Medicine and Health Sciences Commons^™

Aging Lowers Pex5 Levels In Cortical Neurons In Male And Female Mouse Brains, Ndidi-Ese Uzor

Dissertations and Theses (Open Access)

Peroxisomes are small organelles with critical functions: lipid synthesis, breakdown of reactive oxygen species by antioxidant enzymes, and amino acid degradation. In the brain, peroxisomal lipids make up the myelin sheath. Brain peroxisomal dysfunction leads to lipid disruption or neurological consequences if key peroxisomal proteins are absent. Still, it is unclear how peroxisomes are affected in neurodegenerative diseases and in normal brain aging. This work examines peroxisomal markers in three settings: 1) in a neuronal and 2) animal model of Huntington disease (HD), where mutant huntingtin (mHtt), the causative protein in Huntington disease pathogenesis is expressed, and 3) in the …

Prevalence Of Allergic Rhinitis Among Healthcare Workers And Its Impact On Their Work: A Cross-Sectional Survey At A Tertiary Healthcare Centre In Pakistan, Moghira Iqbaluddin Siddiqui, Rahim Dhanani, Huzaifa Moiz

Section of Otolaryngology, Head & Neck Surgery

A study was conducted to determine the frequency of allergic rhinitis among healthcare professionals and its impact on their work at the Aga Khan University Hospital Karachi Pakistan. Healthcare workers including doctors, nurses, technicians and pharmacists were included. Participants were asked to fill a questionnaire consisting of score for allergic rhinitis (SFAR), and work productivity and activity impairment questionnaires. Out of 167 workers, 101 were males. Mean age of the participants was 29.0 ± 5.9 years. Overall prevalence of allergic rhinitis among healthcare workers was found to be frequency (19.2%). We noted that 13 individuals reported to have missed their …

Characterization Of Initial North American Pediatric Surgical Response To The Covid-19 Pandemic, Martha-Conley E Ingram, Mehul V Raval, Christopher Newton, Monica E Lopez, Loren Berman, Md

Department of Surgery Faculty Papers

INTRODUCTION: The impact of COVID-19 pandemic on pediatric surgical care systems is unknown. We present an initial evaluation of self-reported pediatric surgical policy changes from hospitals across North America.

METHODS: On March 30, 2020, an online open access, data gathering spreadsheet was made available to pediatric surgeons through the American Pediatric Surgical Association (APSA) website, which captured information surrounding COVID-19 related policy changes. Responses from the first month of the pandemic were collected. Open-ended responses were evaluated and categorized into themes and descriptive statistics were performed to identify areas of consensus.

RESULTS: Responses from 38 hospitals were evaluated. Policy changes …

Sexually Transmitted Infection Prevalence Among Women At Risk For Hiv Exposure Initiating Safer Conception Care In Rural, Southwestern Uganda, Pooja Chitneni, Mwebesa Bosco Bwana, Moran Owembabazi, Kasey O'Neil, Paul Kato Kalyebara, Winnie Muyindike, Nicholas Musinguzi, David R. Bangsberg, Jeanne M. Marrazzo, Jessica E. Haberer, Angela Kaida, Lynn T. Matthews

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background Knowledge of sexually transmitted infection (STI) prevalence and risk factors is important to the development of tenofovir-based preexposure prophylaxis (PrEP) and safer conception programming. We introduced STI screening among women at risk for HIV exposure who were participating in a safer conception study in southwestern Uganda. Methods We enrolled 131 HIV-uninfected women, planning for pregnancy with a partner living with HIV or of unknown HIV serostatus (2018-2019). Women were offered comprehensive safer conception counseling, including PrEP. Participants completed interviewer-administered questionnaires detailing sociodemographics and sexual history. We integrated laboratory screening for chlamydia, gonorrhea, trichomoniasis, and syphilis as a substudy to …

Combating Covid On College Campuses: The Impact Of Structural Changes On Viral Transmissions, Jared Knofczynski, Aria Killebrew Bruehl, Ben Warner, Ryne Shelton

altREU Projects

One of the most significant issues in the COVID-19 pandemic is the reopening of schools while minimizing the transmission of coronavirus. Opportunities for evaluating the effectiveness of policies that might be utilized at such institutions are limited, as the necessary empirical data has not been gathered yet. Agent-based modeling, where various entities within an environment are simulated as agents, offers an opportunity to examine the effectiveness of various policies in a way that drastically minimizes the health and economic risks involved. Agent-based modeling is common within biology, ecology and other fields; and has seen some use within the coronavirus literature. …

