Barriers to help-seeking among music festival attendees in New South Wales, Australia

Introduction

Prompt help‐seeking behaviour by music festival attendees can reduce risks associated with drug use; however, little is known about perceived barriers to help‐seeking when experiencing or witnessing illness at music festivals. We explored potential barriers and their association with festivalgoer characteristics.

Methods

We conducted an on‐site cross‐sectional survey of attendees at New South Wales music festivals in 2019/2020. Perceived barriers to help‐seeking in the hypothetical event of the respondent or a friend becoming unwell at the festival were assessed, and regression analyses were conducted to identify characteristics associated with these barriers.

Results

Across six festivals, 1229 people were surveyed and four‐fifths (83.2%) reported ≥1 barrier: 32.7% fear of getting in trouble with the police, 20.6% not knowing where to find help, 17.2% not knowing how unwell someone might be and 15.3% concern about friends or relatives finding out. In multivariable analyses, people of diverse sexuality and people using drugs that day had greater odds of reporting fear of trouble with the police. People reporting drug use that day had lower odds of reporting not knowing where to find help. Men, gender‐diverse people and people using drugs that day had greater odds of reporting concern about friends or relatives finding out.

Discussion and Conclusions

Our data substantiate concerns regarding policing strategies and their impact on festivals. Initiatives to support conversations about drugs with friends and families may be best targeted to younger people and those from gender‐diverse backgrounds.

Correlates of higher-risk drug-related behaviours at music festivals in New South Wales, Australia

INTRODUCTION

There are few contemporary data on illicit drug use at music festivals. We describe drug use patterns and prevalence of specific higher-risk drug-related behaviours, and their associations with festivalgoer characteristics.

METHODS

We approached attendees at six major music festivals in New South Wales, Australia, from November 2019 to March 2020. Participants self-completed an anonymous survey on prior and intended drug use and associated higher-risk behaviours; double dropping; higher-volume ethanol alongside drug use; higher quantity 3,4-methylenedioxymethamphetamine (MDMA); mixing stimulants; and preloading. Logistic regression and UpSet analyses were performed to identify festivalgoer characteristics and the intersection of high-risk behaviours, respectively.

RESULTS

Of 1229 participants, 372 (30.3%) used or planned to use drugs at the festival. In multivariable analyses, men and those purchasing drugs both inside and outside the venue had greater odds of engaging in higher-risk behaviours. Of those using MDMA, 47.9% reported double dropping. People using drugs for the first time had 3.3 (95% confidence interval 1.2-8.7) greater odds of higher-volume ethanol alongside drug use. People reporting that police/police dog presence influenced their decision to take drugs had 2.2 (95% confidence interval 1.4-3.6) greater odds of preloading. In UpSet analysis, preloading was the most common intersection (17% of those using drugs).

DISCUSSIONS AND CONCLUSIONS

Engagement in the five higher-risk drug behaviours was common, particularly amongst males and those using drugs for the first time, while police/police dog presence appeared to influence higher-risk behaviours amongst festival attendees. This information can be used to inform harm reduction advice, public health and law enforcement strategies.

Wastewater analysis for psychoactive substances at music festivals across New South Wales, Australia in 2019-2020

INTRODUCTION

Implementation of wastewater surveillance at music festivals has been limited to date. We aimed to use wastewater analysis and a self-report survey to determine the range of psychoactive substances being used during a music festival season in New South Wales, Australia.

METHODS

We sampled six single-day music festivals requiring a music festival license in New South Wales from March 2019 to March 2020; between 15% and 100% of portaloos (temporary, un-fixed toilet facilities) were sampled at each festival. Samples were screened for 98 psychoactive substances and/or their metabolites with results qualitatively expressed as detection frequencies for each substance at each festival and across all festivals. We compared these data with the results of surveys of self-reported drug use at four of the six festivals.

RESULTS

Festival attendance ranged from 6200 to 14,975 people. Amphetamine, cocaine, ketamine, methylone, MDMA, MDA, alprazolam, diazepam, etizolam, oxazepam and temazepam were found in almost all samples from all festivals. Ethylone, mephedrone and methcathinone were also found in over 50% of festivals. A norfentanyl (a fentanyl metabolite) and n-ethylpentylone were found at 2/6 and 1/6 festivals. No festival survey participant reported intentionally taking cathinones.

