scholarly journals Opioid distribution trends (2006–2017) in the US Territories

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e6272 ◽  
Author(s):  
Fedor F. Cabrera ◽  
Erik R. Gamarra ◽  
Tiffany E. Garcia ◽  
Ashanti D. Littlejohn ◽  
Poul A. Chinga ◽  
...  
Keyword(s):  
Puerto Rico ◽  
Oral Morphine ◽  
Distribution Patterns ◽  
The United States ◽  
Virgin Islands ◽  
Treatment Programs ◽  
Drug Enforcement ◽  
The Us ◽  
Per Capita ◽  
Distribution Trends

BackgroundThe US mainland is experiencing an epidemic of opioid overdoses. Unfortunately, the US Territories (Guam, Puerto Rico, and the Virgin Islands) have often been overlooked in opioid pharmacoepidemiology research. This study examined common prescription opioids over the last decade.MethodsThe United States Drug Enforcement Administration’s Automation of Reports and Consolidated Orders System (ARCOS) was used to report on ten medical opioids: buprenorphine, codeine, fentanyl, hydrocodone, hydromorphone, meperidine, methadone, morphine, oxycodone, and oxymorphone, by weight from 2006 to 2017. Florida and Hawaii were selected as comparison areas.ResultsPuerto Rico had the greatest Territorial oral morphine mg equivalent (MME) per capita (421.5) which was significantly higher (p< .005) than the Virgin Islands (139.2) and Guam (118.9) but significantly lower than that of Hawaii (794.6) or Florida (1,509.8). Methadone was the largest opioid by MMEs in 2017 in most municipalities, accounting for 41.1% of the total in the Virgin Islands, 37.9% in Florida, 36.6% in Hawaii but 80.8% in Puerto Rico. Puerto Rico and Florida showed pronounced differences in the distribution patterns by pharmacies, hospitals, and narcotic treatment programs for opioids.ConclusionsContinued monitoring of the US Territories is needed to provide a balance between appropriate access to these important agents for cancer related and acute pain while also minimizing diversion and avoiding the opioid epidemic which has adversely impacted the US mainland.

scholarly journals Methadone Distribution Trends from 2017-2019 in the United States

2020 ◽  
Author(s):  
John A. Furst ◽  
Nicholas J. Mynarski ◽  
Kenneth L. McCall ◽  
Brian J. Piper
Keyword(s):  
United States ◽  
Rhode Island ◽  
Distribution Patterns ◽  
The United States ◽  
Opioid Use Disorder ◽  
Primary Objective ◽  
Treatment Programs ◽  
Opioid Use ◽  
Drug Enforcement ◽  
The Us

AbstractObjectiveMethadone is an evidence based treatment for opioid use disorder and is also employed for acute pain. The primary objective of this study was to explore methadone distribution patterns between the years 2017 and 2019 across the United States (US). This study builds upon previous literature that has analyzed prior years of US distribution patterns, and further outlines regional and state specific methadone trends.MethodsThe Drug Enforcement Administration’s Automated Reports and Consolidated Ordering System (ARCOS) was used to acquire the number of narcotic treatment programs (NTPs) per state and methadone distribution weight in grams. Methadone distribution by weight, corrected for state populations, and number of NTPs were compared from 2017 to 2019 between states, within regions, and nationally.ResultsBetween 2017 and 2019, the national distribution of methadone increased 12.30% for NTPs but decreased 34.57% for pain, for a total increase of 2.66%. While all states saw a decrease in distribution for pain, when compared regionally, the Northeast showed a significantly smaller decrease than all other regions. Additionally, the majority of states experienced an increase in distribution for NTPs and most states demonstrated a relatively stable or increasing number of NTPs, with an 11.49% increase in NTPs nationally. The number of NTPs per 100K in 2019 ranged from 2.08 in Rhode Island to 0.00 in Wyoming.ConclusionAlthough methadone distribution for OUD was increasing in the US, there were pronounced regional disparities.

