Pub Date : 2024-10-04DOI: 10.1080/00952990.2024.2394487
Kody Hafen, Harlan Wallace, Kayla Fritz, Cole Fordham, Tyler Haskell, A Taylor Kelley, Audrey L Jones, Gerald Cochran, Adam J Gordon
Background: Rural and frontier communities face high rates of opioid use disorders (OUDs). In 2021, the Rural Addiction Implementation Network (RAIN) sought to establish a rural hospital/clinic-system practice-based research network (RH-PBRN) to facilitate implementation of evidence-based addiction-related prevention, treatment, and recovery (PTR) services to reduce the morbidity of OUD and substance use disorder (SUD) in rural communities.Objective: To describe the goals and implementation of PTR activities of RAIN, a novel RH-PBRN.Methods: RAIN identified teams of external/internal facilitators at four rural hospitals/clinic-networks to achieve at least 15 PTR activities involving OUD and other SUDs. RAIN utilized an implementation-facilitation approach: facilitators assessed the implementation environment and promoted interventions to overcome barriers to PTR implementation. Other interventions included site visits, community of learning calls, and e-communication. RAIN assessed and recorded facilitators and barriers to implementation, milestone attainment, and outcomes of PTR activities. At 18 months, we queried facilitators about the fidelity and implementation of RAIN activities.Results: RAIN established an HP-PBRN in four sites (Idaho, Montana, Utah, and Wyoming). Within the HP-PBRN, 20 PTR activities were established (p = 7, T = 10, R = 3; range 3-7 per site). Barriers to implementation of PTR activities included competing clinical demands, especially due to COVID-19, lack of dedicated effort for staff at sites, and stigma of addiction and its treatment. Facilitators of implementation included the use of trained expert facilitators and communication between the sites.Conclusions: RAIN implemented 20 addiction-related PTR activities in four rural hospitals/clinic-networks. RAIN's intervention model could be replicated to address addiction-related harms in other rural communities.
{"title":"A novel rural hospital/clinic-system practice-based research network: the Rural Addiction Implementation Network (RAIN) initiative and its goals, implementation, and early results.","authors":"Kody Hafen, Harlan Wallace, Kayla Fritz, Cole Fordham, Tyler Haskell, A Taylor Kelley, Audrey L Jones, Gerald Cochran, Adam J Gordon","doi":"10.1080/00952990.2024.2394487","DOIUrl":"10.1080/00952990.2024.2394487","url":null,"abstract":"<p><p><i>Background:</i> Rural and frontier communities face high rates of opioid use disorders (OUDs). In 2021, the Rural Addiction Implementation Network (RAIN) sought to establish a rural hospital/clinic-system practice-based research network (RH-PBRN) to facilitate implementation of evidence-based addiction-related prevention, treatment, and recovery (PTR) services to reduce the morbidity of OUD and substance use disorder (SUD) in rural communities.<i>Objective:</i> To describe the goals and implementation of PTR activities of RAIN, a novel RH-PBRN.<i>Methods:</i> RAIN identified teams of external/internal facilitators at four rural hospitals/clinic-networks to achieve at least 15 PTR activities involving OUD and other SUDs. RAIN utilized an implementation-facilitation approach: facilitators assessed the implementation environment and promoted interventions to overcome barriers to PTR implementation. Other interventions included site visits, community of learning calls, and e-communication. RAIN assessed and recorded facilitators and barriers to implementation, milestone attainment, and outcomes of PTR activities. At 18 months, we queried facilitators about the fidelity and implementation of RAIN activities.<i>Results:</i> RAIN established an HP-PBRN in four sites (Idaho, Montana, Utah, and Wyoming). Within the HP-PBRN, 20 PTR activities were established (<i>p</i> = 7, <i>T</i> = 10, <i>R</i> = 3; range 3-7 per site). Barriers to implementation of PTR activities included competing clinical demands, especially due to COVID-19, lack of dedicated effort for staff at sites, and stigma of addiction and its treatment. Facilitators of implementation included the use of trained expert facilitators and communication between the sites.<i>Conclusions:</i> RAIN implemented 20 addiction-related PTR activities in four rural hospitals/clinic-networks. RAIN's intervention model could be replicated to address addiction-related harms in other rural communities.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Although nitrous oxide (N₂O) is increasingly misused recreationally, its use and risks among medical students who have professional access to it are rarely explored.Objectives: To investigate the recreational use of N₂O among medical students in Paris Region (France).Methods: This cross-sectional study used an online questionnaire distributed in 2022 through social networks, to all medical students (undergraduate student from the 2nd year of medical studies to residents until the end of the residency) from the six medical universities in Paris Region. We collected demographic characteristics, patterns of N₂O consumption, co-consumptions, and N₂O training (academic course or self-training). Factors associated with N₂O consumption and complications were analyzed using multivariable logistic regressions.Results: The questionnaires of 444 students (mean age: 25.9 years (SD = 2.69), 75.5% female, and 63.74% residents) were analyzed. Recreational N₂O consumption was reported by 71.85% of students and 20.50% consumed at least monthly. N₂O consumption was associated with being a resident (versus undergraduate student) (adjusted OR (aOR) = 3.07[1.45-6.72]; p < .01), receiving training on N₂O (aOR) = 3.13[1.84-6.24]; p < .01), and consumption of cannabis (aOR = 18.21[3.47-104.26]; p < .01), ecstasy (aOR = NA, p = .048) and poppers (aOR = 13.9[2.64-77.94]; p < .01). Complications (mainly dizziness, paresthesia and burns) were reported in 8.15% of students consuming N₂O. They were associated with consuming more than 10 balloons per intake (aOR = 6.04[1.32-25.00); p < .01) and inversely associated with receiving training (aOR = 0.35[0.14-0.86]; p = .01).Conclusions: Almost three-quarters of medical students experienced recreational N₂O consumption, particularly with poly-drug use. Given that complications were associated with high consumption and lack of education, risk training and screening for N₂O consumption could be beneficial.
