Category: travel

Travel posts by Jano Klimas who writes about academic mobility, hotels, B&B, jetlags and culture shock.

Renting a guitar for Healdsburg Guitar Festival

The guitar festival in Healdsburg, just north of Santa Rosa, California (August 9-11), was busy with wonderful luthiers and some great players performing concerts. Among the players was Kelly Joe Phelps, also teaching a workshop for advanced bottleneck players.


For this year’s birthday, my wife surprised me with a ticket for the workshop with Kelly Joe Phelps– my guitar hero. She didn’t know much about guitars, or about my limited bottleneck skills, but most importantly, I did not have an acoustic guitar. My classical guitar had nylon strings which were not good for bottleneck playing. So, I had a ticket for the workshop, but no guitar.

I asked my friend who promised to borrow me his acoustic guitar. As most guitarists, he loved his guitar and told me not to leave his Ibanez anytime during my flight to Santa Rosa. I understood. I have never flown with a guitar before so I called the airlines a day before the flight and they told me that I have to check-in my guitar. If I wanted to take it with me on board of the airplane, I would have to pay $300. My friend did not know what was happening when I showed up at his door with his guitar, but borrowed me his hard case in case I needed it.

I went to borrow another guitar. It was surprisingly quick and I was cycling back with a Takamine guitar on my back within hours. When I arrived home, I was disappointed to find out that the guitar did not fit the borrowed case. I forgot that the cases are not universal. There was no time left to try finding another guitar and no point in flying with my classical guitar – I departed guitar-less.

When we arrived to Santa Rosa, we told the cab driver to take us straight to the Bananas guitar shop. No luck there. A nearby pawn shop had a selection of used guitars at reasonable prices but when I said that I plan to return the guitar back on Monday, they refused to sell me one. Makes sense – they sell, they don’t rent. My last hope was the second music store in the town – the Stanroys. As I told them my story, they scratched their heads and looked at me pitifully. There were no guitars for rent in this store. Steve, the new manager, talked to the former owner and decided to borrow me his own guitar. I was amazed about his generosity. We arranged a place and time for the pick up and went to get some cash for Steve’s deposit.

The next morning, we woke up in an AIR B&B accommodation and I went to explore the house. The first thing I spotted in the living room was a Tayloracoustic guitar. It hanged on the wall next to the window, untouched and covered with a thin layer of dust. The house owner encouraged me to take it and play it, so I did not need Steve’s guitar any more. I was happy and content that I finally found a guitar at the end of my journey, just a couple of hours before the workshop. The lesson I’ve learned through this guitar story was to worry less about things – they will always work out somehow at the end of the day. All I need to do now is to put this wisdom in practice.

PS. In case you wonder how the workshop went, it was great: we talked and played and I got to know my guitar hero better.

A decade in the addictions field

… or 5 key decisions and accidents that kept me in addiction science

Career in addiction health services research can be daunting. There are moments when people in this career path struggle at work. Have you ever been in that situation yourself? Here’s my story.

1. Needle exchange movie at 16

The internet was still a toddler and I watched the TV rarely. But when I turned on the box on one of such occasions, a summer afternoon, I was brought into the streets of the Slovakian capital, Bratislava, which was a world far far away for me. Young social work students backpacked those streets with bags full with clean needles and distributed them to drug users and sex workers; they talked about what this exciting and controversial pastime meant for them. They worked for a needle exchange project – Odyseus – and I wanted to do it too. I was excited to help drug users in the same way these women did, but I had to wait a couple of years until I grew up.

At that time, they still called it ‘Street work’ which later became ‘Terrain Social Work’. In the following years, I learned from my future boss that the Slovakian public TV screened the film quite often, but mainly as a filler in the downtime hours.

2. Unanswered phone call at 20

After acceptance at the psychology degree, my world changed and the range of my interests expanded. Nevertheless, I never forgot about that documentary. It was in the second year when I saw a poster at our university board, at advertised Needle Exchange as a part time job for students. I picked up a public phone and dialled a number from the poster – following my teenage dream. Nobody picked it up, so I left a message which too remained unanswered, forever. The number on the advert wasn’t for the Needle Exchange which the documentary talked about, but I didn’t know it at that time. By chance, I ended up working for the agency from the documentary movie because they had an email address posted on the internet and were more responsive than the project which advertised on our student board.