DISCUSSION

The detection frequency for cathinones was higher than expected relative to recent other data sources and this may represent adulteration or substitution. Similarly, the appearance of etizolam may be related to the use of counterfeit alprazolam. The detection of highly toxic substances such as N-ethylpentylone and norfentanyl may warrant public health alerts.

CONCLUSION

If provided close to real time, wastewater analysis at festivals could be complemented with information sources such as drug checking, on-site surveys, medical presentations and intelligence from peer networks to feed into early warning systems, public health alerts and peer-based harm reduction education during the festival season.

Coevolution between flight morphology, vertical stratification and sexual dimorphism: what can we learn from tropical butterflies?

Occurrence patterns are partly shaped by the affinity of species with habitat conditions. For winged organisms, flight-related attributes are vital for ecological performance. However, due to the different reproductive roles of each sex, we expect divergence in flight energy budget, and consequently different selection responses between sexes. We used tropical frugivorous butterflies as models to investigate coevolution between flight morphology, sex dimorphism and vertical stratification. We studied 94 species of Amazonian fruit-feeding butterflies sampled in seven sites across 3341 ha. We used wing-thorax ratio as a proxy for flight capacity and hierarchical Bayesian modelling to estimate stratum preference. We detected a strong phylogenetic signal in wing-thorax ratio in both sexes. Stouter fast-flying species preferred the canopy, whereas more slender slow-flying species preferred the understorey. However, this relationship was stronger in females than in males, suggesting that female phenotype associates more intimately with habitat conditions. Within species, males were stouter than females and sexual dimorphism was sharper in understorey species. Because trait-habitat relationships were independent from phylogeny, the matching between flight morphology and stratum preference is more likely to reflect adaptive radiation than shared ancestry. This study sheds light on the impact of flight and sexual dimorphism on the evolution and ecological adaptation of flying organisms.

Edaphic and arboricolous oribatid mites (Acari; Oribatida) in tropical environments: changes in the distribution of higher level taxonomic groups in the communities of species

We analysed the community of oribatid mites in 25 environments of northern Brazil and one in a rain forest in Peru, encompassing fauna sampled on natural and artificial (nylon-mesh bags) substrata, from primary and secondary forests, caatinga, savannahs, flooded forests, bark and epiphytes of trees, and polyculture. A hundred and forty six species are definitively identified from a total of 444 taxa. To determine changes in the community, we took as a basis of comparison the species dominance of Lower Oribatida vs. Oppioidea and Lower Oribatida vs. Poronota. Even considering the different periods in which the inventories were realized and the different sampling methodology compared, the partition of the species of Oribatid mite in larger groups shows tendencies indicating partition of species dominance among the environments studied, showing that they differed in their suitability as habitats for the Oribatid mite community, mainly in respect to the Lower Oribatida, Oppioidea and Poronota composition. These tendencies should be explored in more detail as more becomes known about the species composition in each environment.

Diversity and distribution of oribatid mites (Acari:Oribatida) in a lowland rain forest in Peru and in several environments of the Brazilians states of Amazonas, Rondônia, Roraima and Pará

We are summarizing the current state of knowledge of the diversity and distribution of oribatid mites in 26 environments in northern Brazil and of a rain forest in Peru. The published studies were mostly concentrated in Central Amazon. Only one report is a result from an agricultural polyculture. We are providing the first lists of species for savannas and for the Brazilian states of Roraima and Pará. Up to date, 146 species are definitively identified from a total of 444 taxa with 188 known genera, reinforcing the notion of a rich biodiverse area. The high number of 298 non-described species (morphospecies) clearly shows the inadequacy of the current taxonomic knowledge for the region. Most of the registers are from forest environments. In the soil from primary forests, we registered the highest diversity (54-155 species/morphospecies). Eighty-nine species were unique to primary forests, followed by 34 for savannas, 32 in trees, 10 in "igapó", 4 in caatinga, 3 in secondary forests, two in "várzea" and one in polyculture. Twenty genera were the most speciose. The species with the largest home ranges were Rostrozetes foveolatus, Scheloribates sp. A, and Galumna sp. A. Our numbers reflect the lack of taxonomists and show that the taxonomic knowledge must be improved for the region or we will continue to work with taxonomic resolution of Order or Family and a high percentage of morphospecies, which will probably be appropriate to the question being asked in each study, but not for a comparison among environments.

