Medicine and Health Sciences Commons^™

Physician-Perceived Barriers To Treating Opioid Use Disorder In The Emergency Department, Gideon Logan, Amber Mirajkar, Jessica Houck, Fernando Rivera-Alvarez, Emily Drone, Parth Patel, Alexandra Craen, Larissa Dub, Nubaha Elahi, David Lebowitz, Ayanna Walker, Latha Ganti

Emergency Medicine Faculty Publications

Objective

We aimed to assess physicians' perceptions of barriers to starting medication-assisted treatment (MAT) in the Emergency Department (ED), views of the utility of MAT, and abilities to link patients with opioid use disorder (OUD) to MAT programs in their respective communities.

Methods

This was a cross-sectional survey study of American emergency medicine (EM) physicians with a self-administered online survey via SurveyMonkey (Survey Monkey, San Mateo, California). The survey was emailed to the Council of Residency Directors in Emergency Medicine (CORD) listserv and HCA Healthcare affiliated EM residency programs' listservs. Attendings and residents of all post-graduate years participated. Questions assessed …

Functional Seizures: The Patient’S Perspective Of A Diagnostic And Treatment Odyssey, Heather J. Andrini, Sydni L. Au Hoy, Ashley M. Okhovat, Juliana Lockman, Gregory R. Goldsmith

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

Functional seizures can be challenging to properly diagnose, often leading to delays in treatment. The etiology of functional seizures is multifactorial, with psychological factors identified in many, but not all cases. Misdiagnosis may occur due to clinical features mimicking other medical conditions. Once a correct diagnosis is reached, delivery of definitive, evidence-based treatment may be challenging due to limited availability of specialized resources. Research shows psychological education and cognitive behavioral therapy (CBT) have the greatest efficacy. However, individual differences, including acceptance of the diagnosis, therapeutic alliance, duration of symptoms, comorbidities, and access to care may influence outcomes. There is a …

Differential Item Functioning Analysis On The Geriatric Depression Scale-15: An Iterative Hybrid Ordinal Logistic Regression, Elahe Allahyari

BioMedicine

The elderly population has extensively increased globally, so depression like a common problem in late life may convert to one of the economic, social, and health challenges of the 21st century. Due to the high cost of clinical diagnosis of depression, it is necessary to provide effective questionnaires like the 15-item Geriatric Depression Scale (GDS-15) for screening. But, the measurement invariance of GDS-15 is still unknown in the general population. In our study, 1473 participants of all Iranʼs ethnic groups were asked to answer GDS-15 and demographic factors such as human settlements, employment, disease, marital status, age, gender, homebound, financial …

Measuring The Social Net Benefits Of Covid-19 Restrictions: The Case Of Reduced Vehicle Use In A Pollution-Prone Region Of Utah, Ethan Hartley, Arthur Caplan

Applied Economics Faculty Publications

A number of natural experiments have recently found that COVID-19 restrictions imposed in nations worldwide are correlated with short-term reductions – in some cases dramatic reductions – in mobile-source air pollutants. Noticeably absent from these studies are estimates of the social net benefits associated with the changes in human behavior underlying the pandemic-induced effects. Using readily available data provided by the state of Utah and the U.S. Environmental Protection Agency’s Co-Benefits Risk Assessment Health Impacts Screening and Mapping Tool (COBRA), we find that daily social net benefit was positive during a pandemic-induced shutdown from March-April, 2020 in Utah’s Wasatch Front …

A Study On The Efficacy Of A Naloxone Training Program, Gillian A. Beauchamp Md, Hoonani M. Cuadrado, Seth A. Campbell Pa-C, Bennie Eliason Chw, Chase Jones Do, Aaron Fedor Do, Lauren Grantz Pharmd, Csp, Paige Roth Lsw, Marna Greenberg