3. Student project at 21

Part of my comprehensive exam in the 3rd year of my undergrad was a research project. As most of my friends, I struggled with access to patients. Because of that, almost everyone did a literature review – without having a clue what we were doing. I chose the role of family and drugs as my topic, but it wasn’t an easy choice. At that time, my interest in drugs was drifting away and I felt like researching something else, for example depression or disabilities. I don’t remember how I ended up with drugs again, but my review led to working with Dr Timulak, and eventually, to my MSc and PhD projects.

4. Dr Peter Halama, PhD and Hungarian trams at 25

Dr Halama, PhD was this new face at the Trnava University, when I wrapped up my comprehensive exam. They were good friends with Dr Timulak and when I asked him about ideas for my MSc research, he said that Dr Halama was doing some interviews with drug users. Two years later, I found myself co-presenting our findings with Peter at a psychotherapeutic conference in Slovakia. Read more about that research here. From there, it was easy to continue in my research with Peter at a doctoral level. I enrolled as a part time student in Social Psychology, which did not convince him that I would finish it. When I announced – after two years of studies – that I’m moving to Hungary for a year, I think Peter had a hard time suppressing his doubts that I would finish my PhD from Hungary. My Hungarian adventure was, however, a real turning point. I had to commute between offices and spent long hours in trams. Being too bored of watching cars and people pass by, I started to read open access articles which I downloaded from internet the previous day. Some were more interesting, others less, but when I found something really relevant to my work, I felt like a gold miner who just dug his jewel out of piles of dirt. My passion grew stronger with every new paper.

5. Irish job hunt at 28

When we arrived to Ireland in early Autumn 2008, all I had was a small EU grant with a budget of 3000 euros and an unclear host organization. We managed to survive for almost a year with a great help of my wife’s EVS stipend and occasional p/t jobs. The work on my PhD and the EU grant took most of my time, leaving only a couple of hours for finding a more stable position. When I eventually ran out of money, it was late winter and the job market had dried up. I submitted my resume to many advertisements, including a research job on men’s sexual health. I must say that research was not on my list of Top 5 jobs, but when this position came up after 8 hopeless months of job hunt it was a true God-send. The pictured ad initially offered a PhD post in drugs research, but at the interview, my current boss – Prof Walter Cullen – told me about a p/t place on the same project. That’s how I came to research drinking among methadone patients in primary care at UCD.

6. Dr Dennis McCarty, PhD at 31

OK, I know I said that there were 5 key decisions earlier, but there has been a lot going on recently. In July 2011, I have been to a summer school on drugs in Amsterdam, Netherlands – no one could imagine a better place for this adventure. Dr McCarty, lectured for several days on different policy models and evidence based treatments. Two years later, I’m sitting in an office down the hall from Dr McCarty’s office, writing my final report about the INVEST fellowship. Visit this post to read more about how I got here. I did not think that the summer school would lead to a fellowship in Portland, OR and I’m most grateful that it did.

With Dennis, I have learned about things I thought did not exist. For example, about researchers who enjoy writing. Writing up research projects is a task that many new researchers fear the most. Dennis is a master writer and his craft is contagious; I’ve discovered a need in me, a strong urge to write a lot and in many different formats. I hope this ‘fire’ will keep on burning for at least another 10 years.

26 weeks investing in Portland

Portland

Welcome to my INVESTing log. INVEST is the International Visiting Scientists & Technical Exchange Program for drug abuse research sponsored by NIDA (National Institute on Drug Abuse). From March-August, 2013, I was an INVEST researcher at the Oregon Health& Science University in Portland and this is a log about my experiences.

Three INVESTing points weekly (from newest to oldest):

Last Week 26 (August 26-31)

Windy and Sandy Jersey shore
Funny looking banknotes in my purse; different scent in my bathroom
With that soulful look on your face

Week 25 (August 19-25)

Here’s the opposite – a lot of professionals and not enough patients
A good bye lunch in the park
We don’t own anything; it’s on loan

Week 24 (August 12-18)

I lost my voice in Santa Rosa
I feel like I’m swimming upstream
Humans make up stories. Most people are better in the abstract

Week 23 (August 5-11)

Please note that your OHSU PC access will expire on 9/2/2013
The goal of writing is to stretch the limits of your thinking
Oregon spirit

Week 22 (July 29 – August 4)

A week of strong decisions
Picnic at Skidmore bluffs
Document the experience

Week 21 (July 22-28)

