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4 HIV Status and Cannabis Use: A Rigorous Examination of Between Group Differences in Neurocognitive Functioning
- Ashley R Adams, Sarah M Lehman, Erin L Thompson, Brenda Lerner, Raul Gonzalez
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 684-685
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Objective:
A recent review called for a more robust assessment of cannabis use (CU), including amount and timing of recent use to assess neurocognitive effects of CU among people living with HIV (PWH) (Ellis et al., 2021). The current study addresses some issues raised by investigating between group neurocognitive differences among healthy controls and PWH who differ on their cannabis use histories, using strict inclusion criteria, robust classification of CU, and administration of an established neurocognitive test battery.
Participants and Methods:Among this community sample of adults (N=309), 58 were classified as CU+/HIV+ group (84.5% Male), 76 as CU-/HIV+ (57.9% M), 86 as CU+/HIV- (58.1% M), and 89 as CU-/HIV- (53.9% M). Exclusion criteria included history of past 12-month dependence and extensive lifetime dependence or significant use of illicit substances other than cannabis, severe or current mood or thought disorder, and other medical conditions that adversely impact neurocognitive functioning. Inclusion criteria for CU+ groups included <30-days since last CU, >10 times of CU in last month, 3 times of CU per month in last 12 months, > 1 year of CU, and > 500 times used in lifetime. CU parameters did not statistically differ between HIV+/CU+ and HIV-/CU+. CU- groups’ inclusion criteria required no CU in last 6 months, 196 lifetime number of times used, and no history of CU dependance. Lifetime CU did not statistically differ between CU-/HIV+ and CU-/HIV- groups. HIV+ groups did not differ significantly on HIV viral load in plasma or nadir CD4+ counts. Significant between group differences included age, sex, years of education, and amount of alcohol and nicotine use within 12 months. The aforementioned sociodemographic and substance use variables that differed between groups were covariates in analyses. A battery of 10 neurocognitive measures, two measures per each domain of learning, memory, motor, executive functioning, and processing speed. Global composite summary scores for overall neurocognitive performance were calculated by averaging M T-scores for each neurocognitive domain. Data transformations were used to address any violations of statistical assumptions.
Results:To facilitate data reduction, neurocognitive task scores were standardized to T-scores using the M and SD of the CU-/HIV-group. An omnibus model of between-group comparisons on global neurocognitive task performance revealed no significant differences, F(3) = .16, p = .923. Subsequent Tukey’s post hoc test revealed no significant differences among the four groups. Results also revealed nonsignificant differences between groups in neurocognitive performance within each domain. However, the CU-/HIV- group performed significantly worse than the CU-/HIV+ group on the Executive Functioning domain, based on Tukey’s post hoc test.
Conclusions:We found no significant global neurocognitive differences among groups; however, there was some evidence for domain-specific neurocognitive differences in executive functioning. This contrasts somewhat with existing literature on HIV and cannabis-associated neurocognitive deficits. Several factors may have contributed to this, including our relatively healthy PWH sample. Future analyses will examine interactive effects of HIV severity and severity of CU on neurocognition. This analysis will better determine who, among PWH, are most at-risk for cannabis-associated neurocognitive effects and what factors may exacerbate them.
Cannabis use and episodic memory performance among adolescents: Moderating effects of depression symptoms and sex
- Sarah M. Lehman, Erin L. Thompson, Ileana Pacheco-Colón, Samuel W. Hawes, Ashley R. Adams, Karen Granja, William J. Pulido, Raul Gonzalez
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue 8 / October 2023
- Published online by Cambridge University Press:
- 13 February 2023, pp. 715-723
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Objective:
Cannabis use has been linked to poorer episodic memory. However, little is known about whether depression and sex may interact as potential moderators of this association, particularly among adolescents. The current study addresses this by examining interactions between depression symptoms and sex on the association between cannabis use and episodic memory in a large sample of adolescents.
