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This review examines the concentration of seven major cannabinoids, including Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD), in illicit herbal cannabis products seized by the Drug Enforcement Administration (DEA) over the last 10 years in the United States. Cannabis samples received from DEA regional laboratories were analyzed by a validated gas chromatography with flame ionization detection method, and the results are given in the report. A total of 14,234 samples of herbal cannabis have been analyzed over the last 10 years (between January 1, 2009, and December 31, 2019). The number of samples received over the last 5 to 6 years has decreased dramatically owing to the legalization of marijuana for either medical or recreational purposes in many U.S. states. The results showed that the mean Δ9-THC concentration has increased over the last 10 years, from 9.75% in 2009 to 14.88% in 2018 and 13.88% in 2019. The mean Δ9-THC:CBD ratio rose substantially from 24.81 in 2009 to 103.48 in 2017. A decrease in THC:CBD ratio was recorded in the last 2 years, 54.39 in 2018 and 24.58 in 2019, indicating the trend in the production of more high-CBD-containing products. Our results showed an overall increase in potency of illicit cannabis, from approximately 10% in 2009 to approximately 14% in 2019. These results are in agreement with other potency monitoring programs in several European countries. There appears to be a recent trend of the inclusion of higher CBD levels containing chemovars in illicit cannabis.

Through the potency monitoring program at the University of Mississippi supported by National Institute on Drug Abuse (NIDA), a total of 18108 samples of cannabis preparations have been analyzed over the last decade, using a validated GC/FID method. The samples are classified as sinsemilla, marijuana, ditchweed, hashish, and hash oil (now referred to as cannabis concentrate). The number of samples received over the last 5 years has decreased dramatically due to the legalization of marijuana either for medical or for recreational purposes in many US states. The results showed that the mean Δ9-THC concentration has increased dramatically over the last 10 years, from 8.9% in 2008 to 17.1% in 2017. The mean Δ9-THC:CBD ratio also rose substantially from 23 in 2008 to 104 in 2017. There was also marked increase in the proportion of hash oil samples (concentrates) seized (0.5-4.7%) and their mean Δ9-THC concentration (6.7-55.7%) from 2008 to 2017. Other potency monitoring programs are also present in several European countries such as The Netherlands, United Kingdom, France, and Italy. These programs have also documented increases in Δ9-THC concentrations and Δ9-THC:CBD ratios in cannabis. These trends in the last decade suggest that cannabis is becoming an increasingly harmful product in the USA and Europe.

In this paper, we outline the history of efforts to convert nursing student-led paper records to Electronic Health Records (EHRs) in the academic setting. The Affordable Care Act (ACA) and Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 helped to pave the way for advancements in the usage of technology in the healthcare industry. Nursing education plays a pivotal role in the development of key skills in nursing informatics. Early exposure to EHR systems is imperative to producing nurse graduates who are competent and comfortable utilizing healthcare technology. Based upon this need, we proposed a system built on the content management system WordPress and titled the system as "PeayNotes." PeayNotes has been in use for the past two semesters at Austin Peay State University School of Nursing, where nursing students have used the software in an educational simulation lab setting. The success of the project is evident by the expansion of use in additional nursing courses and student/faculty feedback through an anonymous survey. A key feature is the ability to tailor the system to fit individual course needs readily. The paper outlines the need for an EHR documentation system in nursing education, the beginnings of the initiative, and the future perspective works. We conclude the paper with a detailed account of the student and the instructor’s reactions to the software through an anonymous survey.

In the original publication, table 2 contained data that should not have been included in table 2 and also was not discussed in the body of the manuscript.

Background Marijuana is the most widely used illicit drug in the United States and all over the world. Reports indicate that the potency of cannabis preparation has been increasing. This report examines the concentration of cannabinoids in illicit cannabis products seized by the U.S. Drug Enforcement Administration over the last 2 decades, with particular emphasis on Δ 9 -tetrahydrocannabinol and cannabidiol. Methods Samples in this report were received over time from materials confiscated by the Drug Enforcement Administration and processed for analysis using a validated gas chromatography with flame ionization detector method. Results Between January 1, 1995, and December 31, 2014, 38,681 samples of cannabis preparations were received and analyzed. The data showed that although the number of marijuana samples seized over the last 4 years has declined, the number of sinsemilla samples has increased. Overall, the potency of illicit cannabis plant material has consistently increased over time since 1995 from ~4% in 1995 to ~12% in 2014. The cannabidiol content has decreased on average from ~.28% in 2001 to 9 -tetrahydrocannabinol to cannabidiol from 14 times in 1995 to ~80 times in 2014. Conclusions There is a shift in the production of illicit cannabis plant material from regular marijuana to sinsemilla. This increase in potency poses higher risk of cannabis use, particularly among adolescents.