Swimming in the Frog lake under the Hood mountain
A beautiful place where I have time to think and write
The work ethics in US is different

Week 20 (July 15-21)

2 Free books in 2 days: paradise
Methamorphosis at Marquam hill
‘If the water is dark, the lake must be deep’

Week 19 (July 7-14)

It’s hard to get a credit line
Two writing workshops this week
You are my fountain of knowledge
Great art can emerge from aimless meanderings

Week 18 (July 1-7)

Charts reviews started, best time – 4.06 sec
The department is empty these days, the head brought a cake to appreciate staff
I thought I was here to learn more about research, but I’m actually learning a lot about leadership and group interaction

Week 17 (June 24-30)

73 new emails after a week out of office
A strange proposal will arrive soon
Everything depends on your determination

Week 16 (June 17-23)

at the CPDD conference, visiting San Diego again after 9 years
A complete different time space
Controlled expansion

Week 15 (June 10-16)

First focus group, first night ride through the Terwilliger… feels like on the top of the world
How long have you been using internet for? – 15 years
My first potluck at the OHSU public health

Week 14 (June 3-9)

Release from immediacy
Their number will grow, our number will die
The floor is slippery when wet (Really?)
Sometimes you don’t know what’s possible until you’re forced to do it

Week 13 (May 27 – June 2)

Where is the sun gone?
The atempt here is creating
sometimes, the most powerful and profound changes can be brought about by the most subttle and innocent moments
Journal of Japanese Gardens

Week 12 (May 20 -26)

IRB (Institutional Review Board) approval out now!
Working with other writers is good for me
Quote from a song: “Should I stay or should I go now?
If I stay, there will be trouble – If I go, there will be double.”

Week 11 (May 13 -19)

weeks started to fly by
I said: I’m an office monkey. They said: We are donkeys.
Work, Play, Love, Read

Week 10 (May 6 -12)

How to spill an oatmeal on the office floor
Two copulating mosquitos sucking blood from my arm
everybody has a different style of working

Week 9 (April 29-May 5)

My first ride to work on the cable car (aerial tram)
My friends at work make their own bread and apple preserves
I’ve been bitten by a writing buy

Week 8 (April 22-28)

First day at work in my 10-year old American sandals – the summer’s comming
Learning about my limits and acknowledging my strengths
“A lot of media advertising is based on things that make people insecure and anxious” (the Missrepresentation movie)

Getting warm welcomes by OHSU Department of Public Health and Preventive Medicine (PHPM) in The Liason Newsletter:

Dr. Jan Klimas joined PHPM as an INVEST Fellow beginning March 1. The National Institute on Drug Abuse supports the INVEST Fellows program to accelerate career development for new investigators who are citizens of a country other than the US. Jan will work in the US for six months assessing the value of screening and brief intervention for alcohol use disorders among opioid dependent patients being treated with an opioid agonist medication (i.e., methadone or buprenorphine). He plans to collaborate with Richmond Clinic and CODA to contrast US agonist treatment services with those in Ireland provided through general practitioners.

Jan and his wife Johanka Macekova are Slovakian. Jan is currently working in Ireland where he studies screening and brief intervention for alcohol use disorders among opioid dependent patients receiving agonist medication. The US provides opportunities for comparative research….
For more info, check the Winter 2013 edition of The Liaison, PHPM’s internal newsletter, is published the first week of the month and highlights news and events that took place the previous month, in addition to listing upcoming events as well.

Week 7 (April 15-21)

New office, new start
What is the American standard?
First stolen bike saddle
Forging new friendships

Week 6 (April 8-14)
car hand brake is actually a foot brake in new US cars
moving to a new desk next week
restrooms and water fountains are so common in Portland
tatoos and piercings are so tolerated… everywhere

Week 5 (April 1-7)

Who uses buses in Portland or US? Discovering Portland Metro area
Really tired
Changed my location on skype/ twitter to PDX

Week 4 (March 22-31)

First fruit of my labour on the INVEST project are here
Beautiful mornings, cycling to work on the hill
Work and life routine, getting used to it

Week 3 (March 15-21)

Conference at Washington DC
Getting to know myself better, my expectations
Everything’s so expensive
A photo from the Spring NIDA CTN 2013 conference: INVEST scholar links with Humphrey scholars:

Week 2 (March 8-14)

Why does it take so long to get used to this, longer than I expected
Too many things to do at work
I miss Ireland – listening to RTE Lyric.fm

