cells distinguished by the expression of CD45RA in HIV-1(+) alcohol and cocaine co- users but not in drug-free HIV-1(+) patients. Following stratification for CD4+ cell number, we found the (CD4+)CD45RA+ subpopulation to be significantly higher (p < 0.05) in the drug user compared to drug-free HIV-1(+). Drug abuse may alter the change from the (CD4+)CD45RA+ to the (CD4+)CD45RA- phenotype selectively, which recovers in HIV-1+ methamphetamine abusers during treatment from baseline to 4-weeks, as manifested by improved IL-2 production in vitro. of TH1 and TH2 cytokines during progression to AIDS.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/inmunología , Consumo de Bebidas Alcohólicas/inmunología , Negro o Afroamericano , Trastornos Relacionados con Cocaína/inmunología , VIH-1 , Adulto , Biomarcadores/análisis , Linfocitos T CD4-Positivos , Femenino , Humanos , Inmunidad Celular , Inmunofenotipificación , Molécula 1 de Adhesión Intercelular , Recuento de Linfocitos , Masculino , Fenotipo , Estudios ProspectivosRESUMEN
Intravenous drug use exists in a cultural context this requires thorough investigation to understand its origins and conduct. This paper will emphasize anthropological approaches to studying and intervening in behaviours practiced by people who inject illegal drugs into their bodies. Since anthropology as a discipline specializes in systematic investigation of cultural contexts, anthropological techniques and strategies continue to be useful in obtaining data that are necessary for more complete understanding of intravenous drug users' (IDUs') behaviours that place them at risk for HIV infection. In the brief history of the AIDS epidemic, however, the first information came from medical practice and medical sociology. Early studies of the relationship between parenteral drug use (drug use by injection) and infection by the Human Immunodeficiency Virus (HIV) depended on retrospective self report by patients with AIDS for information about ways that IDUs become infected. Later studies have focused on the clientele of centres for treatment of drug abuse to learn about risk of becoming infected by the HIV in a somewhat less retrospective mode. More recently, studies focused on IDUs and their risk of HIV have employed prospective methods as well as ethnographic techniques for recruitment and analysis. These efforts have provided a wide range of new perspectives on risk of infection by the HIV. Recent studies have in common an anthropological approach to studyings risk of HIV infection. As studies of this nature have progressed, they have shown that this kind of approach is highly productive in discoverying variants of behaviours that place people at risk and defining systems of values associated with complexes of risk. Given its great utility in the study of risk, the anthropological perspective is crucial to discussion of risk of HIV infection related to drug injection and sexual behaviour, especially among ethnic minorities in the United States. (AU)