A medium-spatial scale distribution pattern of Pseudoscorpionida (Arachnida) in a gradient of topography (altitude and inclination), soil factors, and litter in a central Amazonia forest reserve, Brazil

In Amazonia, nothing is known about the distribution of the invertebrates on a medium-spatial scale pattern. In a trail system of 64 km2 at Ducke Reserve, we sampled 72 transects using the hand-sorting method and Berlese-Tullgren extraction. The reserve possesses ecosystems of "terra-firme" forest and the trail system represents a gradient of topographic soil factors and vegetation, avoiding categorizations. Considering the abundance and diversity of Pseudoscorpionida, we investigated the relation of the community to environmental factors tested (topography, clay percentage, litter, and soil pH), to the two major drainage basins of the reserve, and if these invertebrates can be used as biological indicators to monitor changes. We registered two species for the first time in the reserve, increasing the known diversity to 17 species. The lack of correlation with the predictor variables and the large home range, indicate that pseudoscorpions are not good biological indicators in the reserve. As the eastern and western watersheds are not separate management units for the community, our results show that they are generalist predators. In spite of our results and lack of knowledge concerning their biology, life history and taxonomy, pseudoscorpions are cosmopolitan and easy to find and measure. Compared with previous studies in the reserve, they have a consistent pattern of abundance and diversity throughout the years showing the stability of the community which can be checked mainly by comparison with environmental changes that would occur in the reserve. An investigation on a medium-spatial scale pattern and over a long-term period including other habitats, and also other predictor variables, like humidity, the structure of the vegetation and canopy closure, will be necessary to reinforce the observed tendencies.

Oribatid mite (Acari: Oribatida) contribution to decomposition dynamic of leaf litter in primary forest, second growth, and polyculture in the Central Amazon

We studied the contribution of oribatid mites in the dynamics of litter decomposition in an experiment using litterbags of three different mesh sizes (20 µm, 250 µm, and 1 cm). The experiment was carried out at a primary forest (FLO), a secondary forest (SEC), and at two polyculture systems (POA and POC). We compared the weight loss of the leaves of Vismia guianensis and the changes of the oribatid mite species community. We processed the samples after 26, 58, 111, 174, 278, and 350 days from the beginning of the experiment by using the Berlese-Tullgren to extract the animals. We hypothesized that: 1. the abundance and diversity of oribatid mites would exert an influence in the decomposition process; 2. there would be a successional changing of the species during decomposition; and 3. there would be differences in the colonization of species in relation to the mesh size of the litterbags. A total of 95 species of oribatid mites was found. The biomass data was the first registered for the Amazon region. The great dominance of oribatid mites did not exert an influence in the decomposition process. There was not a successional changing of the species during the course of the decomposition process, unlike those shown by results obtained in the temperate forest, because we found neither early colonizers nor species that prefer advanced decomposition stages. The oribatid mite community, which developed in the litterbags under tropical conditions, was atypical of the normal stages of leaf litter breakdown and decomposition. There were differences in the colonization of species in relation to the mesh size of the litterbags. These differences were very closely related to the specific habits and habitat of the dominant species.

Prevalence and determinants of erectile dysfunction in hemodialysis patients

BACKGROUND

The prevalence of erectile dysfunction (ED) among patients with end-stage renal disease (ESRD) is not known.

METHODS

A cross-sectional study was conducted to determine the prevalence of ED among a community-based hemodialysis (HD) population using a two-stage cluster random sampling design. The presence and severity of ED were assessed among 302 ESRD patients using the self-administered International Index of Erectile Function-5 (IIEF-5). Logistic regression was used to examine and test associations between ED and other medical conditions.

RESULTS

The prevalence of any level of ED was 82% (95% CI, 76 to 87%) for all HD subjects. The prevalence of severe ED was 45% (CI, 36 to 55%). Subjects younger than 50 years had a prevalence of ED of 63% (CI, 53 to 71%), while in subjects 50 years or older, it was 90% (CI, 84 to 94%). A multivariable analysis demonstrated increasing age (50 to 59, OR = 2.04, 95% CI, 1.3 to 3.1; 60 to 69, OR = 5.5, 95% CI, 1.9 to 15.6) and diabetes (OR = 2.0, 95% CI, 1.2 to 3.3) to be independently associated with the presence of any level of ED. However, neither the subjects' age nor history of diabetes predicted the severity of ED among subjects with ED. The use of angiotensin-converting enzyme inhibitors (ACEIs) was inversely associated with ED (OR = 0.41, 95% CI, 0.17 to 0.98). Poor functional status (Karnofsky score or the Index of Physical Impairment) was not associated with ED.