Method:Cross-sectional data from 360 adolescents (Mage = 17.38, SD = .75) were analyzed at the final assessment wave of a two-year longitudinal study. We used the Drug Use History Questionnaire to assess for lifetime cannabis use, and the Computerized Diagnostic Interview Schedule for Children, Fourth edition to assess the number of depression symptoms in the past year. Subtests from the Wechsler Memory Scale, Fourth Edition and the California Verbal Learning Test, Second Edition were used to assess episodic memory performance.
Results:The effect of the three-way interaction among cannabis use, depression symptoms, and sex did not have a significant impact on episodic memory performance. However, follow-up analyses revealed a significant effect of the two-way interaction of cannabis use and depression symptoms on episodic memory, such that associations between cannabis use and episodic memory were only significant at lower and average levels of depression symptoms.
Conclusions:Contrary to our hypotheses, we found that as depression symptoms increased, the negative association between cannabis use and episodic memory diminished. Given the use of a predominantly subsyndromic sample, future studies should attempt to replicate findings among individuals with more severe depression.
Equal Rights vs. Special Rights: Rights Discourses, Framing, and Lesbian and Gay Antidiscrimination Policy in Washington State
- Erin M. Adam, Betsy L. Cooper
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- Journal:
- Law & Social Inquiry / Volume 42 / Issue 3 / Summer 2017
- Published online by Cambridge University Press:
- 27 December 2018, pp. 830-854
- Print publication:
- Summer 2017
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This study argues that rights discourse influences heterosexual public opinion in Washington State. We tested this through a survey experiment conducted in the 2011 Washington Poll. We broke interviewees into three groups, with each group exposed to a different frame: a pro–lesbian and gay equal rights frame, an anti–lesbian and gay special rights frame, and a control or no frame. Immediately following the treatment, we asked interviewees if they agreed with a pro–lesbian and gay policy: changing state antidiscrimination law to encompass those who identify as lesbian and gay. Overall, this study concludes that a special rights frame dampens support among some while an equal rights frame has no effect. Respondents who indicated that they were against same-sex marriage even more strongly opposed altering antidiscrimination policy to include sexual orientation when confronted with an equal rights frame than when confronted with the special rights frame or no frame at all.
28 - Mental Health Policy in the United States: Critical Reflection and Future Directions for Sociological Research
- from Part III - Mental Health Systems and Policy: Introduction to Part III
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- By Dennis P. Watson, Assistant Professor, Department of Health Policy and Management, Interim Director, Center for Health Policy, Erin L. Adams, Doctoral Candidate, Department of Psychology, School of Science, Graduate Research Assistant, Center for Health Policy, School of Public Health, Indiana University - Purdue University Indianapolis, Joanna R. Jackson, Graduate Research Assistant, Center for Health Policy, Department of Health Policy and Management, Indiana University Richard M. Fairbanks School of Public Health
- Edited by Teresa L. Scheid, University of North Carolina, Charlotte, Eric R. Wright, Georgia State University
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- Book:
- A Handbook for the Study of Mental Health
- Published online:
- 28 May 2018
- Print publication:
- 08 June 2017, pp 573-590
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Summary
This chapter provides an overview of the history of mental health policy in the United States divided into three periods: (1) the development and establishment of the state asylum as the primary mode of mental health treatment; (2) deinstitutionalization and the move to community-based care; and (3) recovery as the guiding vision of mental health care. Federal involvement is a relatively new development in mental health policy, a fact that has lead to significant fragmentation in the mental health care system. While a number of policies since the 1950s have sought to increase social inclusion and the ability for people with mental illness to control their own lives, lack of support for these policies has resulted in relatively slow actual change. However, recent national reforms have potential to make lasting and substantial change. Watson and colleagues describe these reforms and how they may lead to implementation of recovery-oriented principles by improving mental health care access and service quality. They close with a discussion of potential areas for sociological mental health research related to contemporary health policy. What are the gaps in current mental health policy? How can mental health policy promote recovery for people living with mental health problems?