背景:尽管一氧化二氮(N₂O)被越来越多地滥用于娱乐,但却很少有人探讨专业医学生使用一氧化二氮的情况及其风险:调查法国巴黎大区医科学生娱乐性使用一氧化二氮的情况:这项横断面研究于 2022 年通过社交网络向巴黎大区六所医科大学的所有医学生(从医学专业二年级的本科生到住院医师,直至住院医师培训结束)发放了一份在线调查问卷。我们收集了人口特征、N₂O 消费模式、共同消费和 N₂O 培训(学术课程或自我培训)。使用多变量逻辑回归分析了与 N₂O 消费和并发症相关的因素:对 444 名学生(平均年龄:25.9 岁(SD = 2.69),75.5% 为女性,63.74% 为居民)的问卷进行了分析。71.85%的学生报告了娱乐性消费 N₂O,20.50%的学生至少每月消费一次。N₂O 消费与住院医师(相对于本科生)(调整 OR (aOR) = 3.07[1.45-6.72]; p p p = .048)和 poppers(aOR = 13.9[2.64-77.94]; p p p = .01)有关:结论:近四分之三的医科学生有娱乐性消费 N₂O的经历,尤其是使用多种药物。鉴于并发症与高消耗量和缺乏教育有关,风险培训和N₂O消耗筛查可能是有益的。
{"title":"High lifetime prevalence of regular nitrous oxide use in French medical students.","authors":"Mathilde Thevenin, Alexandre Malmartel, Laurent Karila, Mathilde Camus Jacqmin","doi":"10.1080/00952990.2024.2392566","DOIUrl":"https://doi.org/10.1080/00952990.2024.2392566","url":null,"abstract":"<p><p><i>Background:</i> Although nitrous oxide (N₂O) is increasingly misused recreationally, its use and risks among medical students who have professional access to it are rarely explored.<i>Objectives:</i> To investigate the recreational use of N₂O among medical students in Paris Region (France).<i>Methods:</i> This cross-sectional study used an online questionnaire distributed in 2022 through social networks, to all medical students (undergraduate student from the 2nd year of medical studies to residents until the end of the residency) from the six medical universities in Paris Region. We collected demographic characteristics, patterns of N₂O consumption, co-consumptions, and N₂O training (academic course or self-training). Factors associated with N₂O consumption and complications were analyzed using multivariable logistic regressions.<i>Results:</i> The questionnaires of 444 students (mean age: 25.9 years (SD = 2.69), 75.5% female, and 63.74% residents) were analyzed. Recreational N₂O consumption was reported by 71.85% of students and 20.50% consumed at least monthly. N₂O consumption was associated with being a resident (versus undergraduate student) (adjusted OR (aOR) = 3.07[1.45-6.72]; <i>p</i> < .01), receiving training on N₂O (aOR) = 3.13[1.84-6.24]; <i>p</i> < .01), and consumption of cannabis (aOR = 18.21[3.47-104.26]; <i>p</i> < .01), ecstasy (aOR = NA, <i>p</i> = .048) and poppers (aOR = 13.9[2.64-77.94]; <i>p</i> < .01). Complications (mainly dizziness, paresthesia and burns) were reported in 8.15% of students consuming N₂O. They were associated with consuming more than 10 balloons per intake (aOR = 6.04[1.32-25.00); <i>p</i> < .01) and inversely associated with receiving training (aOR = 0.35[0.14-0.86]; <i>p</i> = .01).<i>Conclusions:</i> Almost three-quarters of medical students experienced recreational N₂O consumption, particularly with poly-drug use. Given that complications were associated with high consumption and lack of education, risk training and screening for N₂O consumption could be beneficial.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142330585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-25DOI: 10.1080/00952990.2024.2402569
Zhitao Chen, Chenchen Ding, Kailei Chen, Chicheng Lu, Qiyong Li