Department of Emergency Medicine

Introduction: The use of naloxone to reverse a potentially fatal opioid overdose is a harm reduction strategy that reduces mortality and increases the potential for referral to substance use treatment for affected individuals. In the setting of outreach performed by a street medicine team, we aimed to determine the effectiveness of an educational intervention involving distribution of naloxone accompanied by a brief instructive session about opioids, opioid overdose, and medication administration. Methods: Our street medicine outreach team distributed 200 naloxone kits to clinicians and volunteers involved in caring for patients on ‘street rounds,’ as well as in shelters, soup kitchens, …

Medicated-Assisted Treatment And 12-Step Programs: Evaluating The Referral Process, Candace S. Brown, Chudney Williams, Ryan E. Stephens, Jacqueline Sharp, Bobby Bellflower, Martinus T. Zeeman

Doctor of Nursing Practice Projects

Purpose/Background Overdose deaths in the U.S. from opioids have dramatically increased since the COVID-19 pandemic. Although medicated-assisted treatment (MAT) programs are widely available for sufferers of opiate addiction, many drop out of treatment prematurely. Twelve-step programs are considered a valuable part of treatment, but few studies have examined the effect of combining these approaches. We aimed to compare abstinence rates among patients receiving MAT who were referred to 12-step programs to those only receiving MAT.

Methods In this prospective study, a cohort of participants from a MAT clinic agreeing to attend a 12-step program was compared to 15 controls selected …

Rapid-Onset Anti-Stress Effects Of A Kappa-Opioid Receptor Antagonist, Ly2795050, Against Immobility In An Open Space Swim Paradigm In Male And Female Mice, Caroline Baynard, Thomas E. Prisinzano, Eduardo R. Butelman

Pharmaceutical Sciences Faculty Publications

The kappa-opioid receptor (KOR) / dynorphin system is implicated with behavioral and neurobiological effects of stress exposure (including heavy exposure to drugs of abuse) in translational animal models. Thus some KOR-antagonists can decrease the aversive, depressant-like and anxiety-like effects caused by stress exposure. The first generation of selective KOR-antagonists have slow onsets (hours) and extremely long durations of action (days-weeks), in vivo. A new generation of KOR antagonists with rapid onset and shorter duration of action can potentially decrease the effects of stress exposure in translational models, and may be of interest for medication development. This study examined the …

Clinical Predictors Of Response To Depression Treatment In Persons With Epilepsy, Juliana Hager, Frank Gilliam

MEDI 9331 Scholarly Activities Clinical Years

Abstract:

Background

The literature on predictors of response to treatment of depression for persons with epilepsy is limited. This study examined predictors of response to treatment of major depression disorder (MDD) by cognitive behavioral therapy (CBT) or Sertraline in Epilepsy patients.

Methods:

In the original two-site comparative effectiveness trial, 140 adult outpatients with active epilepsy and current major depressive disorder were randomly assigned to either sertraline (at a dose starting at 50 mg per day, titrating as needed at two-week intervals up to 200 mg per day) or weekly cognitive behavior therapy (CBT) for 16 weeks¹. The …

Covid-19-Related Mental Health Burdens: Impact Of Educational Level And Relationship Status Among Low-Income Earners Of Western Uganda, Ann Monima Lemuel, Ibe Michael Usman, Keneth Iceland Kasozi, Saad Alghamdi, Eric Osamudiamwen Aigbogun, Victor Archibong, Robinson Ssebuufu, Annet Kabanyoro, Josiah Eseoghene Ifie, Dominic Terkimbi Swase, Fred Ssempijja, John Tabakwot Ayuba, Kevin Matama, Hope Onohuean, Stellamaris Kembabazi, Rachael Henry, Said Odoma, Helen Yusuf, Adam Moyosore Afodun, Hamza M. Assaggaf, Emmanuel Kairania, Akhmed Aslam, Owoisinke Okon, Gaber El-Saber Batiha, Susan Christina Welburn

School of Nursing & Midwifery, East Africa

Objective: The study aimed to investigate the relationship between mental health with the level of education, relationship status, and awareness on mental health among low-income earners in Western Uganda.

Methods: This was a cross-sectional descriptive study carried out among 253 participants. Anxiety, anger, and depression were assessed using a modified generalized anxiety disorder (GAD-7), Spielberger's State-Trait Anger Expression Inventory-2, and Beck Depression Inventory item tools, respectively.

