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Academic literature on the topic 'Substance Use Prioritization Workgroup'
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Journal articles on the topic "Substance Use Prioritization Workgroup"
1
Bukstein, Oscar. "Substance Use Disorders and ADHD." CNS Spectrums 14, S6 (July 2009): 10–12. http://dx.doi.org/10.1017/s1092852900024834.
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In examining the challenges in treating comorbid attention-deficit/hyperactivity disorder (ADHD) and substance use disorder (SUD), there are a number of issues regarding misinformation and misconception that exist for clinicians. Like other ADHD comorbidities, there is a lack of screening, particularly among adult clinical populations who have the psychiatric comorbidity or, for patients with SUDs, there is the issue of prioritization, which condition to treat first, and determining the place of medication management—particularly stimulant medication—paramount in treatment planning.
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Chelgren-Koterba, Pamela, Larry Iwamoto, Charlene Hutton, and Carl Lautenberger. "ALASKA INCIDENT MANAGEMENT SYSTEM (AIMS) GUIDE FOR OIL AND HAZARDOUS SUBSTANCE RESPONSE." International Oil Spill Conference Proceedings 2001, no. 2 (March 1, 2001): 1059–66. http://dx.doi.org/10.7901/2169-3358-2001-2-1059.
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ABSTRACT In January 2000, the ad hoc Alaska Statewide Oil and Hazardous Substance Incident Management System workgroup submitted standardized spill response management guidelines (Alaska Incident Management System, AIMS #1) to the Alaska Regional Response Team (ARRT) for their review, use, and feedback. These guidelines are a landmark step in response management systems because they merge the concepts of the National Contingency Plan (NCP#2) with NIIMS #3, received acceptance by both government and industry users in Alaska, have been customized to meet Alaska's unique needs, are consistent with the latest update being prepared by the States/British Columbia Task Force FOG #4 update workgroup, and will yield substantial savings to all users by providing guidelines for adoption and maintenance of a single system for the Alaska spill response community.
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Hopkins, Richard S., Michael Landen, and Megan Toe. "Development of Indicators for Public Health Surveillance of Substance Use and Mental Health." Public Health Reports 133, no. 5 (August 3, 2018): 523–31. http://dx.doi.org/10.1177/0033354918784913.
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Substance use and mental health disorders can result in disability, death, and economic cost. In the United States, rates of death from suicide, drug overdose, and chronic liver disease (a marker for alcohol abuse) have been rising for the past 15 years. Good public health surveillance for these disorders, their consequences, and their risk factors is crucially important for their prevention and control, but surveillance has not been conducted consistently in the states. In 2015, the Council of State and Territorial Epidemiologists convened a workgroup to develop a set of uniformly defined surveillance indicators that could be used by state and local health departments to monitor these disorders and to compare their occurrence in various jurisdictions. This report briefly describes the indicators and outlines the process used to develop them.
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Nolan, Karen, Andrew R. Zullo, Elliott Bosco, Christine Marchese, and Christine Berard-Collins. "Controlled substance diversion in health systems: A failure modes and effects analysis for prevention." American Journal of Health-System Pharmacy 76, no. 15 (July 18, 2019): 1158–64. http://dx.doi.org/10.1093/ajhp/zxz116.
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Abstract Purpose The purpose of this study was to demonstrate the utility of failure modes and effects analysis (FMEA) for systematically identifying potential sources of controlled substance diversion and developing solutions in an academic health system. Methods The FMEA was conducted by an 18-member cross-functional team from the department of pharmacy. The team developed scoring criteria specifically for controlled substance diversion, outlined the controlled substance processes from procurement to administration or disposal, and identified ways in which each step of the medication supply process might fail (failure modes) and result in diversion of controlled substances. Failure modes with a vulnerability score of 48 or 64 were considered highest risk and were immediately intervened on by the FMEA team. Results The FMEA outlined a total of 10 major steps and 30 substeps in the controlled substance supply process. From this, 103 potential failure modes were identified, with 24 modes (23%) receiving a vulnerability score of 48 or 64. Development of specific reports addressed 15 failure modes, while 9 involved pharmacy workflow alterations. Notable reports included controlled substance activity under temporary patients and discrepancy trends by user, medication, and patient care area. Notable workflow alterations included expanded use of cameras in high-risk areas and additional verification checks. Conclusion FMEA allowed for systematic identification of controlled substance diversion opportunities, prioritization by level of vulnerability, and the development of targeted strategies to reduce risk of diversion.