The Question of Racial Mixing in the American Possessions

2017 ◽  
Author(s):  
Paul Schor
Keyword(s):  
United States ◽  
Puerto Rico ◽  
The United States ◽  
Virgin Islands ◽  
Racial Classification ◽  
National History ◽  
Us Virgin Islands ◽  
Black And White ◽  
The Us ◽  
Us Census

This chapter discusses the imposition of the US system of racial classification in the US Virgin Islands, Puerto Rico, and Hawaii. The original use in certain US territories of a “mixed” racial category highlights the national norm that made mulattoes into “lighter-skinned” blacks. In the various territories acquired by the United States after 1898, a rigid imposition of the categories of the US census was difficult because they were the product of a national history that had not been shared. Whether in the US Virgin Islands, Puerto Rico, or Hawaii the perception of what made a person black, white, or mulatto was very different from North American usage, showing that binary black and white mainland tradition was not working there.

scholarly journals Ocular Findings and Visual Function in Children Examined during the Zika Health Brigade in the US Virgin Islands, March 2018

2021 ◽  
Vol 6 (2) ◽  
pp. 66
Author(s):  
S. Grace Prakalapakorn ◽  
Lucas Bonafede ◽  
Linda Lawrence ◽  
Daniel Lattin ◽  
Nicola Kim ◽  
...  
Keyword(s):  
Visual Function ◽  
Retrospective Chart Review ◽  
The United States ◽  
Virgin Islands ◽  
Neurologic Examination ◽  
Zikv Infection ◽  
Us Virgin Islands ◽  
Ocular Findings ◽  
Ocular Structure ◽  
The Us

Among children born with laboratory-confirmed Zika virus (ZIKV) infection, visual impairment (VI) can occur despite normal ocular structure. The objective of this report is to describe ocular findings and visual function among children examined during the Department of Health Zika Health Brigade (ZHB) in the United States Virgin Islands in March 2018. This analysis is based on a retrospective chart review of children eligible to participate in the ZHB (i.e., part of the US Zika Pregnancy and Infant Registry) and who were examined by ophthalmologists. Eighty-eight children attended the ZHB. This report includes 81 children [48 (59.3%) males] whose charts were located [average gestational age = 37.6 weeks (range: 27.6–41.3) and average adjusted age at examination = 9.1 months (range: 0.9–21.9)]. Of those examined, 5/81 (6.2%) had microcephaly at birth, 2/81 (2.5%) had a structural eye abnormality, and 19/72 (26.4%) had VI. Among children with normal ocular structure and neurologic examination, 13/51 (25.5%) had VI. Despite a low incidence of abnormal ocular structure and microcephaly, about a quarter of children examined had VI. Our findings emphasize that ophthalmological examinations should be performed in all children with suspicion for antenatal ZIKV infection, even children with normal ocular structure and neurologic examination.

scholarly journals Potential Habitat of Acropora spp. on Reefs of Florida, Puerto Rico, and the US Virgin Islands

2015 ◽  
Vol 3 ◽  
pp. 242-255 ◽  
Author(s):  
Katherine E. Wirt ◽  
Pamela Hallock ◽  
David Palandro ◽  
Kathleen Semon Lunz
Keyword(s):  
Puerto Rico ◽  
Virgin Islands ◽  
Us Virgin Islands ◽  
Potential Habitat ◽  
The Us

scholarly journals A spatially detailed blue water footprint of the United States economy

2018 ◽  
Vol 22 (5) ◽  
pp. 3007-3032 ◽  
Author(s):  
Richard R. Rushforth ◽  
Benjamin L. Ruddell
Keyword(s):  
United States ◽  
Water Use ◽  
Water Footprint ◽  
Virtual Water ◽  
The United States ◽  
Energy Information Administration ◽  
Blue Water ◽  
Consumptive Use ◽  
The Us ◽  
Per Capita

Abstract. This paper quantifies and maps a spatially detailed and economically complete blue water footprint for the United States, utilizing the National Water Economy Database version 1.1 (NWED). NWED utilizes multiple mesoscale (county-level) federal data resources from the United States Geological Survey (USGS), the United States Department of Agriculture (USDA), the US Energy Information Administration (EIA), the US Department of Transportation (USDOT), the US Department of Energy (USDOE), and the US Bureau of Labor Statistics (BLS) to quantify water use, economic trade, and commodity flows to construct this water footprint. Results corroborate previous studies in both the magnitude of the US water footprint (F) and in the observed pattern of virtual water flows. Four virtual water accounting scenarios were developed with minimum (Min), median (Med), and maximum (Max) consumptive use scenarios and a withdrawal-based scenario. The median water footprint (FCUMed) of the US is 181 966 Mm3 (FWithdrawal: 400 844 Mm3; FCUMax: 222 144 Mm3; FCUMin: 61 117 Mm3) and the median per capita water footprint (FCUMed′) of the US is 589 m3 per capita (FWithdrawal′: 1298 m3 per capita; FCUMax′: 720 m3 per capita; FCUMin′: 198 m3 per capita). The US hydroeconomic network is centered on cities. Approximately 58 % of US water consumption is for direct and indirect use by cities. Further, the water footprint of agriculture and livestock is 93 % of the total US blue water footprint, and is dominated by irrigated agriculture in the western US. The water footprint of the industrial, domestic, and power economic sectors is centered on population centers, while the water footprint of the mining sector is highly dependent on the location of mineral resources. Owing to uncertainty in consumptive use coefficients alone, the mesoscale blue water footprint uncertainty ranges from 63 to over 99 % depending on location. Harmonized region-specific, economic-sector-specific consumption coefficients are necessary to reduce water footprint uncertainties and to better understand the human economy's water use impact on the hydrosphere.