Introduction
Historically, there has been a lack of strong federal involvement in US mental health policy making. The result has been a highly fragmented mental health system with significant differences at the state and local levels of government. In this chapter, we provide an overview of the history of US mental health policy from the seventeenth century to the present, with a particular focus on polices affecting people living with serious and persistent mental illness (SPMI). We have divided the chapter into three broad periods of reform. The first period, the late 1700s through the 1940s, was a time marked by increasing social control over the lives of people with mental illness as states started to assume more responsibility for their care. This period culminated with the state psychiatric hospital (also known as the asylum) as the primary locus of mental health treatment. The 1950s–1980s was a time of advocacy leading to the movement of patients from state mental hospitals and into the community. This period was also marked by increased recognition of the rights of people living with mental illness, albeit with relatively few polices or resources to support them.
Cover Crop Impact on Weed Dynamics in an Organic Dry Bean System
- Erin C. Hill, Karen A. Renner, Christy L. Sprague, Adam S. Davis
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- Journal:
- Weed Science / Volume 64 / Issue 2 / June 2016
- Published online by Cambridge University Press:
- 20 January 2017, pp. 261-275
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Weed suppression is one possible benefit of including cover crops in crop rotations. The late spring planting date of dry beans allows for more growth of cover crops in the spring. We assessed the influence of cover crops on weed dynamics in organic dry beans and weed seed persistence. Medium red clover, oilseed radish, and cereal rye were planted the year before dry beans; a no-cover-crop control was also included. After cover-crop incorporation, common lambsquarters, giant foxtail, and velvetleaf seeds were buried in the red clover, cereal rye, and no-cover control treatments and then retrieved 0, 1, 2, 4, 6, and 12 mo after cover-crop incorporation. Dry beans were planted in June and weed emergence and biomass measured. Eleven or more site-years of data were collected for each cover-crop treatment between 2011 and 2013, allowing for structural equation modeling (SEM), in addition to traditional analyses. Cereal rye residue increased giant foxtail and velvetleaf seed persistence by up to 12%; red clover decreased common lambsquarters seed persistence by 22% in 1 of 2 yr relative to the no-cover-crop control. Oilseed radish and incorporated cereal rye rarely reduced weed densities. When red clover biomass exceeded 5 Mg ha−1, soil inorganic N was often higher (5 of 6 site-years), as were weed density and biomass (5 and 4 of 12 main site sample times, respectively). Using SEM, we identified one causal relationship between cover-crop N content and weed biomass at the first flower stage (R1), as mediated through soil N at the time of dry bean planting and at the stage with two fully expanded trifoliates. Increasing cover-crop C : N ratios directly reduced weed biomass at R1, not mediated through changes in soil N. Cover crops that make a significant contribution to soil N may also stimulate weed emergence and growth.
Prevalence and Characteristics of Antimicrobial Stewardship Programs at Freestanding Children's Hospitals in the United States
- Jason G. Newland, Jeffrey S. Gerber, Scott J. Weissman, Samir S. Shah, Chelsea Turgeon, Erin B. Hedican, Cary Thurm, Matt Hall, Joshua Courter, Thomas V. Brogan, Holly Maples, Brian R. Lee, Adam L. Hersh
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 35 / Issue 3 / March 2014
- Published online by Cambridge University Press:
- 10 May 2016, pp. 265-271
- Print publication:
- March 2014
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Background and Objective.
Antimicrobial stewardship programs (ASPs) are a mechanism to ensure the appropriate use of antimicrobials. The extent to which ASPs are formally implemented in freestanding children's hospitals is unknown. The objective of this study was to determine the prevalence and characteristics of ASPs in freestanding children's hospitals.
Methods.We conducted an electronic survey of 42 freestanding children's hospitals that are members of the Children's Hospital Association to determine the presence and characteristics of their ASPs. For hospitals without an ASP, we determined whether stewardship strategies were in place and whether there were barriers to implementing a formal ASP.