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Harper, Gary W., Jessica Crawford, Katherine Lewis, Caroline Rucah Mwochi, Gabriel Johnson, Cecil Okoth, Laura Jadwin-Cakmak, Daniel Peter Onyango, Manasi Kumar, and Bianca D. M. Wilson. "Mental Health Challenges and Needs among Sexual and Gender Minority People in Western Kenya." International Journal of Environmental Research and Public Health 18, no. 3 (February 1, 2021): 1311. http://dx.doi.org/10.3390/ijerph18031311.
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Background: Sexual and gender minority (SGM) people in Kenya face pervasive socio-cultural and structural discrimination. Persistent stress stemming from anti-SGM stigma and prejudice may place SGM individuals at increased risk for negative mental health outcomes. This study explored experiences with violence (intimate partner violence and SGM-based violence), mental health outcomes (psychological distress, PTSD symptoms, and depressive symptoms), alcohol and other substance use, and prioritization of community needs among SGM adults in Western Kenya. Methods: This study was conducted by members of a collaborative research partnership between a U.S. academic institution and a Kenyan LGBTQ civil society organization (CSO). A convenience sample of 527 SGM adults (92.7% ages 18–34) was recruited from community venues to complete a cross-sectional survey either on paper or through an online secure platform. Results: For comparative analytic purposes, three sexual orientation and gender identity (SOGI) groups were created: (1) cisgender sexual minority women (SMW; 24.9%), (2) cisgender sexual minority men (SMM; 63.8%), and (3) gender minority individuals (GMI; 11.4%). Overall, 11.7% of participants reported clinically significant levels of psychological distress, 53.2% reported clinically significant levels of post-traumatic stress disorder (PTSD) symptoms, and 26.1% reported clinically significant levels of depressive symptoms. No statistically significant differences in clinical levels of these mental health concerns were detected across SOGI groups. Overall, 76.2% of participants reported ever using alcohol, 45.6% home brew, 43.5% tobacco, 39.1% marijuana, and 27.7% miraa or khat. Statistically significant SOGI group differences on potentially problematic substance use revealed that GMI participants were less likely to use alcohol and tobacco daily; and SMM participants were more likely to use marijuana daily. Lifetime intimate partner violence (IPV) was reported by 42.5% of participants, and lifetime SGM-based violence (SGMV) was reported by 43.4%. GMI participants were more likely than other SOGI groups to have experienced both IPV and SGMV. Participants who experienced SGMV had significantly higher rates of clinically significant depressive and PTSD symptoms. Conclusions: Despite current resilience demonstrated by SGM adults in Kenya, there is an urgent need to develop and deliver culturally appropriate mental health services for this population. Given the pervasiveness of anti-SGM violence, services should be provided using trauma-informed principles, and be sensitive to the lived experiences of SGM adults in Kenya. Community and policy levels interventions are needed to decrease SGM-based stigma and violence, increase SGM visibility and acceptance, and create safe and affirming venues for mental health care. Political prioritization of SGM mental health is needed for sustainable change.
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Sinclair, Ryan G., Joan B. Rose, Syed A. Hashsham, Charles P. Gerba, and Charles N. Haas. "Criteria for Selection of Surrogates Used To Study the Fate and Control of Pathogens in the Environment." Applied and Environmental Microbiology 78, no. 6 (January 13, 2012): 1969–77. http://dx.doi.org/10.1128/aem.06582-11.
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ABSTRACTThis article defines the term surrogate as an organism, particle, or substance used to study the fate of a pathogen in a specific environment. Pathogenic organisms, nonpathogenic organisms, and innocuous particles have been used as surrogates for a variety of purposes, including studies on survival and transport as well as for method development and as “indicators” of certain conditions. This article develops a qualitative surrogate attribute prioritization process and allows investigators to select a surrogate by systematically detailing the experimental process and prioritizing attributes. The results are described through the use of case studies of various laboratories that have used this process. This article also discusses the history of surrogate and microbial indicator use and outlines the method by which surrogates can be used when conducting a quantitative microbial risk assessment. The ultimate goal of selecting a sufficiently representative surrogate is to improve public health through a health-based risk assessment framework. Under- or overestimating the resistance, inactivation, or movement may negatively impact risk assessments that, in turn, will impact health assessments and estimated safety levels. Reducing uncertainty in a risk assessment is one of the objectives of using surrogates and the ultimate motive for any experiment investigating potential exposure of a pathogen.
