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In response to an increase in HIV diagnoses among persons who inject drugs (PWID) in Kanawha County, West Virginia, West Virginia Bureau for Public Health and CDC conducted a qualitative assessment in Kanawha County to inform HIV outbreak response activities. Interviews with 26 PWID and 45 community partners were completed. Transcribed interviews were analyzed to identify barriers to accessing HIV prevention services among PWID using the risk environment framework. Participants identified numerous political, physical, social, and economic community-level barriers that influenced access to HIV prevention services among PWID. Political factors included low community support for syringe services programs (SSPs); physical factors included low SSP coverage, low coverage of HIV testing outreach events, low HIV preexposure prophylaxis availability, and homelessness; social factors included stigma and discrimination; economic factors included community beliefs that SSPs negatively affect economic investments and limited resources for HIV screening in clinical settings. Individual-level barriers included co-occurring acute medical conditions and mental illness. Community-level interventions, such as low-barrier one-stop shop models, are needed to increase access to sterile syringes through comprehensive harm reduction services. [ABSTRACT FROM AUTHOR]

Opioid-related encounters included any with documentation of illicit opioid use (including prescription opioid misuse), a toxicology screen positive for opioids, or provision of syringe services. We analyzed health care encounter and HIV- and opioid-related services data from 1 year before HIV diagnosis through June 18, 2021. INTRODUCTION In 2019, the West Virginia (WV) Bureau for Public Health identified 15 HIV diagnoses among people who inject drugs (PWID) in Kanawha County, an area disproportionately affected by the opioid crisis; previously, annual diagnoses were less than 5. [Extracted from the article]

This qualitative case study describes three adult siblings' experiences and their perceptions of support connected with the time before and after their father's suicide. At the time of the suicide, participants were ages 1, 5, and 8 years old. We considered commonalities and disparities among the three survivors' perceptions. We also considered how their reported experiences compared to extant literature on child survivors of parent suicide. Our findings suggest that, although the siblings experienced the same traumatic event, each had unique perceptions of the parent's suicide. Immediately prior to closing each interview, to deescalate from the intense topic of suicide, participants offered their impressions of potentially therapeutic children's books and how bibliotherapy may or may not support surviving children. Participants' perceptions of selected children's picture books offer insights about opening communication and addressing challenges specific to a parent's suicide. Implications for teachers, parents, and school-based mental health professionals are provided. We conclude that postvention must consider and monitor each child's perceptions and provide individualized interventions that encourage open communication and support adaptive coping to navigate the intense grief associated with a parent's suicide. Highlights: Following a parent's suicide, children's memories are highly influenced by what adults say and do following the suicide. Even though siblings share a similar trauma, their narratives may indicate highly individualized memories and responses. Following a parent's suicide, identify supportive interventions that are individualized to the child's perceptions and needs. Carefully select children's books to support child survivors. Consider how stories might trigger strong responses. [ABSTRACT FROM AUTHOR]

Purpose: To determine, in a cohort with injuries classified anatomically as mainly minor or moderate and for which only 25% were hospitalised acutely, the prevalence of ongoing problems attributed by participants to their injury 2 years prior, and to examine whether three-month post-injury experiences and expectations predict such problems.Methods: Participants (N = 2231; 18-64 years at injury) were those in the Prospective Outcomes of Injury Study who completed the initial three-month and final two-year interviews. The outcome measure was whether participants reported ongoing injury-related problems at 2 years. Possible early post-injury predictors were identified from the first interview; pre-injury and injury-related potential confounders from the first interview, insurer records and hospital discharge records. Multivariable models estimated relative risks.Results: Almost half the participants reported injury-related problems at 2 years. Participants reporting non-recovery at 3 months were more likely than those reporting recovery to have ongoing problems at 2 years, ranging from participants expecting to get better soon [adjusted RR 2.2, 95% CI (1.7,2.8)) to those expecting to never get better (aRR 3.1, 95% CI (2.4,4.0)]. Several three-month post-injury experiences also predicted ongoing problems at 2 years. Participants at highest risk included those with extreme pain [aRR 2.1, 95% CI (1.7,2.5)], and less involvement in usual activities [aRR 1.7, 95% CI (1.5,1.9)].Conclusions: Findings indicate that early post-injury characteristics predict longer-term recovery among this cohort, most of who were not classified as seriously injured, and provide guidance for future studies on interventions to reduce poor outcome prevalence, particularly focussing on pain management and enabling return to independence and social participation. [ABSTRACT FROM AUTHOR]

