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Psychotropic prescription rates continue to increase in the United States (USA). Few studies have investigated whether social-structural factors may play a role in psychotropic medication use independent of mental illness. Food insecurity is prevalent among people living with HIV in the USA and has been associated with poor mental health. We investigated whether food insecurity was associated with psychotropic medication use independent of the symptoms of depression and anxiety among women living with HIV in the USA.
We used cross-sectional data from the Women's Interagency HIV Study (WIHS), a nationwide cohort study. Food security (FS) was the primary explanatory variable, measured using the Household Food Security Survey Module. First, we used multivariable linear regressions to test whether FS was associated with symptoms of depression (Center for Epidemiologic Studies Depression [CESD] score), generalised anxiety disorder (GAD-7 score) and mental health-related quality of life (MOS-HIV Mental Health Summary score; MHS). Next, we examined associations of FS with the use of any psychotropic medications, including antidepressants, sedatives and antipsychotics, using multivariable logistic regressions adjusting for age, race/ethnicity, income, education and alcohol and substance use. In separate models, we additionally adjusted for symptoms of depression (CESD score) and anxiety (GAD-7 score).
Of the 905 women in the sample, two-thirds were African-American. Lower FS (i.e. worse food insecurity) was associated with greater symptoms of depression and anxiety in a dose–response relationship. For the psychotropic medication outcomes, marginal and low FS were associated with 2.06 (p < 0.001; 95% confidence interval [CI] = 1.36–3.13) and 1.99 (p < 0.01; 95% CI = 1.26–3.15) times higher odds of any psychotropic medication use, respectively, before adjusting for depression and anxiety. The association of very low FS with any psychotropic medication use was not statistically significant. A similar pattern was found for antidepressant and sedative use. After additionally adjusting for CESD and GAD-7 scores, marginal FS remained associated with 1.93 (p < 0.05; 95% CI = 1.16–3.19) times higher odds of any psychotropic medication use. Very low FS, conversely, was significantly associated with lower odds of antidepressant use (adjusted odds ratio = 0.42; p < 0.05; 95% CI = 0.19–0.96).
Marginal FS was associated with higher odds of using psychotropic medications independent of depression and anxiety, while very low FS was associated with lower odds. These complex findings may indicate that people experiencing very low FS face barriers to accessing mental health services, while those experiencing marginal FS who do access services are more likely to be prescribed psychotropic medications for distress arising from social and structural factors.
Accurate quantification of rates of glacier mass loss is critical for managing water resources and for assessing hazards at ice-clad volcanoes, especially in arid regions like southern Peru. In these regions, glacier and snow melt are crucial dry season water resources. In order to verify previously reported rates of ice area decline at Nevado Coropuna in Peru, which are anomalously rapid for tropical glaciers, we measured changes in ice cap area using 259 Landsat images acquired from 1980 to 2014. We find that Coropuna Ice Cap is presently the most extensive ice mass in the tropics, with an area of 44.1 km2, and has been shrinking at an average area loss rate of 0.409 km2 a−1 (~0.71% a−1) since 1980. Our estimated rate of change is considerably lower than previous studies (1.4 km2 a−1 or ~2.43% a−1), but is consistent with other tropical regions, such as the Cordillera Blanca located ~850 km to the NW (~0.68% a−1). Thus, if glacier recession continues at its present rate, our results suggest that Coropuna Ice Cap will likely continue to contribute to water supply for agricultural and domestic uses until ~2120, which is nearly 100 years longer than previously predicted.
Archaeological data and research results are essential to addressing such fundamental questions as the origins of human culture; the origin, waxing, and waning of civilizations and cities; the response of societies to long-term climate changes; and the systemic relationships implicated in human-induced changes in the environment. However, we lack the capacity for acquiring, managing, analyzing, and synthesizing the data sets needed to address important questions such as these. We propose investments in computational infrastructure that would transform archaeology’s ability to advance research on the field’s most compelling questions with an evidential base and inferential rigor that have heretofore been impossible. At the same time, new infrastructure would make archaeological data accessible to researchers in other disciplines. We offer recommendations regarding data management and availability, cyberinfrastructure tool building, and social and cultural changes in the discipline. We propose funding synthetic case studies that would demonstrate archaeology’s ability to contribute to transdisciplinary research on long-term social dynamics and serve as a context for developing computational tools and analytical workflows that will be necessary to attack these questions. The case studies would explore how emerging research in computer science could empower this research and would simultaneously provide productive challenges for computer science research.
Significant new opportunities for astrophysics and cosmology have been identified at low radio frequencies. The Murchison Widefield Array is the first telescope in the southern hemisphere designed specifically to explore the low-frequency astronomical sky between 80 and 300 MHz with arcminute angular resolution and high survey efficiency. The telescope will enable new advances along four key science themes, including searching for redshifted 21-cm emission from the EoR in the early Universe; Galactic and extragalactic all-sky southern hemisphere surveys; time-domain astrophysics; and solar, heliospheric, and ionospheric science and space weather. The Murchison Widefield Array is located in Western Australia at the site of the planned Square Kilometre Array (SKA) low-band telescope and is the only low-frequency SKA precursor facility. In this paper, we review the performance properties of the Murchison Widefield Array and describe its primary scientific objectives.
Healthcare-associated transmission of respiratory viruses is a concerning patient safety issue.
Surveillance for influenza virus among a cohort of healthcare workers (HCWs) was conducted in a tertiary care children's hospital from November 2009 through April 2010 using biweekly nasal swab specimen collection. If a subject reported respiratory symptoms, an additional specimen was collected. Specimens from ill HCWs and a randomly selected sample from asymptomatic subjects were tested for additional respiratory viruses by multiplex polymerase chain reaction (PCR).
A total of 1,404 nasal swab specimens were collected from 170 enrolled subjects. Influenza circulated at very low levels during the surveillance period, and 74.2% of subjects received influenza vaccination. Influenza virus was not detected in any specimen. Multiplex respiratory virus PCR analysis of all 119 specimens from symptomatic subjects and 200 specimens from asymptomatic subjects yielded a total of 42 positive specimens, including 7 (16.7%) in asymptomatic subjects. Viral shedding was associated with report of any symptom (odds ratio [OR], 13.06 [95% confidence interval, 5.45–31.28]; P< .0001) and younger age (OR, 0.96 [95% confidence interval, 0.92–0.99]; P = .023) when controlled for sex and occupation of physician or nurse. After the surveillance period, 46% of subjects reported working while ill with an influenza-like illness during the previous influenza season.
In this cohort, HCWs working while ill was common, as was viral shedding among those with symptoms. Asymptomatic viral shedding was infrequent but did occur. HCWs should refrain from patient care duties while ill, and staffing contingencies should accommodate them.
We document changes for Mittivakkat Gletscher, the peripheral glacier in Greenland with the longest field-based observed mass-balance and surface velocity time series. Between 1986 and 2011, this glacier changed by −15% in mean ice thickness and −30% in volume. We attribute these changes to summer warming and lower winter snow accumulation. Vertical strain compensated for ∼60% of the elevation change due to surface mass balance (SMB) in the lower part, and ∼25% in the upper part. The annual mean ice surface velocity changed by −30%, which can be fully explained by the dynamic effect of ice thinning, within uncertainty. Mittivakkat Gletscher summer surface velocities were on average 50–60% above winter background values, and up to 160% higher during peak velocity events. Peak velocity events were accompanied by uplift of a few centimeters.