The evolution of fentanyl-related substances: Prevalence and drug concentrations in postmortem biological specimens at the Miami-Dade Medical Examiner Department.

Since 2014, the Miami-Dade Medical Examiner Department (MDME) has observed a drastic increase in the number of fentanyl and fentanyl analog (fentanyl-related substances (FRSs)) fatalities since its introduction into the heroin and cocaine supply. Due to the prevalence of FRS in Miami-Dade County, the MDME toxicology laboratory began documenting each case in which fentanyl and/or a fentanyl analog was identified. Additional information monitored included demographics (age, race and sex), other drugs identified, cause of death (COD) and manner of death (MOD).

Prevalence of xylazine in overdose cases: An analysis of Miami-Dade County medical examiner case data.

Xylazine sedative, muscle relaxant, and analgesic used in a veterinary setting. Although xylazine was never approved for therapeutic use in humans, it has become popular in the street drug market as a cutting or bulking agent in the fentanyl and heroin supply. Recently, there has been a significant increase in the detection of xylazine in postmortem forensic toxicology casework.

High-quality patient-centered palliative care: interprofessional team members' perceptions of social workers' roles and contribution.

A core tenet of interprofessional collaborative practice (IPCP) is that efficient and effective teams are critical for the delivery of high-quality, patient-centered care. Although palliative care has a history of excellent care, increasing demands and larger patient loads are challenging teams to adapt and strengthen team functioning in hospital settings. The purpose of this qualitative study was to better understand the IPCP contributions of advanced palliative social workers (PSWs) through the eyes of their colleagues.

Food insecurity and loneliness amongst older urban subsidised housing residents: The importance of social connectedness.

Food insecurity and loneliness are shockingly large and growing problems in the older population in the U.S. and globally.

Religious coping and psychological well-being in Latino Alzheimer's caregivers.

Objectives: Prior research has demonstrated the benefits of religion on caregiver well-being; however, less research exists on the processes underlying this relationship, particularly in Latino Alzheimer's disease (AD) families. This study's aim was therefore to explore the direct and indirect influences of positive religious coping (RC-P) and negative religious coping (RC-N) on caregivers' experiences of depression and anxiety.

Methods: The data are from the Circulo de Cuidado Study baseline interviews; participant eligibility criteria were that the person identifies as being Latino, providing at least 5 h of care weekly, and their relative has an AD diagnosis and neuropsychiatric symptoms.

Social work involvement in palliative care heart failure research: a review of recent literature.

Purpose Of Review: The aim of the review is to examine the findings of empirical studies of palliative care interventions for patients with heart failure in which a social worker was identified as a key member of the interprofessional clinical team.

Recent Findings: Our systematic review of the empirical literature from January 2016 to August 2019 found five palliative care interventions with heart failure patients that cited involvement of a social worker as a key team member. The reviewed studies highlighted social workers' roles in the areas of psychosocial assessments and support, advance care planning, and patient-medical team communication.

Quantitative Analysis of Fentanyl and Six Fentanyl Analogs in Postmortem Specimens by UHPLC-MS-MS.

Since 2013, opioid-related deaths have increased in Miami-Dade County, FL due to fentanyl and fentanyl analogs in the local heroin supply. From 2014 to 2015, a near 600% increase in fentanyl and fentanyl analog-related deaths was observed, followed by another 200% increase in 2016. In addition to fentanyl, six fentanyl analogs were identified in this time period: β-hydroxythiofentanyl, acetyl fentanyl, furanyl fentanyl, carfentanil, butyryl fentanyl and para-fluoroisobutyryl fentanyl.

Perceptions of neighborhood safety and depressive symptoms among older minority urban subsidized housing residents: the mediating effect of sense of community belonging.

Objectives: Older minority subsidized housing residents represent a population that is particularly vulnerable to depression. Although research suggests that neighborhood characteristics influence older adults' mental health, it has not been explored in this target population. Drawing on social disorganization and social capital theories, this study's aim was to explore if perceptions of neighborhood safety are associated with depressive symptoms; and, whether a sense of community belonging has a mediating effect on this potential relationship.

Visualization and simulation of density driven convection in porous media using magnetic resonance imaging.

Magnetic resonance imaging is used to observe solute transport in a 40cm long, 26cm diameter sand column that contained a central core of low permeability silica surrounded by higher permeability well-sorted sand. Low concentrations (2.9g/L) of Magnevist, a gadolinium based contrast agent, produce density driven convection within the column when it starts in an unstable state.

Loneliness and Depression Among Older Adults in Urban Subsidized Housing.

Objective: Depression is particularly prevalent in low-income and disabled older adults, and minority populations face a greater risk of poverty and earlier disability onset. Yet, little is known about the mental health of older subsidized housing residents, a population which is disproportionately composed of persons of color. The study's aim was therefore to explore the prevalence and correlates of depression in this target population, with a particular focus on the role of loneliness.

Neuroimaging Biomarkers of a History of Concussion Observed in Asymptomatic Young Athletes.

Participation in contact sports places athletes at elevated risk for repeated head injuries and is associated with negative mental health outcomes later in life. The current study identified changes observable on neuroimaging that persisted beyond the apparent resolution of acute symptoms of concussion. Sixteen young adult ice hockey players with a remote history of concussion but no subjective complaints were compared against 13 of their teammates with no history of concussion.

In vivo quantitative whole-brain T1 rho MRI of multiple sclerosis.

Background: To apply quantitative whole-brain T1 -rho (T1ρ ) and T2 imaging to the detection and quantification of brain changes resulting from multiple sclerosis (MS).

Methods: Twenty-three MS patients with clinically isolated syndrome (10) and relapsing remitting MS (13) phenotypes, compared with 24 age-matched healthy controls were imaged at 3 Tesla. An axial T1ρ -weighted three-dimensional turbo spin echo sequence with a variable flip angle and fluid suppression was used.