CONCLUSIONS

ED is extremely prevalent among HD patients. Increasing age, diabetes, and nonuse of ACEIs were associated with higher prevalence of ED. The high prevalence of ED was seen even among patients with good functional status.

Too hot to handle: an unusual exposure of HDI in specialty painters

BACKGROUND

Hexamethylene Diisocyanate (HDI) is a color stable aliphatic isocyanate that is used in specialty paints as a hardener. Due to the lower vapor pressure of its commercial biuret form, it is considered a relatively "safe" isocyanate from an exposure standpoint. This case series reports on an unusual toxic exposure to HDI. Between November 1993 and May 1994, seven specialty painters and one boiler maker who were working at three different power plants were examined at the Institute of Occupational and Environmental Health at West Virginia University. At their respective work sites, HDI was applied to the hot surfaces of boilers that were not shut down, and allowed sufficient time to cool. Consequently, these workers were exposed to volatile HDI and its thermal decomposition products.

METHODS

All of these workers underwent a complete physical examination, spirometry, and methacholine challenge testing.

RESULTS

All 8 workers complained of dyspnea, while 4 of the 8 also complained of rash. On examination 3 workers were methacholine challenge positive and 2 had persistent rash. At follow-up 4 years later, 5 workers still had to use inhalation medication and one had progressive asthma and dermatitis. All 8 workers, by the time of the follow-up, had gone through economic and occupational changes.

CONCLUSIONS

This case series reports on an unusual exposure to HDI. It is unusual in that: 1) There were two simultaneous sentinel cases with two different Material Safety Data Sheets (MSDS) for the same product, 2) Exposure was to volatile HDI and its decomposition products and 3) Hazardous conditions of exposure occurred at three different sites.

Descending modulation of opioid-containing nociceptive neurons in rats with peripheral inflammation and hyperalgesia

Inflammation and hyperalgesia induce a dramatic up-regulation of opioid messenger RNA and peptide levels in nociceptive neurons of the spinal dorsal horn. Descending axons modulate nociceptive transmission at the spinal level during inflammatory pain, and may play a role in the development of persistent pain. The role of descending bulbospinal pathways in opioid-containing nociceptive neurons was examined. Removal of descending inputs to the spinal cord was performed by complete spinal transection at the midthoracic level. Seven days after spinal transection, rats received a unilateral hindpaw injection of complete Freund's adjuvant, a noxious stimulus that produces inflammation and hyperalgesia. Tissues from the L4 and L5 segments of the spinal cord were removed and analysed by northern blotting and immunocytochemistry. Spinal transection resulted in a further increase in both dynorphin and enkephalin messenger RNA content following complete Freund's adjuvant injection. There was a similar distribution and number of dynorphin-immunoreactive cells in transected rats compared to rats which received sham surgery. These data suggest that increased dynorphin messenger RNA ipsilateral to inflammation, in rats without descending axons, was due to increased expression within the same cells and not to recruitment of additional dynorphin-expressing cells. This reflects a greater dynamic response of nociceptive neurons to noxious stimuli in the absence of descending modulation. Therefore, the net effect of descending afferents on spinal nociceptive circuits may be to reduce the response of opioid-containing neurons to noxious stimulation from the periphery.

Phycoerythrin 545: monomers, energy migration, bilin topography, and monomer/dimer equilibrium

Phycoerythrin 545 was isolated having an alpha2beta2 (dimer) protein structure at pH 6.0 and 2 g/L protein concentration with eight bilin chromophores. Monomers (alphabeta) were produced by lowering the protein concentration to 0.15 g/L and the pH to 4.5. Dimer dissociation was monitored by dynamic light scattering and gel-filtration column chromatography. Monomers were stable and had bilin optical spectra different from the alpha2beta2 dimers, although they have very similar protein secondary structures. The optical spectra of phycoerythrin 545 showed four types of behavior with temperature: 10-20 degrees C, dimers; 40-50 degrees C, dimers/monomers; 60 degrees C, nearly fully disordered; 70 degrees C, disordered alpha and beta polypeptides. At 40 degrees C, the protein dissociated partially to monomer, which could be totally reversed to dimers at 20-25 degrees C. The visible circular dichroism difference spectrum for the protein dimers minus monomers exhibited positive and negative bands--such spectra may indicate exciton splitting between closely-spaced bilins. Circular dichroism also revealed a spectrum suggesting exciton coupling for the second excited state of the bilins. Ultrafast fluorescence using a two-photon method showed the fastest time for protein dimers to be 2. 4 ps and monomers had a 39-ps lifetime. Phycocyanin 645 was found to have a 550-fs lifetime.