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Kokane, Arun, Abhijit Pakhare, Gopalkrishna Gururaj, Mathew Varghese, Vivek Benegal, Girish Rao, Banavaram Arvind, et al. "Mental Health Issues in Madhya Pradesh: Insights from National Mental Health Survey of India 2016." Healthcare 7, no. 2 (March 31, 2019): 53. http://dx.doi.org/10.3390/healthcare7020053.
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Background: About 14% of the global mental health burden is contributed by India. However, there exists a disparity in mental health patterns, utilization, and prioritization among various Indian states. The state of Madhya Pradesh is a low performer among Indian states, ranking lower than the national average on the Human Development Index, Hunger Index, and Gross Domestic Product (GDP). The state also performes poorly on other health-related indicators. Objectives of Study: To estimate the prevalence and patterns of mental illnesses in the state of Madhya Pradesh, India. Material and Methods: This study used the multistage, stratified, random cluster sampling technique, with selection probability proportionate to size at each stage. A total of 3240 individuals 18 years and older were interviewed. The mixed-method study that was employed had both quantitative and qualitative components. The Mini International Neuropsychiatric Interview along with 10 other instruments were used. Results: The overall weighted prevalence for any mental illness was 13.9%, with 16.7% over the lifetime. The treatment gap for all of the mental health problems is very high (91%), along with high suicidal risk and substance use in the state. Conclusions: This study provides evidence of the huge burden of mental, behavioral, and substance use disorders as well as the treatment gap in Madhya Pradesh. This information is crucial for developing an effective prevention and control strategy. The high treatment gap in the state calls for coordinated efforts from all stakeholders, including policy makers, political leaders, health care professionals, and the society at large to give mental health care its due priority. These findings also highlight the need for multi-pronged interventions rooted in health policy directed at reducing the treatment gap in the short term and disease burden in the long run.
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Siva, Shivi, Chung Sang Tse, Nayantara Coelho-Prabhu, and Rajeev Jain. "AMERICAN GASTROENTEROLOGICAL ASSOCIATION’S QUALITY LEADERSHIP COUNCIL’S PRACTICE WORK GROUP: A NATIONWIDE INITIATIVE TO REDUCE THE USE OF PRESCRIPTION OPIOID AMONG PATIENTS WITH INFLAMMATORY BOWEL DISEASE AT A LOCAL LEVEL." Inflammatory Bowel Diseases 27, Supplement_1 (January 1, 2021): S48. http://dx.doi.org/10.1093/ibd/izaa347.114.
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Abstract Background and aims The use of opioids among patients with inflammatory bowel disease (IBD) in the United States is increasing and it is associated with higher mortality, re-admissions, healthcare utilization, and disability. The American Gastroenterological Association’s (AGA) Quality Leadership Council’s practice workgroup developed educational materials to educate and modify narcotic prescribing habits of providers treating IBD and change the attitudes and expectations of patients who require analgesics. Methods Council members participated in two 1-hour virtual planning meetings to develop a key driver diagram to illustrate the aims, theories to achieve the aims, and specific action items to change ideas of opioid prescribing practices. Four working groups were created to perform a literature search and create educational resources for providers and patients regarding the risks of opioid use and non-opioid alternatives for pain management. The educational resources were reviewed by the Crohn’s and Colitis Foundation prior to online publication electronic and dissemination to the AGA membership. Results We developed a key driver diagram (Figure 1) to illustrate the components of promoting non-opioid pain management in patients with IBD. Educational materials were developed to 1) Delineate the risk factors for opioid abuse among patients with IBD to prescribers of a controlled substance including; Crohn’s disease, functional gastrointestinal disorders, anxiety, depression, female sex, a history of narcotic abuse, ≥2 previous surgeries, moderate to severe pain, clinical disease activity, sexual, emotional and physical abuse, 2) Recommend alternative therapies for opioids including medications and non-pharmacological treatment alternatives (Table 1), 3) Address salient key points that patients should discuss with their provider if an opioid is prescribed including complications associated with prolonged use of narcotic medications, and 4) Illustrate alternate medical therapy and other techniques for patients including yoga and mindfulness-based techniques, cognitive behavioral therapy, and medical hypnosis. Conclusions Using quality improvement methods, we developed educational materials for patients with IBD and providers treating IBD on opioid avoidance and non-opioid alternative therapy utilizing an evidence-based approach.