Postconcussion symptoms are associated with cerebral cortical thickness in healthy collegiate and preparatory school ice hockey players.

Objective: To investigate the degree to which concussion history and postconcussive symptoms are associated with cortical morphology among male hockey players.

Study Design: Male subjects (n = 29), ranging in age from 14 to 23 years (mean 17.8 years), were recruited from preparatory school and collegiate ice hockey teams and underwent neuroimaging and baseline Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) testing.

Navigating dual relationships in rural communities.

The literature examining dual relationships in rural communities is limited, and existing ethical guidelines lack guidelines about how to navigate these complex relationships. This study uses grounded theory to explore rural therapists' perceptions of dual relationship issues, the perceived impact of minority and/or religious affiliation on the likelihood of dual relationships, and the ways rural therapists handle inevitable dual relationship situations. All of the therapists who participated in the study practiced in small communities and encountered dual relationship situations with regularity.

The Effectiveness of a Culturally Sensitive Cognitive Behavioral Group Intervention for Latino Alzheimer's Caregivers.

Purpose Of The Study: Demographic projections suggest that the older Latino population will experience the fastest growth among all racial/ethnic groups; and by 2050 will constitute 20% of the nation's seniors. Yet, Latino Alzheimer's elders and their families remain underrepresented in the health care system and caregiver intervention studies. To address this gap, this study tested the effectiveness of Circulo de Cuidado, a culturally-sensitive, cognitive behavioral (CBT) group intervention, in supporting Latino families' ability to manage the disease's neuropsychiatric symptoms and improve caregiver well-being.

In vivo whole-brain T1-rho mapping across adulthood: normative values and age dependence.

Purpose: To report a systematic investigation of variations in brain T1ρ (T1-rho) values over adulthood, and present normative values for cortical gray matter, juxtacortical white matter, selected white matter tracts and subcortical structures.

Materials And Methods: Forty-one healthy control subjects (23 males aged 18-76 years and 18 females aged 21-73 years) were imaged at 3.0 Tesla (T) using a novel whole-brain T1ρ-weighted fluid suppressed three-dimensional turbo spin echo technique.

In vivo quantification of T1ρ in lumbar spine disk spaces at 3 T using parallel transmission MRI.

Objective: T1ρ MRI is an emerging, quantitative imaging modality that has been shown to correlate with proteoglycan content of disk material in vitro at 1.5 T. The purpose of this study is to quantify T1ρ values at all lumbar spine disk space levels at 3 T with parallel-transmission MRI in healthy adult volunteers.

Improving health care delivery to aging adults with disabilities: social work with dual eligibles in a climate of health care reform.

Adults aging with disabilities comprise a diverse group. In this article, we identify the prevalence and characteristics of this target population, focusing on adults who are dually eligible for Medicare and Medicaid. We articulate challenges in the delivery of health, social, and support services to adults aging with disabilities, particularly how existing health care policy and financing contributes to fragmentation of care.

Baby Boomers and the shifting political construction of old age.

Employing the political construct of "target" populations, we suggest that the Boomers in old age will constitute a conceptually distinct population from that represented by either their parents or grandparents. A fourfold typology organized along the dimensions posited by Schneider and Ingram (1993) yields categorizations of target populations as Dependent, Deviant, Advantaged, or Contender. Although these authors labeled the aged as Advantaged, categorizations of target populations can and do change over time.

The complexities of elder homelessness, a shifting political landscape and emerging community responses.

Despite their growing numbers, homeless older adults remain largely invisible in society and there has been a pervasive lack of public focus on elder homelessness. In this article, we seek to shine light on this forgotten population and deepen understanding of difficult challenges they confront in regaining housing security. We also examine the shifting political climate regarding homelessness, particularly the enactment and subsequent reauthorizations of the McKinney-Vento Homeless Assistance Act, and how these shifts are influencing community responses to elder homelessness.

Magnetic resonance diffusion tensor imaging and tractography of the lower spinal cord: application to diastematomyelia and tethered cord.

Objectives: To investigate the feasibility of routine clinical DTI of the lower spinal cord using high-field-strength MRI and parallel imaging, and to evaluate the utility of diffusion tensor imaging and tractography as tools for study of lower cord pathology.

Methods: Three patients with diastematomyelia, one patient with tethered cord, and six normal volunteers underwent MR imaging of the lower spine at 3 T. A 15-channel spine coil and parallel imaging were used with a six-direction single-shot echo-planar gradient echo technique.

Magnetic resonance diffusion tensor imaging and tractography of intracranial cavernous malformations: preliminary observations and characterization of the hemosiderin rim.

Object: Cavernous malformations (CMs) can cause symptoms that appear out of proportion to the lesion size, leading one to hypothesize that they may have an effect on adjacent white matter that is not fully explained by local mass effect. The goal of this study was to investigate the diffusion tensor (DT) properties of CMs, the hemosiderin rim, and normal-appearing adjacent white matter.

Methods: Eighteen cavernous malformations were characterized using standard MR imaging sequences as well as 6-direction DT imaging with single-shot echo planar-gradient echo imaging at 3 tesla.

Magnetic resonance diffusion tensor imaging of the optic nerves to guide treatment of pediatric suprasellar tumors.

Background/aims: As a preoperative planning tool, conventional magnetic resonance (MR) imaging may have limited value in differentiating tumors from white matter tracts. MR diffusion tensor imaging (MRDTI) has become a useful tool for evaluating white matter tracts in relation to surrounding structures and has been used in surgical planning for brain tumors involving white matter. We investigated the use of DTI of the optic nerves in surgical planning for pediatric suprasellar tumors.