Purpose: To examine participation in paid work, unpaid work and activities 12 months after a sentinel (initial) injury, and to determine the impact of sustaining a subsequent injury (SI) on these participation outcomes.Methods: Participants were recruited to the Prospective Outcomes of Injury Study following an Accident Compensation Corporation (ACC; New Zealand's no-fault injury insurer) entitlement claim injury. Outcomes were whether participants reported reduced paid work hours, reduced unpaid work (e.g. housework, gardening) or reduced activities (e.g. socialising, leisure pursuits) at 12 months compared to before the sentinel injury event. SIs were ACC claims of any type. Using multivariable models, characteristics of SIs were examined as potential predictors of reduced participation.Results: At 12 months, 30% had reduced paid work hours, 12% had reduced unpaid work and 25% had reduced activities. Sustaining a SI predicted reduced paid work (RR 1.5; 95% CI 1.2, 1.8), but not unpaid work or activities. Participants who had sustained intracranial SIs were at highest risk of reduced paid work (RR 3.2, 95% CI 1.9, 5.2). Those sustaining SIs at work were less likely to have reduced paid work (RR 0.7; 95% CI 0.6, 1.0) than those with only non-work SIs. Participants sustaining assaultive SIs had higher risk of reduced unpaid work (RR 2.6, 95% CI 1.0, 6.8).Conclusions: Reduced participation is prevalent after a substantive sentinel injury, and sustaining a SI impacts on return to paid work. Identification of SI characteristics that put people at high risk of participation restriction may be useful for focusing on rehabilitative attention. [ABSTRACT FROM AUTHOR]

Little is known about the metabolism of deep-living, benthic invertebrates, despite its importance in estimating energy flow through individuals and populations. To evaluate the effects of depth and broad taxonomic group/locomotory mode, we measured the respiration rates of 25 species of benthic decapod crustaceans and 18 species of echinoderms from the littoral zone to the deep slope of Hawaii. Specimens were collected by hand, trap, or submersible and maintained in the laboratory at temperatures close to ambient temperatures recorded at the time of collection. After acclimatization to laboratory conditions, oxygen consumption was measured for each individual in closed chambers. Overall, crustaceans had higher metabolic rates than echinoderms, and within the crustaceans, caridean shrimps had higher rates than crabs and lobsters. These differences are probably related to locomotory mode and general levels of activity. At in situ environmental temperatures, metabolic rates of deeper-living invertebrates are much lower than those of shallower living species, but this decline is explained by changes in temperature. When the data were compared with similar data sets collected off California and in the Mediterranean, Hawaiian crabs, lobsters, and echinoderms had lower metabolic rates than similar species in the other regions after adjustments for temperature were made. Some of these differences could be methodological. Regional food web models should use broad taxonomic groupings and region-specific data when possible. [ABSTRACT FROM AUTHOR]

Studying defined mutants of Mycobacterium tuberculosis in the mouse model of infection has led to the discovery of attenuated mutants that fall into several phenotypic classes. These mutants are categorized by their growth characteristics compared with those of wild-type M. tuberculosis, and include severe growth in vivo mutants, growth in vivo mutants, persistence mutants, pathology mutants and dissemination mutants. Here, examples of each of these mutant phenotypes are described and classified accordingly. Defining the importance of mycobacterial gene products responsible for in vivo growth, persistence and the induction of immunopathology will lead to a greater understanding of the host-pathogen interaction and potentially to new antimycobacterial treatment options. [ABSTRACT FROM AUTHOR]

Presents research news, as of January 2003. Treatment for atrial fibrillation; Role of kinase in maintaining the stability at the fragile sites of a chromosome; Development of an oral male contraceptive.