Results: The majority of our respondents were male (n = 150/253, 59.3), had a secondary level of education (104/253, 41.1), and were single (137/253, 54.2). No formal education and primary education (r …

Evaluating The Efficacy Of Automated Smoking Treatment For People With Hiv: Protocol For A Randomized Controlled Trial, Damon J Vidrine, Thanh C Bui, Michael S Businelle, Ya-Chen Tina Shih, Steven K Sutton, Lokesh Shahani, Diana Stewart Hoover, Kristina Bowles, Jennifer I Vidrine

Faculty, Staff and Student Publications

BACKGROUND: Smoking prevalence rates among people with HIV are nearly 3 times higher than those in the general population. Nevertheless, few smoking cessation trials targeting smokers with HIV have been reported in the literature. Efforts to develop and evaluate sustainable, low-cost, and evidence-based cessation interventions for people with HIV are needed. Given the widespread proliferation of mobile phones, the potential of using mobile health apps to improve the reach and efficacy of cessation interventions is promising, but evidence of efficacy is lacking, particularly among people with HIV.

OBJECTIVE: This study will consist of a 2-group randomized controlled trial to evaluate …

The Acute And Persisting Impact Of Covid-19 On Trajectories Of Adolescent Depression: Sex Differences And Social Connectedness, Sabrina R. Liu, Elyssia Poggi Davis, Anton M. Palma, Curt A. Sandman, Laura M. Glynn

Psychology Faculty Articles and Research

Background

The COVID-19 era is a time of unprecedented stress, and there is widespread concern regarding its short- and long-term mental health impact. Adolescence is a sensitive period for the emergence of latent psychopathology vulnerabilities, often activated by environmental stressors. The present study examined COVID-19′s impact on adolescent depression and possible influences of different domains of social connectedness (loneliness, social media use, social video game time, degree of social activity participation).

Methods

A community sample of 175 adolescents (51% boys, mean age = 16.01 years) completed questionnaires once before and twice during the COVID-19 pandemic. Piecewise growth modeling examined the …

Bipolar I And Bipolar Ii Subtypes In Older Age: Results From The Global Aging And Geriatric Experiments In Bipolar Disorder (Gage-Bd) Project, Farren Briggs, Martha Sajatovic, Kaylee Sarna, Joy Yala

Faculty Scholarship

Objectives: The distinction between bipolar I disorder (BD-I) and bipolar II disorder (BD-II) has been a topic of long-lasting debate. This study examined differences between BD-I and BD-II in a large, global sample of OABD, focusing on general functioning, cognition and somatic burden as these domains are often affected in OABD. Methods: Cross-sectional analyses were conducted with data from the Global Aging and Geriatric Experiments in Bipolar Disorder (GAGE-BD) database. The sample included 963 participants aged ≥50 years (714 BD-I, 249 BD-II). Sociodemographic and clinical factors were compared between BD subtypes including adjustment for study cohort. Multivariable analyses were conducted …

Intersectionality, Relational Positionality, And The Lived Experiences Of Inequality: Contextualizing Intergenerational Opioid Use And The Constrained Choices Of Indigenous, Latina, And White Women Caregivers In Rural New Mexico, Carmela M. Roybal

Sociology ETDs

Opioid addiction is a serious and persistent global health issue. The federal Centers for Disease Control and Prevention (CDC) reported that between 1999 and 2016, more than 630,000 people in the United States died of an overdose of a prescription opioid or illicit drug (CDC 2018). Extant research has suggested that for nearly a century, New Mexico has experienced some of the highest rates of prescription and illicit opioid death in the nation (Goldstein and Herrera, 1995; Landon, 2003; Shah et al., 2008). I examined intergenerational opioid dependence through the lived experience of women caregivers of opioid-addicted family members. Data …

Correlates Of Covid-19 Pandemic On Anxiety Among Adults In Appalachia, Usa, Ram Lakhan, Louisa Summers, David Tataw, Peter Hackbert, Manoj Sharma