Predicting The Efficacy Of Psilocybin In Treating Mental Health And Addiction, Courtney Ledford

altREU Projects

Machine Learning is used to predict the efficacy of psilocybin in treating mental health and addiction by using a random forest algorithm. Psilocybin is a chemical compound found in fungi. Following ingestion, it is converted to psilocin which acts as a serotonin agonist, producing altered states of consciousness and hallucinations. Research suggests the use of psilocybin as a potential treatment for mental health disorders and addiction. An analysis of thirty-one experiments from the Altered States Database was inputted into the model. Past meta-analysis performed on this experimental data focuses on healthy participants rather than participants diagnosed with a mental illness. …

Nighttime Quiet In The Intensive Care Unit: An Integrative Review, Heather Rae Smith

Doctoral Dissertations and Projects

Excessive environmental noise in the ICU often negatively impacts patient sleep. The World Health Organization (WHO) and Environmental Protection Agency (EPA) have published recommendations for hospital decibel levels, but the literature indicates that noise levels in the ICU often exceed these values. Patients experience disturbed sleep and rarely enter into N3 and REM sleep. The integrative review examined both the patients’ and healthcare workers’ perception of noise in the ICU environment to identify contributors and suggested interventions to mitigate these occurrences. In addition, this study evaluated objective measurements of patient sleep to further determine how well patients were sleeping in …

Using Natural Language Processing And Sentiment Analysis To Augment Traditional User-Centered Design: Development And Usability Study, Curtis L. Petersen, Ryan Halter, David Kotz, Lorie Loeb, Summer B. Cook, Dawna M. Pidgeon, Brock Christensen, John A. Batsis

Dartmouth Scholarship

Background: Sarcopenia, defined as the age-associated loss of muscle mass and strength, can be effectively mitigated through resistance-based physical activity. With compliance at approximately 40% for home-based exercise prescriptions, implementing a remote sensing system would help patients and clinicians to better understand treatment progress and increase compliance. The inclusion of end users in the development of mobile apps for remote-sensing systems can ensure that they are both user friendly and facilitate compliance. With advancements in natural language processing (NLP), there is potential for these methods to be used with data collected through the user-centered design process.

Objective: This study aims …

Trajectories Of Initiation For The Heroin-Based Drug Whoonga – Qualitative Evidence From South Africa, Griffin A. Tyree, Nzwakie Mosery, Elizabeth F. Closson, Zonke Mabude, Carol Du Toit, David Bangsberg, Steven A. Safren, Kenneth H. Mayer, Jennifer A. Smit, Matthew J. Mimiaga, David J. Grelotti

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Whoonga is a smoked heroin-based street drug that first emerged in South Africa a decade ago. While previous scientific reports suggest that use is growing and youth are particularly vulnerable, trajectories of initiation are not well characterized. Methods: In 2015, 30 men undergoing residential addiction treatment for this smoked heroin drug in KwaZulu-Natal, South Africa participated in semi-structured interviews about their experiences using the drug. Interview data were coded using qualitative content analysis. Results: Participant trajectories to initiating smoked heroin were “vertical” in the context of marijuana use or “horizontal” in the context of other hard drug use. Participants …

Responding To Covid-19: How Massachusetts Senior Centers Are Adapting, Ceara Somerville, Caitlin Coyle, Jan Mutchler

Center for Social and Demographic Research on Aging Publications

The COVID-19 pandemic has swept the United States with force and speed. Massachusetts is one of the hardest hit states in nation, with over 120,000 cases and over 8,500 deaths to date. Local governments across the Commonwealth have had to work quickly to meet the needs of their constituents in a constantly changing environment. With older adults being at high risk of contracting COVID-19, having more severe symptoms, and at higher risk of dying from the disease, special efforts are warranted to ensure that they are supported in their efforts to maintain physical distance while meeting needs for food and …

