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ng the intervention, which is important to ensure acceptability and feasibility of the intervention. this website Interestingly, the contextually informed intervention components had several commonalities with BIs developed and tested in high-income countries.
The research team designed this study to consider contextual factors while developing the intervention, which is important to ensure acceptability and feasibility of the intervention. Interestingly, the contextually informed intervention components had several commonalities with BIs developed and tested in high-income countries.
In clinical trial settings, extended-release buprenorphine (XR-BUP) is noninferior to sublingual buprenorphine and may offer some advantages. However, real-world experiences of XR-BUP are limited and outcomes are unknown for low-threshold clinics with high-risk populations. Practical guidance is lacking on overcoming treatment challenges, such as inability for some to stabilize on sublingual (SL) BUP for seven days prior to XR-BUP and ongoing craving/withdrawal symptoms during treatment.
Retrospective case series of a convenience sample of 40 serial adults with opioid use disorder (OUD) treated with XR-BUP from Massachusetts General Hospital bridge clinic from February 1, 2019, to July 31, 2019.
Patients were mostly male (67.5%), non-Hispanic white (97.5%), unstably housed (77.5%), and average age of 32.1years old. The average SL BUP dose prior to XR-BUP was 18.6mg (standard deviation [SD]=5; range 8-32) for an average treatment duration of 105days (SD=191; range 1-810). Ten (25%) patients received SL Bividuals choosing to continue treatment and a majority with no evidence of ongoing opioid use or precipitated withdrawal.
This real-world evaluation of XR-BUP in a low-threshold clinic found that treatment was feasible, well tolerated, and outcomes were good, with most individuals choosing to continue treatment and a majority with no evidence of ongoing opioid use or precipitated withdrawal.Practitioner adherence to the Brief Negotiation Interview (BNI) for high-risk alcohol consumption and opioid use disorder can be measured using the BNI Adherence Scale, for alcohol (BAS-A) and opioids (BAS-O), respectively. However, no psychometrically validated brief intervention adherence scale for smoking cessation has been reported in the literature. Our objective was to develop and examine the psychometric properties of a BAS for smoking cessation (BASS). In the context of a clinical trial of the BNI in an emergency department (ED)-which incorporates motivational interviewing (MI), feedback, and behavioral contracting-plus nicotine replacement therapy (NRT), and a Smokers’ Quitline referral and brochure (BNI), compared with brochure-only (control), we developed and examined the psychometric properties of the BAS-S, a scale that requires raters to answer whether each critical action of the BNI was implemented. Three independent raters rated three hundred and eighty-eight audio-recorded BNI sessions. The results indicated that the BAS-S had excellent internal consistency, and discriminant validity, inter-rater reliability, and construct validity. The following 3-factor (10-item) solution accounted for 43% of the variance factor 1, “Feedback,”, factor 2, “NRT Motivation,” and factor 3, “Plan Negotiation.” The study found predictive validity for the Feedback factor, suggesting that patients who were provided feedback on the harms of their smoking were significantly less likely to achieve biologically confirmed 7-day tobacco abstinence at their 3-month follow-up than those who were not provided such feedback (p less then 0.03). The BAS-S is a psychometrically valid measure of adherence to the BNI for smoking cessation.
Research suggests that individuals treated for substance use disorders are not routinely assessed for post-traumatic stress disorder (PTSD) symptomatology despite high rates of comorbidity. One area of research that has been overlooked in theory, research, and practice on the comorbidity of substance use disorders and PTSD is the study of post-traumatic growth. The purpose of the current study is to explore the relevance of post-traumatic growth for the treatment of comorbid substance use disorders among individuals suffering from traumatic stress or PTSD.
A sample of 256 adults who survived the 2010 earthquake in Haiti completed measures of coping and the Posttraumatic Growth Inventory (PTGI). The study regressed a measure of substance use coping on the scores on the subscales of the Posttraumatic Growth Inventory adjusting for PTSD symptoms, general coping, and religious coping.
The findings suggest that one PTGI subscale, appreciation of life, was a statistically significant predictor of substance use coping among trauma survivors.
The principles of post-traumatic growth may have clinical implications for comorbid substance use among survivors of traumatic events. This study provides a path forward in efforts to create rapprochement between basic research and clinical services in the treatment of comorbid substance use in trauma survivors.
The principles of post-traumatic growth may have clinical implications for comorbid substance use among survivors of traumatic events. This study provides a path forward in efforts to create rapprochement between basic research and clinical services in the treatment of comorbid substance use in trauma survivors.Papular mycosis fungoides (MF) is an uncommon clinical variant of early MF without prognostic implications that follows an indolent course over years. It is characterized by the presence of multiple, small, pruritic, flat-topped, erythematous papules, often presenting as a nonspecific papular eruption which makes early diagnosis difficult. We describe two cases of elderly patients with papular MF, a probably underdiagnosed entity, which causes a significant deterioration in quality of life of patients who may benefit from specific treatments such as phototherapy.
The potentially inappropriate prescription by omission of a drug is defined as the failure to prescribe drugs that are clinically indicated. The objective of this article is to describe and analyse the evolution of inappropriate prescriptions by omission in nursing homes of a health department.
Retrospective observational descriptive study carried out in nursing homes of the Valencia-Clínico-Malvarrosa health department during the period 2016-2018. All institutionalized patients during this period were included. The prevalence of potentially inappropriate prescriptions by omission was assessed based on version 2 of the START criteria. The variables came from the electronic medical records of ambulatory care of the Conselleria de Sanitat (Abucasis).
2251 different patients were selected, mean age of 79,53years, 69% women, and an average of 4,60 chronic drugs/resident. A total of 2647 inappropriate prescriptions by omission were identified during the study period, and the results were similar during these 3years.