Social and Behavioral Health Faculty Research

Background: Anxiety problems have increased in the COVID-19 pandemic worldwide. However, very little is known about the anxiety rates in the new normal phase of the disease when adults have been assumed to be adjusted. The study aimed to find out the difference in anxiety in a convenience sample of Appalachian adults during the new normal phase of the COVID-19 pandemic, examine its association with sociodemographic factors, and compare it with the anxiety levels before the pandemic as recalled by the participants. Study design: A cross-sectional study. Methods: The Generalized Anxiety Disorder-7 scale was used in the present study. The …

Sex And The Streets: The Open Secret Of Sexual Abuse Among Pakistan's Two Million Street Children, Amir Humza Sohail, Muhammad Hassaan Arif Maan, Sachal Sohail

Medical College Documents

Background: About two million children live on the streets in Pakistan. Their complicated past and dire living conditions make them susceptible to many psychological and physical problems, including sexual abuse.
Main body: With little research on the topic, the prevalence of sexual intercourse among street children is reported to be as high as 88% in Pakistan. With commercial sex a common practice among the street children, public places such as bus terminals and parks have become foci of prostitution and sexual exploitation. A growing concern is the spread of HIV/AIDS among the affected children due to a general lack of …

Treatment Selection Using Prototyping In Latent-Space With Application To Depression Treatment, Akiva Kleinerman, Ariel Rosenfeld, David Benrimoh, Robert Fratila, Caitrin Armstrong, Joseph Mehltretter, Eliyahu Shneider, Amit Yaniv-Rosenfeld, Jordan Karp, Charles F. Reynolds, Gustavo Turecki, Adam Kapelner

Publications and Research

Machine-assisted treatment selection commonly follows one of two paradigms: a fully personalized paradigm which ignores any possible clustering of patients; or a sub-grouping paradigm which ignores personal differences within the identified groups. While both paradigms have shown promising results, each of them suffers from important limitations. In this article, we propose a novel deep learning-based treatment selection approach that is shown to strike a balance between the two paradigms using latent-space prototyping. Our approach is specifically tailored for domains in which effective prototypes and sub-groups of patients are assumed to exist, but groupings relevant to the training objective are not …

Perspectives On Extended-Release Naltrexone Induction Among Patients Living With Hiv And Opioid Use Disorder: A Qualitative Analysis, Kim A. Hoffman, Robin Baker, Laura C. Fanucchi, Paula J. Lum, Lynn E. Kunkel, Javier Ponce Terashima, Dennis Mccarty, Petra Jacobs, P. Todd Korthuis

Internal Medicine Faculty Publications

BACKGROUND: The CHOICES study randomized participants with HIV and opioid use disorder (OUD) to HIV clinic-based extended-release naltrexone (XR-NTX), which requires complete cessation of opioid use, versus treatment-as-usual (i.e., buprenorphine, methadone). Study participants randomized to XR-NTX were interviewed to assess their experiences with successful and unsuccessful XR-NTX induction.

METHODS: Semi-structured qualitative interviews were completed with a convenience sample of study participants with HIV and OUD (n = 37) randomized to XR-NTX in five HIV clinics between 2018 and 2019. All participants approached agreed to be interviewed. Interviews were digitally recorded, professionally transcribed, and analyzed using thematic analysis.

RESULTS: Participants …

Exercise Prescription Practices In University Counseling Centers: Testing The Information-Motivation-Behavioral Skills Model, A'Naja M. Newsome

USF Tampa Graduate Theses and Dissertations

The co-occurence of physical inactivity and poor mental health in the college student population can lead to chronic health issues that have negative short-term (e.g., academic success and weight gain) and long-term (e.g., obesity, serious mental illness, and premature mortality) impacts. Integrating exercise prescription into the mental health treatment plan of college students could enhance the holistic care model described by The American College Health Association (ACHA) and Healthy Campus task force. Understanding the knowledge, attitudes, and skills that mental health professionals (MHPs) hold regarding exercise prescription is important for policy formation and program development for college student health. The …

Traumatic Stress In Families, Joanna Burkhardt

Library Impact Statements

No abstract provided.