Lower Rates Of Heart Failure And All-Cause Hospitalizations During Pulmonary Artery Pressure-Guided Therapy For Ambulatory Heart Failure: One-Year Outcomes From The Cardiomems Post-Approval Study., David M Shavelle, Akshay S Desai, William T Abraham, Robert C Bourge, Nirav Raval, Lisa D Rathman, J Thomas Heywood, Rita A Jermyn, Jamie Pelzel, Orvar T Jonsson, Maria Rosa Costanzo, John D Henderson, Marie-Elena Brett, Philip B Adamson, Lynne W Stevenson, Cardiomems Post-Approval Study Investigators, Jacob Abraham (Cardiomems Post-Approval Study Investigator)

Articles, Abstracts, and Reports

BACKGROUND: Ambulatory hemodynamic monitoring with an implantable pulmonary artery (PA) sensor is approved for patients with New York Heart Association Class III heart failure (HF) and a prior HF hospitalization (HFH) within 12 months. The objective of this study was to assess the efficacy and safety of PA pressure-guided therapy in routine clinical practice with special focus on subgroups defined by sex, race, and ejection fraction.

METHODS: This multi-center, prospective, open-label, observational, single-arm trial of 1200 patients across 104 centers within the United States with New York Heart Association class III HF and a prior HFH within 12 months evaluated …

Rate Of Unscheduled Administration Of An Epidural Bolus Among Pregnant Women Receiving Labor Epidurals, Aleksandr A. Lyakhov, Emily L. Mcquaid-Hanson, Amanda Affleck, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background The labor and delivery process is a painful experience that pregnant women undergo and while various medical options are available for managing labor pain, labor epidurals are the most common.1,3 Breakthrough pain, or inadequate analgesia, is a significant complication of labor epidurals that is typically managed with the administration of an unscheduled epidural bolus. The purpose of this evidence-based practice (EBP) project is to describe the rate of unscheduled epidural bolus administration in pregnant women receiving continuous labor epidurals (CLE) at Providence Sacred Heart Medical Center (PSHMC) and Providence Holy Family Hospital (PHFH).

Methods • Design: Retrospective, observational, EBP …

Intratracheal Lidocaine And Postoperative Sore Throat At Providence Sacred Heart Medical Center And Providence Holy Family Hospital, Jennifer Cowgill, Scot Pettey, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Postoperative sore throat (POST) is a common side effect from general anesthesia (GA) and has a prevalence of 14.4-50%.1 The experience of POST contributes to patient discomfort during recovery from surgery. The etiology of this is thought to be from tracheal mucosal erosion from the cuff of the endotracheal tube (ETT), trauma from intubation, coughing and bucking, and friction between the ETT and the tracheal mucosa during general anesthesia.2 Risk factors shown to contribute to the development of POST include, but are not limited to, elderly age, smoking history, patient positioning, ETT cuff pressure, and movement of ETT during …

Rates Of Ondansetron Administration Prior To Spinal Anesthesia: Evaluating The Practice Of Prophylactic Attenuation Of Spinal-Induced Hypotension And Bradycardia, Clare Santana, Scot Pettey, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Hypotension and bradycardia are common complications of spinal anesthesia. Intraoperative hypotension and bradycardia may lead to complications that require additional treatment and increase cost. The literature identifies intervention strategies to attenuate spinalinduced hypotension (SIH) and bradycardia.1 Prophylactic administration of ondansetron, a serotonin 5-hydroxytryptamine receptor antagonist, prior to spinal anesthesia is associated with reduced SIH and bradycardia.1,2,3,4,6 The objective of this scholarly project was to report the practice of ondansetron prophylaxis for SIH and bradycardia and the rate of rescue interventions in patients who received ondansetron prior to spinal anesthesia.