Week 1 (March 1-7): starting in Portland

Jet lag, almost all week
My first chai
Everything is so big, different, weird
Arrived safely at OHSU; checking the “Hall of fame” aka Notice board with faculty publications by OHSU Department of Public Health (2011-13):

What happened before my arrival to OHSU in Portland, Oregon:

31/Jan/2013

Jan will speak about his previous and current research in Ireland and plans for future research in Portland, OR at the The Spring 2013 CTN Steering Committee Meeting. It will be held at the Hyatt Regency Bethesda, Bethesda, Maryland, on March 12-15, 2013.
For more info, check the section about International Symposium in the latest issue of the NIDA CTN Bulletin (January 31, 2013, Volume 13 – 02): http://ctndisseminationlibrary.org/ctnbulletin.htm

15/Nov/2012

Jan Klimas, PhD, joins the Western States Node on March 1, 2013, as a NIDA CTN INVEST Fellow.  NIDA is National Institute on Drug Abuse, and INVEST is International Visiting Scientists & Technical Exchange Program for drug abuse research, which combines
“postdoctoral research training in the US with professional development activities and grant-writing guidance to form a unique program for drug abuse scientists”(link).
Oregon Health & Sciences University hosts Dr. Klimas’ six months fellowship during which he will assess the use of Screening and Brief Intervention (SBIRT) for alcohol use disorders among patients receiving agonist medication for opioid use disorders.

Professor Dennis McCarty, Co-PI for the Western States Node, will supervise Dr. Klimas during his fellowship.  The research examines addiction treatment in primary and specialty care settings with respect to implementation of screening and treatment for unhealthy alcohol use among opioid-dependent patients in methadone or buprenorphine maintenance treatment in Ireland and Oregon.  Dr. Klimas’ prior work in Ireland informs the U.S. investigation… read more in the NIDA CTN bulletin, (issue November 15th, 2012): http://ctndisseminationlibrary.org/bulletin/20121115.pdf

Doing research with busy doctors – an open space world

Family doctors are notoriously busy. Lack of their time is the number #1 barrier of doing anything outside their patient workload, including research. And yet, some enthusiasts get involved in the research endeavour, believing it can enhance primary care.

Knowing this, I looked for ways to do research with busy family physicians for my INVEST fellowship in Portland, OR. I needed to get them in one room and ask the group a couple of questions about their recent resident training initiative, SBIRT Oregon. The only time when my doctors were all in the clinic was right after another meeting. One of them suggested doing an open meeting technology. The phrase vaguely rang a bell with me.

‘Open space’ describes the process by which a wide range of individuals, in any organisation, can facilitate creative meetings around a complex theme of importance to all stakeholders 1. While a theme may be important to all stakeholders, they may have differing perspectives and responses, so this approach permits all voices to be heard and facilitates a process where stakeholders move from conflicting views to consensus. The approach has been widely used in commerce, religious communities, (non-)governmental agencies and war zones 2.

How did this work for us?

Our field ‘experiment’ lasted for about 90 minutes with two meetings in one room, right after each other. The meetings were unrelated, but 3/4 of the participants from the first meeting were scheduled for the second meeting too. I and my co-facilitator arrived well ahead of the first meeting. As doctors started to show up for the 2nd meeting – the 1st meeting was still in progress – some people were confused; others patiently listened to people talking at the 1st meeting. I found it very useful to sit on the 1st meeting and the transition to the 2nd meeting was much easier – all were in their seats already.

All in all, this set up had many advantages for multiple meetings with extra busy attendees. It can help solve problems and it works best with many people attending your meeting, but maybe it’s not ideal for research focus groups. A tip for a freshman facilitator: it’s amazing how much powerful an incentive for research can food be, especially pizza.

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1http://www.michaelherman.com/cgi/wiki.cgi
2http://www.openspaceworld.com/papers.htm

Helping agonist patients with alcohol problems: A NEW guide for primary care staff

What should doctors do differently when screening for alcohol use and delivering brief interventions for agonist patients in primary care? General principles remain the same like for other people, but:
  1. the screening and treatment processes should be more systematic and proactive in all problem drug users, especially in those with concurrent chronic illnesses or psychiatric co-morbidity,
  2. lower thresholds should be applied for both identification and intervention of problem alcohol use and referral to specialist services,
  3. special skills and specialist supervision is required if managing persistent/dependent alcohol use in primary care.