Apathy Is Not Associated With A Panel Of Biomarkers In Older Adults With Hiv Disease, Steven Paul Woods, Jennifer L Thompson, Michelle A Babicz, Lokesh Shahani, Gabriela Delevati Colpo, Natalia P Rocha, Erin E Morgan, Antonio L Teixeira

Faculty, Staff and Student Publications

OBJECTIVE: Apathy is prevalent in HIV disease and can significantly impact personal well-being; however, little is known about its neurobiological substrates in persons with HIV (PWH) disease.

METHODS: This cross-sectional, correlational study examined the association between apathy and several plasma biomarkers (tumor necrosis factor alpha, kynurenine, tryptophan, quinolinic acid, brain-derived neurotrophic factor, glial fibrillary acidic protein, neurofilament light chain, and phosphorylated tau at position threonine 181) in 109 PWH and 30 seronegative participants ages 50 and older. Apathy was measured with a composite score derived from subscales of the Frontal Systems Behavior Scale and the Profile of Mood States.

RESULTS: …

An Exploratory Analysis Of Virtual Delivery Alternatives For University-Based Animal Assisted Activities During Covid-19, Aleisha Fernandes, Yu Seon Chae, Cluny S. South

People and Animals: The International Journal of Research and Practice

Animal-assisted activities (AAAs) are being offered progressively in universities to support students’ well-being. However, with the recent health restrictions due to COVID-19, all classes and health services are being delivered remotely. Due to this, many postsecondary institutions have put a temporary pause on AAAs. Most recently, there has been a growing interest and rise in virtual AAAs being facilitated at universities in North America, which vary in duration, group size, and other organizational elements. Furthermore, prior to the pandemic there was also an interest in collaborative events that sought to combine multiple activities with AAAs. Due to the nature of …

Dextromethorphan-Quinidine Is Helpful For Pseudobulbar Affect Disorder In Stroke Patients, Michael Francis, Mira Hamame, Md, Mariam Nasrallah, Md, Alison Nesbitt, Do, James Peter Meza, Md, Phd

Clinical Research in Practice: The Journal of Team Hippocrates

An informed consent article using

Hammond FM, Alexander DN, Cutler AJ, et al. PRISM II: an open-label study to assess effectiveness of dextromethorphan/quinidine for pseudobulbar affect in patients with dementia, stroke or traumatic brain injury. BMC Neurology. 2016;16:89. https://doi.org/10.1186/s12883-016-0609-0

for a patient with pseudobulbar affect following stroke

Rebuilding A Foundation Of Trust: A Call To Action In Creating A Safe Environment For Everyone, Cynda H. Rushton, Laura J. Wood, Karen Grimley, Jerry Mansfield, Barbara Jacobs, Jason A. Wolf

Patient Experience Journal

Well before the COVID-19 pandemic, incivility and physical threats directed toward healthcare employees and often registered nurses was a growing concern by Chief Nurse Executive (CNE) leaders. In 2019, conversations initiated by The Beryl Institute’s Nurse Executive Council (NEC) to consider how best to achieve a much-needed balance between patient/family and staff safety have now become a critical priority to ensure the safety of everyone receiving and providing health care services. The heart of this work was organized around a set of newly developed ethical precepts designed to guide the exploration of key concepts. A call to action grounded in …

The Value Of Adapting Counseling To Client’S Spirituality And Religion: Evidence-Based Relationship Factors, Amelia L. Evans, Jennifer Koenig Nelson

Graduate School Faculty Publications

There is a strong tradition of attention to relationship factors in the field of counseling. The research on the importance of the relationship and adapting to client factors continues to grow, supporting the importance of professional multicultural competence. The field of counseling, specifically within the United States context, has focused on Multicultural Counseling Competencies with more recent emphasis on social justice through the Multicultural and Social Justice Counseling Competencies. Within these competencies, spirituality and religion are mentioned as multicultural components to consider as potentially salient to clients. Yet, there has been less emphasis on ways to adapt counseling to a …

Support For Me: Substance Use Disorder Prevalence And Treatment Capacity Assessment, Rachel T. Gallo Mph, Katharine Knight Mph, Mary Lindsey Smith Phd

Substance Use Research & Evaluation

The aim of this report was to understand the sociodemographic and geographic distribution of substance use disorder (SUD) prevalence in Maine, through a claims-based analysis which assessed current statewide capacity to address SUD by examining current SUD treatment and recovery infrastructure, service utilization patterns, and geographic distribution of services and usage throughout the state to identify any gaps in treatment and recovery capacity.

