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Concept: New England


We compared the impact of media vs. direct exposure on acute stress response to collective trauma. We conducted an Internet-based survey following the Boston Marathon bombings between April 29 and May 13, 2013, with representative samples of residents from Boston (n = 846), New York City (n = 941), and the remainder of the United States (n = 2,888). Acute stress symptom scores were comparable in Boston and New York [regression coefficient (b) = 0.43; SE = 1.42; 95% confidence interval (CI), -2.36, 3.23], but lower nationwide when compared with Boston (b = -2.21; SE = 1.07; 95% CI, -4.31, -0.12). Adjusting for prebombing mental health (collected prospectively), demographics, and prior collective stress exposure, six or more daily hours of bombing-related media exposure in the week after the bombings was associated with higher acute stress than direct exposure to the bombings (continuous acute stress symptom total: media exposure b = 15.61 vs. direct exposure b = 5.69). Controlling for prospectively collected prebombing television-watching habits did not change the findings. In adjusted models, direct exposure to the 9/11 terrorist attacks and the Sandy Hook School shootings were both significantly associated with bombing-related acute stress; Superstorm Sandy exposure wasn’t. Prior exposure to similar and/or violent events may render some individuals vulnerable to the negative effects of collective traumas. Repeatedly engaging with trauma-related media content for several hours daily shortly after collective trauma may prolong acute stress experiences and promote substantial stress-related symptomatology. Mass media may become a conduit that spreads negative consequences of community trauma beyond directly affected communities.

Concepts: United States, New York City, Massachusetts, New England, Marathon, Remainder, September 11 attacks, Acute stress reaction


From the eighteenth century through to the abolition of public executions in England in 1868, the touch of a freshly hanged man’s hand was sought after to cure a variety of swellings, wens in particular. While the healing properties of corpse hands in general were acknowledged and experimented with in early modern medicine, the gallows cure achieved prominence during the second half of the eighteenth century. What was it about the hanged man’s hand (and it always was a male appendage) that gave it such potency? While frequently denounced as a disgusting ‘superstition’ in the press, this popular medical practice was inadvertently legitimised and institutionalised by the authorities through changes in execution procedure.

Concepts: Medicine, Therapy, Science, Capital punishment, Hanging, New England, Decapitation, Gallows


On April 15, two improvised explosive devices (IEDs) were detonated in short succession near the finish line of the Boston Marathon, in the middle of a densely packed crowd of thousands of runners, families, friends, and spectators. Three people were killed and 264 were injured,(1) with more than 20 sustaining critical injuries. Yet in the face of these tragic and horrifying events, despite catastrophic injuries not commonly seen in civilian medicine and the fact that these were the first IEDs to cause mass injuries in the United States, the overall medical response has generally been considered successful.(2) Victims at the . . .

Concepts: United States, Massachusetts, New England, Iraq War, Improvised explosive device, Explosive weapons, War in Afghanistan


Non-medical prescription opioid (NMPO) use is a substantial public health problem in the United States, with 1.5 million new initiates annually. Only 746,000 people received treatment for NMPO use in 2013, demonstrating substantial disparities in access to treatment. This study aimed to assess correlates of accessing substance use treatment among young adult NMPO users in Rhode Island, a state heavily impacted by NMPO use and opioid overdose.

Concepts: United States, United States Constitution, U.S. state, North Carolina, Massachusetts, New England, American Civil War, English American


Borrelia miyamotoi sensu lato, a relapsing fever Borrelia sp., is transmitted by the same ticks that transmit B. burgdorferi (the Lyme disease pathogen) and occurs in all Lyme disease-endemic areas of the United States. To determine the seroprevalence of IgG against B. miyamotoi sensu lato in the northeastern United States and assess whether serum from B. miyamotoi sensu lato-infected persons is reactive to B. burgdorferi antigens, we tested archived serum samples from area residents during 1991-2012. Of 639 samples from healthy persons, 25 were positive for B. miyamotoi sensu lato and 60 for B. burgdorferi. Samples from ≈10% of B. miyamotoi sensu lato-seropositive persons without a recent history of Lyme disease were seropositive for B. burgdorferi. Our results suggest that human B. miyamotoi sensu lato infection may be common in southern New England and that B. burgdorferi antibody testing is not an effective surrogate for detecting B. miyamotoi sensu lato infection.