Methods Retrospective, multi-center observational evidence-based practice project conducted at Providence …

Correlation Of Ondansetron Timing In Postoperative Nausea And Vomiting: A Retrospective Evaluation Amongst Adult Patients Receiving General Anesthesia, Jeff Tanguay, Braden Hemingway, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Addressed as a national quality initiative by the Centers for Medicare and Medicaid Services (CMS), postoperative nausea and vomiting (PONV) is a vexing complication requiring further attention by anesthesia providers.3 Medication optimization is an area of focus to address this complication.4 Ondansetron, a selective 5- hydroxytryptophan subtype 3 (5-HT3 ) receptor antagonist, is effective and considered the “gold standard” in the prevention of PONV.4 GlaxoSmithKline™ suggests administering Zofran® (ondansetron) before the induction of anesthesia.5 These directions are in contrast to the synthesis of the research evidence, which supports increased effectiveness of ondansetron when administered 30 minutes before emergence from …

Postoperative Nausea And Vomiting With Low-Dose Propofol Infusions In Patients Undergoing Gynecological Surgeries With Volatile Anesthetics At Providence Sacred Heart Medical Center And Providence Holy Family Hospital, Adrianna Silva, Braden Hemingway, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Postoperative nausea and vomiting (PONV) is a common complication following surgery. It remains the most important determinant of length of stay and leading cause of dissatisfaction in anesthesia.4 Females undergoing gynecological laparoscopic surgery have the highest rates.8 Apfel’s baseline risk factors for PONV include female gender, history of motion sickness and/or PONV, non-smoking status and administration of postoperative opioids.1 Propofol has antiemetic properties and Gan’s evidence supports the use of an intraoperative low-dose infusion to reduce baseline risk factors for PONV.6 This project aims to describe the rates of intraoperative low-dose propofol infusions in female patients undergoing gynecological surgery …

Beyond Single Nucleotide Polymorphisms: Cyp3a5∗3 ∗6 ∗7 Composite And Abcb1 Haplotype Associations To Tacrolimus Pharmacokinetics In Black And White Renal Transplant Recipients, Daniel A. Brazeau, Kristopher Attwood, Calvin J. Meaney, Gregory E. Wilding, Joseph D. Consiglio, Shirley S. Chang, Aijaz Gundroo, Rocco C. Venuto, Louise Cooper, Kathleen M. Tornatore

Pharmaceutical Science and Research

Interpatient variability in tacrolimus pharmacokinetics is attributed to metabolism by cytochrome P-450 3A5 (CYP3A5) isoenzymes and membrane transport by P-glycoprotein. Interpatient pharmacokinetic variability has been associated with genotypic variants for both CYP3A5 or ABCB1. Tacrolimus pharmacokinetics was investigated in 65 stable Black and Caucasian post-renal transplant patients by assessing the effects of multiple alleles in both CYP3A5 and ABCB1. A metabolic composite based upon the CYP3A5 polymorphisms: ^∗3(rs776746), ^∗6(10264272), and ^∗7(41303343), each independently responsible for loss of protein expression was used to classify patients as extensive, intermediate and poor metabolizers. In addition, the …

Evaluating Soluble Axl As A Biomarker For Glioblastoma, Daniel Raymond

All NMU Master's Theses

AXL, a receptor tyrosine kinase, is known to promote malignant phenotypes in various types of cancer. AXL overexpression is commonly observed in glioblastoma and correlates with a worse prognosis. Detectable in most biological fluids, the extracellular domain of AXL, sAXL, is the product of enzymatic cleavage by ADAM10/17. Here we used ELISA, BCA and BCG assays to characterize blood serum from 23 newly diagnosed GBM patients which was collected roughly 24 hours before and after surgery as well as every three months post-surgery, corresponding to follow-up treatment visits. Immunoblotting was used to determine relative AXL expression in 13 patient tumor …

The Prevalence And Predictors Of Complementary And Alternative Medicine (Cam) Use Among Racially/Ethnically Diverse College Students, Hermella Misiker

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: National data on complementary and alternative medicine (CAM) use, available through the National Health Interview Survey (NHIS), convey higher prevalence of CAM use among college students compared to the general U.S population. NHIS findings also highlight non-vitamin non- mineral (NVNM) products are the most widely used form of CAM in the U.S. The purpose of this study was to identify the socio-cognitive and demographic predictors of CAM and NVNM use among a racially/ethnically diverse college student body.