The authors would like to note that this report was completed during the planning phase of the SUPPORT for ME project, which was funded by the Centers for Medicare & Medicaid Services (CMS) via the SUPPORT Act …

Endoxifen: A New Hope For Bipolar Disorder, Muneeba Amin, Alviya Shafique, Muhammad Yusuf Hafiz

Department of Psychiatry

No abstract provided.

Fidelity Monitoring In The Solution Focused Wellness For Hiv (Sfwh) Intervention For Women, Helen Taylor Yates, Spencer Elise Lee

Journal of Solution Focused Practices

Solution Focused methods are often interpreted by different practitioners with a degree of flexibility and adaptation to specific practice settings (Lehmann & Patton, 2012). This flexibility is one of the features that makes SFBT a very client-centered approach and has been highlighted as one of the key aspects of successful co-construction of desired outcomes with clients (Franklin et al., 2017). This collaborative approach is possible due to SFBT’s utilization of social constructionist principals in the solution-building process (Blundo & Simon, 2015). While encouraging flexibility of implementation of SFBT, identifying the main tenets of the therapy, including specific techniques and mindsets …

High Anxiety And Depression Scores And Mental Health Service Use Among South Asian Advanced Cancer Patients: A Multi-Country Study, Irene Teo, Semra Ozdemir, Chetna Malhotra, Grace Meijuan Yang, Remee Rose Quintana Ocampo, Sushma Bhatnagar, Thushari Hapuarachchi, Anjum Khan Joad, Lubna Mariam, Gayatri Palat, Rubayat Rahman, Eric A. Finkelstein

Research Collection School of Social Sciences

Context. Addressing symptoms of anxiety and depression is important in cancer palliative care. However, little information exists on the prevalence of anxiety and depression and mental health service use among advanced cancer patients in South Asia. Objectives. To examine among South Asian advanced cancer patients, the 1) prevalence of high anxiety and depression scores, 2) factors associated with high anxiety and depression scores, and 3) mental health service use. Methods. This cross-sectional, multi-site study recruited patients receiving oncology care across six major public hospitals in India, Bangladesh and Sri Lanka. Participants were adults, diagnosed with stage IV metastatic solid cancer …

“Nadie Nos Han Preguntado…” (Nobody Has Asked Us...), Mark Nagasawa

Straus Institute for Thriving Children & Families

This is the latest in a series of reports from the Listening to Teachers Study, which seeks understanding of how New York City's early childhood educators are faring during the ongoing COVID-19 pandemic. The purpose of this study is to use data gathered through surveys (May 2020, n=3355; June 2021, n=663) and in-depth interviews (spring 2022) to prompt reflection and discussion about what a more equitable post-pandemic ECE system could look like.

This report focuses on describing the June 2021 sample and preliminary findings:

1. As in 2020, emotional/mental health support was the most frequently requested need, but professional …

How Domestic Violence Counselors With Personal Histories Of Trauma Experience Their Clients Who Were Victims Of Domestic Violence: A Heuristic Study, Janis Edralin

Dissertations

The heuristic inquiry-based phenomenological approach values focusing on a question or problem that has been a personal challenge in one’s quest to understand oneself and the phenomenon. Previous research has shown that counselors with a personal history of trauma who provide services to victims with a similar history report a range of negative consequences. The researcher utilized a heuristic research design to answer the following question: How do domestic violence counselors who have personal histories of trauma experience their clients who were victims of domestic violence? The methodology involved interviewing eight counselors, from whom four themes were identified: awareness of …