Concepts: Immune system, Bacteria, United States, Lyme disease, Tick, Borrelia burgdorferi, Borrelia, New England


Drugged driving is a safety issue of increasing public concern. Using data from the Fatality Analysis Reporting System for 1999-2010, we assessed trends in alcohol and other drugs detected in drivers who were killed within 1 hour of a motor vehicle crash in 6 US states (California, Hawaii, Illinois, New Hampshire, Rhode Island, and West Virginia) that routinely performed toxicological testing on drivers involved in such crashes. Of the 23,591 drivers studied, 39.7% tested positive for alcohol and 24.8% for other drugs. During the study period, the prevalence of positive results for nonalcohol drugs rose from 16.6% in 1999 to 28.3% in 2010 (Z = -10.19, P < 0.0001), whereas the prevalence of positive results for alcohol remained stable. The most commonly detected nonalcohol drug was cannabinol, the prevalence of which increased from 4.2% in 1999 to 12.2% in 2010 (Z = -13.63, P < 0.0001). The increase in the prevalence of nonalcohol drugs was observed in all age groups and both sexes. These results indicate that nonalcohol drugs, particularly marijuana, are increasingly detected in fatally injured drivers.

Concepts: United States, United States Constitution, U.S. state, Massachusetts, New England, American Civil War, Humid continental climate, Vermont


Many patients even those with health insurance pay out-of-pocket for medicines. We investigated the availability and prices of essential medicines in the Boston area.

Concepts: Health care, Health insurance, Pharmacy, Price, Massachusetts, New England, Boston, Greater Boston


Bladder cancer mortality rates have been elevated in northern New England for at least five decades. Incidence rates in Maine, New Hampshire, and Vermont are about 20% higher than the United States overall. We explored reasons for this excess, focusing on arsenic in drinking water from private wells, which are particularly prevalent in the region.

Concepts: United States, Native Americans in the United States, Massachusetts, Maine, New England, New Hampshire, Northeastern United States, Vermont


The United States is facing an unprecedented opioid epidemic. The Affordable Care Act (ACA) included several provisions designed to increase care coordination in state Medicaid programs and improve outcomes for those with chronic conditions, including substance use disorders. Three states-Maryland, Rhode Island, and Vermont - adopted the ACA’s optional Medicaid health home model for individuals with opioid use disorder. The model coordinates opioid use disorder treatment that features opioid agonist therapy provided at opioid treatment programs (OTPs) and Office-based Opioid Treatment (OBOT) with medical and behavioral health care and other services, including those addressing social determinants of health. This study examines state approaches to opioid health homes (OHH) and uses a retrospective analysis to identify facilitators and barriers to the program’s implementation from the perspectives of multiple stakeholders.

Concepts: United States, U.S. state, Massachusetts, New England, American Civil War, English American, Humid continental climate, Vermont


New England has lost more than 350,000 ha of forest cover since 1985, marking a reversal of a two-hundred-year trend of forest expansion. We a cellular land-cover change model to project a continuation of recent trends (1990-2010) in forest loss across six New England states from 2010 to 2060. Recent trends were estimated using a continuous change detection algorithm applied to twenty years of Landsat images. We addressed three questions: (1) What would be the consequences of a continuation of the recent trends in terms of changes to New England’s forest cover mosaic? (2) What social and biophysical attributes are most strongly associated with recent trends in forest loss, and how do these vary geographically? (3) How sensitive are projections of forest loss to the reference period-i.e. how do projections based on the period spanning 1990-to-2000 differ from 2000-to-2010, or from the full period, 1990-to-2010? Over the full reference period, 8201 ha yr-1 and 468 ha yr-1 of forest were lost to low- and high-density development, respectively. Forest loss was concentrated in suburban areas, particularly near Boston. Of the variables considered, ‘distance to developed land’ was the strongest predictor of forest loss. The next most important predictor varied geographically: ‘distance to roads’ ranked second in the more developed regions in the south and ‘population density’ ranked second in the less developed north. The importance and geographical variation in predictor variables were relatively stable between reference periods. In contrast, there was 55% more forest loss during the 1990-to-2000 reference period compared to the 2000-to-2010 period, highlighting the importance of understanding the variation in reference periods when projecting land cover change. The projection of recent trends is an important baseline scenario with implications for the management of forest ecosystems and the services they provide.

Concepts: Earth, Geography, Period, New England, Projection, Human geography, Psychological projection, Fischer projection