Results.We received responses from 38 (91%) of 42. Among responding institutions, 16 (38%) had a formal ASP, and 15 (36%) were in the process of implementing a program. Most ASPs (13 [81%] of 16) were started after 2007. The median number of full-time equivalents dedicated to ASPs was 0.63 (range, 0.1–1.8). The most common antimicrobials monitored by ASPs were linezolid, vancomycin, and carbapenems. Many hospitals without a formal ASP were performing stewardship activities, including elements of prospective audit and feedback (9 [41%] of 22), formulary restriction (9 [41%] of 22), and use of clinical guidelines (17 [77%] of 22). Antimicrobial outcomes were more likely to be monitored by hospitals with ASPs (100% vs 68%; P = .01), although only 1 program provided support for a data analyst.
Conclusions.Most freestanding children's hospitals have implemented or are developing an ASP. These programs differ in structure and function, and more data are needed to identify program characteristics that have the greatest impact.
Contributors
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- By Basem Abdelmalak, Joseph Abdelmalak, Alaa A. Abd-Elsayed, David L. Adams, Eric E. Adelman, Maged Argalious, Endrit Bala, Gene H. Barnett, Sheron Beltran, Andrew Bielaczyc, William Bingaman, James M. Blum, Alina Bodas, Vera Borzova, Richard Bowers, Adam Brown, Chad M. Brummett, Alexandra S. Bullough, James F. Burke, Juan P. Cata, Neeraj Chaudhary, Michael J. Claybon, Miguel Cruz, Milind Deogaonkar, Vikram Dhawan, Thomas Didier, D. John Doyle, Zeyd Ebrahim, Hesham Elsharkawy, Wael Ali Sakr Esa, Ehab Farag, Ryen D. Fons, Joseph J. Gemmete, Matt Giles, Phil Gillen, Goodarz Golmirzaie, Marcos Gomes, Lisa Grilly, Maged Guirguis, David W. Healy, Heather Hervey-Jumper, Shawn L. Hervey-Jumper, Paul E. Hilliard, Samuel A. Irefin, George K. Istaphanous, Teresa L. Jacobs, Ellen Janke, Greta Jo, James W. Jones, Rami Karroum, Allen Keebler, Stephen J. Kimatian, Colleen G. Koch, Robert Scott Kriss, Andrea Kurz, Jia Lin, Michael D. Maile, Negmeldeen F. Mamoun, Mariel Manlapaz, Edward Manno, Donn Marciniak, Piyush Mathur, Nicholas F. Marko, Matthew Martin, George A. Mashour, Marco Maurtua, Scott T. McCardle, Julie McClelland, Uma Menon, Paul S. Moor, Laurel E. Moore, Ruairi Moulding, Dileep R. Nair, Todd Nelson, Julie Niezgoda, Edward Noguera, Jerome O’Hara, Aditya S. Pandey, Mauricio Perilla, Paul Picton, Marc J. Popovich, J. Javier Provencio, Venkatakrishna Rajajee, Mohit Rastogi, Stacy Ritzman, Lauryn R. Rochlen, Leif Saager, Vivek Sabharwal, Oren Sagher, Kenneth Saliba, Milad Sharifpour, Lesli E. Skolarus, Paul Smythe, Wolf H. Stapelfeldt, William R. Stetler, Peter Stiles, Vijay Tarnal, Khoi D. Than, B. Gregory Thompson, Alparslan Turan, Christopher R. Turner, Justin Upp, Sumeet Vadera, Jennifer Vance, Anthony C. Wang, Robert J. Weil, Marnie B. Welch, Karen K. Wilkins, Erin S. Williams, George N. Youssef, Asma Zakaria, Sherif S. Zaky, Andrew Zura
- Edited by George A. Mashour, Ehab Farag
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- Book:
- Case Studies in Neuroanesthesia and Neurocritical Care
- Published online:
- 03 May 2011
- Print publication:
- 03 February 2011, pp x-xvi
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