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Greg Miller, W., Gary L. Myers, Mary Lou Gantzer, Stephen E. Kahn, E. Ralf Schönbrunner, Linda M. Thienpont, David M. Bunk, et al. "Roadmap for Harmonization of Clinical Laboratory Measurement Procedures." Clinical Chemistry 57, no. 8 (August 1, 2011): 1108–17. http://dx.doi.org/10.1373/clinchem.2011.164012.
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Abstract Results between different clinical laboratory measurement procedures (CLMP) should be equivalent, within clinically meaningful limits, to enable optimal use of clinical guidelines for disease diagnosis and patient management. When laboratory test results are neither standardized nor harmonized, a different numeric result may be obtained for the same clinical sample. Unfortunately, some guidelines are based on test results from a specific laboratory measurement procedure without consideration of the possibility or likelihood of differences between various procedures. When this happens, aggregation of data from different clinical research investigations and development of appropriate clinical practice guidelines will be flawed. A lack of recognition that results are neither standardized nor harmonized may lead to erroneous clinical, financial, regulatory, or technical decisions. Standardization of CLMPs has been accomplished for several measurands for which primary (pure substance) reference materials exist and/or reference measurement procedures (RMPs) have been developed. However, the harmonization of clinical laboratory procedures for measurands that do not have RMPs has been problematic owing to inadequate definition of the measurand, inadequate analytical specificity for the measurand, inadequate attention to the commutability of reference materials, and lack of a systematic approach for harmonization. To address these problems, an infrastructure must be developed to enable a systematic approach for identification and prioritization of measurands to be harmonized on the basis of clinical importance and technical feasibility, and for management of the technical implementation of a harmonization process for a specific measurand.
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Giannitrapani, Karleen F., Soraya Fereydooni, Maria J. Silveira, Azin Azarfar, Peter A. Glassman, Amanda Midboe, Maria Zenoni, William C. Becker, and Karl A. Lorenz. "How Patients and Providers Weigh the Risks and Benefits of Long-Term Opioid Therapy for Cancer Pain." JCO Oncology Practice 17, no. 7 (July 2021): e1038-e1047. http://dx.doi.org/10.1200/op.20.00679.
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PURPOSE: To understand how patients and providers weigh the risks and benefits of long-term opioid therapy (LTOT) for cancer pain. METHODS: Researchers used VA approved audio-recording devices to record interviews. ATLAS t.i., a qualitative analysis software, was used for analysis of transcribed interview data. Participants included 20 Veteran patients and 20 interdisciplinary providers from primary care– and oncology-based practice settings. We conducted semistructured interviews and analyzed transcripts used thematic qualitative methods. Interviews explored factors that affect decision making about appropriateness of LTOT for cancer related pain. We saturated themes for providers and patients separately. RESULTS: Factors affecting patient decision-making included influence from various information sources, persuasion from trusted providers, and sometimes deferral of the decision to their provider. Relative prioritization of pain management as the focal patient concern varied with some patients describing comparatively more fear of chemotherapy than opioid analgesics, comparatively more knowledge of opioids in relation to other drugs;patients expressed a preference to spend the limited time they have with their oncologist discussing cancer treatment rather than opioid use. Factors affecting provider decision making included prognosis, patient goals, patient characteristics, and provider experience and biases. Providers differed in how they weigh the relative importance of alleviating pain or avoiding opioids in the face of treating patients with cancer and histories of substance abuse. CONCLUSION: Divergent perspectives on factors need to be considered when weighing risks and benefits. Policies and interventions should be designed to reduce variation in practice to promote equal access to adequate pain management. Improved shared decision-making initiatives will take advantage of patient decision-making factors and priorities.