Methods: An online survey was used to collect data from 392 University of Nevada, Las Vegas (UNLV) undergraduate, graduate, and professional students. …

Communication In Healthcare Settings: Access And Barriers To Care Experienced By Deaf Patients, Elizabeth Schniedewind

Boise State University Theses and Dissertations

Deaf persons who use American Sign Language (ASL) as their primary form of communication are members of a cultural and linguistic minority that experiences significant health disparities yet are not recognized as a health disparity population by the National Institutes of Health. Studies have reported ineffective communication in healthcare interactions and reduced access to care experienced by Deaf patients. Requests for sign language interpreters in healthcare encounters are frequently denied, despite federal mandates to provide effective communication. Comprised of three articles, this dissertation investigates the diminished access to communication in healthcare settings experienced by Deaf patients and qualitative research methods …

Evaluation Of The Humoral Immune Response As A Potential Indicator Of Disease Severity For Patients Hospitalized With Covid-19, Spencer Sterling

Capstone Experience: Master of Public Health

Members of the family Coronaviridae, including the severe acute respiratory syndrome coronaviruses (SARS-CoV-1 and SARS-CoV-2), Middle East respiratory syndrome coronavirus (MERS-CoV) and seasonal human coronaviruses (HCoV-HKU1and HCoV-OC43), are highly communicable respiratory viruses; SARS-CoV-1, SARS-CoV-2, and MERS can cause severe disease, while seasonal human coronaviruses present with mild to moderate illness. Coronavirus envelope spike (S) glycoproteins are involved in receptor binding and cell fusion, and are the primary target for a neutralizing humoral response. The S protein is comprised of the S₁ and S₂ subunits; the S₁ subunit contains the receptor-binding domain (RBD), while the S_{2 …}

Calmodulin Hvcam1 Negatively Regulates Salt Tolerance Via Modulation Of Hvhkt1s And Hvcamta4, Qiufang Shen, Liangbo Fu, Tingting Su, Lingzhen Ye, Lu Huang, Liuhui Kuang, Liyuan Wu, Dezhi Wu, Zhong-Hua Chen, Guoping Zhang

Publications

Calcium (Ca) signaling modulates sodium (Na) transport in plants; however, the role of the Ca sensor calmodulin (CaM) in salt tolerance is elusive. We previously identified a salt-responsive calmodulin (HvCaM1) in a proteome study of barley (Hordeum vulgare) roots. Here, we employed bioinformatic, physiological, molecular, and biochemical approaches to determine the role of HvCaM1 in barley salt tolerance. CaM1s are highly conserved in green plants and probably originated from ancestors of green algae of the Chlamydomonadales order. HvCaM1 was mainly expressed in roots and was significantly up-regulated in response to long-term salt stress. Localization analyses revealed that HvCaM1 is an …

The Relationship Between Cell-Free Dna And Resistance Training, Henry Lang

Electronic Theses and Dissertations

The primary purposes of this dissertation were to explore relationship between cell free DNA (cf-DNA), creatine kinase (CK), C-reactive protein (CRP), vertical jump testing delayed onset muscle soreness (DOMS) in response to a high-volume resistance training protocol, and to assess the sensitivity of cf-DNA to different resistance training volume loads. The secondary purpose was to examine the relationship between cf-DNA and relative strength. Study 1 was an exploratory attempt to discover relationships between cf-DNA, CK, CRP, delayed onset muscle soreness, and performance variables. Seventeen resistance trained males were recruited, 9 were randomly assigned to receive BCAAs while 8 received a …

The Long-Term Persistence And Tissue Tropism Of Brazilian Zika Virus In Monodelphis Domestica, Marisol Morales

Theses and Dissertations

Zika virus (ZIKV) rose as a major public health concern due to the congenital abnormalities of infants born to infected mothers during the 2015 Latin American outbreak. While animal models such as transgenic mice and nonhuman primates are used to study ZIKV pathogenesis, they display various limitations. Additionally, the persistence and tissue distribution of long-term ZIKV infection remains unknown. We describe the laboratory opossum, Monodelphis domestica, as a potential new model for ZIKV pathogenesis research to address these issues. We utilized immunohistochemistry, RT-PCR, and ELISA to show that: infant animals inoculated intracerebrally were susceptible to infection, ZIKV infection persisted …

Technical Standards For Bioinformatics And Medical Informatics, Jorge L. Contreras, Adrian Thorogood

Utah Law Faculty Scholarship

With a few exceptions, the biomedical industry, and the informatics field in particular, have not been affected by the standards litigation that has plagued the ICT sector. But with the increasing adoption of standards by informatics researchers and vendors, the issues faced by ICT standards groups will become increasingly relevant. This chapter summarizes general legal issues associated with standards development, then surveys standardization efforts in the informatics space and reviews the policies and procedures adopted by SDOs operating in the informatics area. It concludes with recommendations regarding prudent policy adoption by SDOs developing standards for informatics applications.