Femoral vasodilation to cromakalim is blocked by U37883A, a non-sulphonylurea that selectively inhibits KATP channels

The purpose of the present study was to determine the effects of U37883A, a non-sulphonylurea inhibitor of KATP channels, in the femoral vascular bed of the anaesthetized dog. Administration of U37883A, 4-morpholinecarboxamidine-N-1-adamentyl-N"-cyclohexyl hydrochloride (2.5 mg kg-1, i.v.), significantly inhibited the femoral vasodilator response to intra-femoral arterial injection of cromakalim, an activator of KATP channels. In contrast, U37883A had no effect on the femoral vasodilator responses to nitroglycerin, isoprenaline, 5-HT, or 5-carboxamidotryptamine, suggesting this agent is a novel and selective inhibitor of hindlimb vasodilation induced by KATP-channel activation. Since U37883A did not significantly alter baseline femoral blood flow and femoral vascular resistance, the present data suggest that KATP channels do not contribute, in large measure, to regulating the canine femoral vascular bed under resting conditions in-vivo.

Structural studies of a human gamma 3 myeloma protein (Goe) that binds staph protein A

The partial amino acid sequence of the Fc region of an unusual monoclonal immunoglobulin molecule (Goe), which had the allotypic markers Gm (b0, b3, b5, s, t, v), rarely encountered in Caucasians, was determined. Protein Goe was previously shown to belong to the gamma 3 subclass by antigenic typing, to possess a gamma 3-like hinge region and a gamma 1-like carboxy-terminal octadecapeptide, and to bind to staphylococcal protein A. The sequence of protein Goe resembled that of gamma 3 molecules except for the presence of tyrosine at position 296, alanine at position 339, and histidine and tyrosine at positions 435 and 436. It is of interest that histidine 435 appears to play an important role in binding to Staph protein A. Since tyrosine and phenylalanine at 296 and 300 are typical of G3m(g) molecules, whereas protein Goe is G3m(g-), this may correspond to the non-b1 allotypic marker. Of the numerous explanations to account for these findings, the most likely possibilities are that protein Goe is either a hybrid molecule or the product of a germ line gene representing the G3m s allotype, which is rare in Caucasians and common in Mongoloid populations. Support for the latter alternative is provided by the isolation from normal serum of a small amount of a protein having many of the properties of protein Goe.

Structural studies of a human gamma 3 myeloma protein (Goe) that binds staph protein A

The partial amino acid sequence of the Fc region of an unusual monoclonal immunoglobulin molecule (Goe), which had the allotypic markers Gm (b0, b3, b5, s, t, v), rarely encountered in Caucasians, was determined. Protein Goe was previously shown to belong to the gamma 3 subclass by antigenic typing, to possess a gamma 3-like hinge region and a gamma 1-like carboxy-terminal octadecapeptide, and to bind to staphylococcal protein A. The sequence of protein Goe resembled that of gamma 3 molecules except for the presence of tyrosine at position 296, alanine at position 339, and histidine and tyrosine at positions 435 and 436. It is of interest that histidine 435 appears to play an important role in binding to Staph protein A. Since tyrosine and phenylalanine at 296 and 300 are typical of G3m(g) molecules, whereas protein Goe is G3m(g-), this may correspond to the non-b1 allotypic marker. Of the numerous explanations to account for these findings, the most likely possibilities are that protein Goe is either a hybrid molecule or the product of a germ line gene representing the G3m s allotype, which is rare in Caucasians and common in Mongoloid populations. Support for the latter alternative is provided by the isolation from normal serum of a small amount of a protein having many of the properties of protein Goe.

Serum complement levels in patients with mixed (IgM-IgG) cryoglobulinaemia

Serum complement levels were determined in seven patients with mixed (IgM–IgG) cryoglobulinaemia. All seven patients had either no measurable or very low levels of C'2. C'50 haemolytic units were determined in three patients and were also found low, although less striking. The mechanism by which the blood of these patients became depleted of C'2 could not be determined.