scholarly journals Desacoplamento entre as Emissões de CO2 e o PIB

2016 ◽  
Vol 2 (3) ◽  
pp. 37-53
Author(s):  
Yves Rocha De Salles Lima ◽  
Tatiane Stellet Machado ◽  
Joao Jose de Assis Rangel
Keyword(s):  
Economic Growth ◽  
Co2 Emissions ◽  
International Energy Agency ◽  
The United States ◽  
Oil Price ◽  
Gdp Per Capita ◽  
Energy Agency ◽  
The Us ◽  
Per Capita ◽  
The One

The objetive of this work is to analyze the variation of CO2 emissions and GDP per capita throughout the years and identify the possible interaction between them. For this purpose, data from the International Energy Agency was collected on two countries, Brazil and the one with the highest GDP worldwide, the United States. Thus, the results showed that CO2 emissions have been following the country’s economic growth for many years. However, these two indicators have started to decouple in the US in 2007 while in Brazil the same happened in 2011. Furthermore, projections for CO2 emissions are made until 2040, considering 6 probable scenarios. These projections showed that even if the oil price decreases, the emissions will not be significantly affected as long as the economic growth does not decelerate.

scholarly journals Granice rzeczywiste i symboliczne. Przypadek Portoryko.

2020 ◽  
Author(s):  
Anna Kaganiec-Kamieńska
Keyword(s):  
United States ◽  
Puerto Rico ◽  
Puerto Rican ◽  
Main Part ◽  
The United States ◽  
The Real ◽  
The Us ◽  
Puerto Rican Diaspora

Borders and Boundaries, Real and Symbolic: The Case of Puerto RicoThe aim of this article is to outline the real and symbolic borders and boundaries, of geographical, political, cultural and racial nature, in the history and present of Puerto Rico, and their role in shaping and transforming the Puerto Rican identity. The main part of the article focuses on the borders and boundaries between Puerto Rico and the United States. The second part looks at the lines dividing the population in the island and the Puerto Rican diaspora in the US. Granice rzeczywiste i symboliczne. Przypadek PortorykoCelem artykułu jest zarysowanie rzeczywistych i symbolicznych granic, geograficznych, politycznych, rasowych i kulturowych, wpisujących się w historię i współczesność Portoryko oraz ich roli w kształtowaniu się i przekształcaniu tożsamości portorykańskiej. Główna część artykułu skupia się na granicach biegnących między Portoryko a Stanami Zjednoczonymi. W drugiej części wskazano linie podziału powstałe między mieszkańcami wyspy a diasporą portorykańską w USA.

Coral-reef Geology: Puerto Rico and the US Virgin Islands

2008 ◽  
pp. 263-302 ◽  
Author(s):  
Dennis K. Hubbard ◽  
Randolph B. Burke ◽  
Ivan P. Gill ◽  
Wilson R. Ramirez ◽  
Clark Sherman
Keyword(s):  
Puerto Rico ◽  
Coral Reef ◽  
Virgin Islands ◽  
Us Virgin Islands ◽  
The Us

The Politics of Status

2020 ◽  
pp. 34-53
Author(s):  
Amílcar Antonio Barreto
Keyword(s):  
Puerto Rico ◽  
Puerto Rican ◽  
Political Party ◽  
Party System ◽  
Puerto Ricans ◽  
The United States ◽  
State Of The Union ◽  
The Us ◽  
The Status ◽  
Political Party System

Puerto Ricans, US subjects since 1898, were naturalized en masse in 1917. Congress did so to eliminate the possibility of independence from the US. That citizenship is the cornerstone of island-mainland relations for those advocating a continued relationship with the United States—either in the form of the 1952 Commonwealth constitution or statehood. The epicenter of Puerto Rican partisan life remains the status question. This remarkably stable political party system featured two strong parties of near-equal strength—the pro-Commonwealth PPD and its statehood challenger, the PNP— and a small independence party, the PIP. A core feature of the PNP’s platform has been estadidad jíbara—"creole statehood.” In theory, a future State of Puerto Rico would be allowed to retain its cultural and linguistic autonomy while attaining full membership as the 51st state of the Union.

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