Postoperative Length Of Stay Following Enhanced Recovery After Surgery Protocol Implementation For Scheduled Cesarean Deliveries, Hannah Zimmerman, Emily L. Mcquaid-Hanson, Amanda Affleck, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Cesarean delivery is the most common major surgery worldwide. 1 In 2018, 1.2 million cesarean deliveries occurred in the United States, accounting for nearly 32% of all deliveries.2 Research has shown ERAS benefits include decreased length of stay, improved pain control, and improved patient satisfaction.2,3 Despite its use in numerous surgical specialties, ERAS implementation within obstetrics has been slow.2 The ERAS Society released a three-part guideline specific to cesarean deliveries in 2018 and 2019,4,5,6 yet few studies have assessed the impact of ERAS on cesarean postoperative outcomes.2 An improved perioperative course would be particularly beneficial for mothers undergoing cesarean …

Opioid Consumption After Scheduled Cesarean Delivery Following Implementation Of Enhanced Recovery After Surgery, Mindy Woodruff, Emily L. Mcquaid-Hanson, Amanda Affleck, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background With 47,600 opioid overdose related deaths in the U.S. in 2017, the opioid crisis is of national concern.1 Cesarean delivery is the most common surgery worldwide, with over 1.2 million in the U.S. in 2018 alone.2,3 As cesarean delivery is a highly prevalent surgery it has a large capacity to influence the opioid epidemic. Literature is showing that Enhanced Recovery after Surgery (ERAS) and multimodal analgesia are effective means of managing postoperative pain while minimizing opioid use.4,5,6,7,8 This project aims to help discover if introduction of ERAS, and more specifically it’s multimodal analgesia aspect, has helped decrease oral morphine …

Prophylactic Phenylephrine Infusion To Mitigate Intraoperative Hypotension After Spinal Anesthesia Among Orthopedic Patients, David Nelson, Braden Hemingway, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background

Intraoperative Hypotension (IOH) is common after spinal anesthesia (SA) and is associated with an increased risk of end organ damage.1 2 3 The treatment regimen for IOH after SA varies in the orthopedic population. However, the current research literature suggests that a prophylactic infusion of phenylephrine significantly reduces the number of episodes and duration of hypotension.1 This EBP project aims to report the proportion of patients receiving prophylactic phenylephrine infusions and the incidence of hypotension following SA among orthopedic surgery patients at Providence Sacred Heart Medical Center (PSHMC) in Spokane, WA.

Methods

• A retrospective, observational EBP project was …

Social Vulnerability And Hurricane Evacuation Behavior In Hampton Roads, Va: Emergency Management Stakeholders’ Perceptions Of Low-To-Moderate Income Households In A Social Construction Paradigm, Mechelle Bonit Smith

School of Public Service Theses & Dissertations

The purpose of this research is to examine current emergency management (EM) evacuation policies and practices with respect to vulnerable populations’ hurricane evacuation behaviors. The response of vulnerable households and local and state governments’ implementation of emergency evacuation policies and practices provide possible linkages to continual problems faced by local governments in addressing its most vulnerable residents. Using social construction as a theoretical foundation provides context for the consideration of vulnerable populations in emergency management policy and hurricane evacuation.

This research is a qualitative case study of emergency management policies, practices, and perceived household evacuation behaviors in several cities of …

Group Treatment Effectiveness For Substance Use Disorders: Abstinence Vs. Harm Reduction, Jill D. Parramore

Counseling & Human Services Theses & Dissertations

The purpose of this systematic review and meta-analysis was to compare group treatment effectiveness for substance use disorders within the U.S. across treatment philosophies as it relates to the primary research question, Is there a significant difference of group treatment effectiveness between Abstinence and Harm Reduction treatment philosophies? It was hypothesized that group treatment will remain an effective intervention to treat substance use disorders between treatment philosophies and that no significant differences exist between-group comparisons. The aim of this study is to provide evidence of treatment effectiveness that will ultimately improve treatment outcomes for substance use disorders, provide guidance for …