Background: Alcoholic liver disease (ALD) significantly contributes to global morbidity and mortality. The role of inflammatory cytokines in alcohol-induced liver injury is pivotal yet not fully elucidated.Objectives: To establish a causal link between inflammatory cytokines and ALD using a Mendelian Randomization (MR) framework.Methods: This MR study utilized genome-wide significant variants as instrumental variables (IVs) for assessing the relationship between inflammatory cytokines and ALD risk, focusing on individuals of European descent. The approach was supported by comprehensive sensitivity analyses and augmented by bioinformatics tools including differential gene expression, protein-protein interactions (PPI), Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis, and analysis of immune cell infiltration.Results: Our findings reveal that increased levels of stem cell growth factor beta (SCGF-β, beta = 0.141, p = .032) and interleukin-7 (IL-7, beta = 0.311, p = .002) are associated with heightened ALD risk, whereas higher levels of macrophage inflammatory protein-1α (MIP-1α, beta = -0.396, p = .004) and basic fibroblast growth factor (bFGF, beta = -0.628, p = .008) are linked to reduced risk. The sensitivity analyses support these robust causal relationships. Bioinformatics analyses around inflammatory cytokine-associated SNP loci suggest multiple pathways through which cytokines influence ALD.Conclusion: The genetic evidence from this study convincingly demonstrates that certain inflammatory cytokines play directional roles in ALD pathogenesis. These findings provide insights into the complex biological pathways involved and underscore the potential for developing targeted therapies that modulate these inflammatory responses, ultimately improving clinical outcomes for ALD patients.
背景:酒精性肝病(ALD)是导致全球发病率和死亡率的重要原因。炎性细胞因子在酒精诱导的肝损伤中的作用至关重要,但尚未完全阐明:利用孟德尔随机化(MR)框架建立炎性细胞因子与 ALD 之间的因果联系:这项MR研究利用全基因组重大变异作为工具变量(IV),评估炎性细胞因子与ALD风险之间的关系,重点关注欧洲后裔。该方法得到了综合敏感性分析的支持,并得到了生物信息学工具的辅助,包括差异基因表达、蛋白质-蛋白质相互作用(PPI)、基因本体(GO)、京都基因和基因组百科全书(KEGG)富集分析以及免疫细胞浸润分析:我们的研究结果表明,干细胞生长因子β(SCGF-β,β=0.141,p=0.032)和白细胞介素-7(IL-7,β=0.311,p=0.002)水平升高与ALD风险升高有关,而巨噬细胞炎症蛋白-1α(MIP-1α,β=-0.396,p=0.004)和碱性成纤维细胞生长因子(bFGF,β=-0.628,p=0.008)水平升高与风险降低有关。敏感性分析支持这些稳健的因果关系。围绕炎性细胞因子相关 SNP 位点的生物信息学分析表明,细胞因子通过多种途径影响 ALD:本研究的遗传学证据令人信服地表明,某些炎性细胞因子在 ALD 发病机制中起着定向作用。这些发现深入揭示了所涉及的复杂生物通路,并强调了开发调节这些炎症反应的靶向疗法的潜力,从而最终改善 ALD 患者的临床预后。
{"title":"Exploring the impact of inflammatory cytokines on alcoholic liver disease: a Mendelian randomization study with bioinformatics insights into potential biological mechanisms.","authors":"Zhitao Chen, Chenchen Ding, Kailei Chen, Chicheng Lu, Qiyong Li","doi":"10.1080/00952990.2024.2402569","DOIUrl":"https://doi.org/10.1080/00952990.2024.2402569","url":null,"abstract":"<p><p><i>Background:</i> Alcoholic liver disease (ALD) significantly contributes to global morbidity and mortality. The role of inflammatory cytokines in alcohol-induced liver injury is pivotal yet not fully elucidated.<i>Objectives:</i> To establish a causal link between inflammatory cytokines and ALD using a Mendelian Randomization (MR) framework.<i>Methods:</i> This MR study utilized genome-wide significant variants as instrumental variables (IVs) for assessing the relationship between inflammatory cytokines and ALD risk, focusing on individuals of European descent. The approach was supported by comprehensive sensitivity analyses and augmented by bioinformatics tools including differential gene expression, protein-protein interactions (PPI), Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis, and analysis of immune cell infiltration.<i>Results:</i> Our findings reveal that increased levels of stem cell growth factor beta (SCGF-β, beta = 0.141, <i>p</i> = .032) and interleukin-7 (IL-7, beta = 0.311, <i>p</i> = .002) are associated with heightened ALD risk, whereas higher levels of macrophage inflammatory protein-1α (MIP-1α, beta = -0.396, <i>p</i> = .004) and basic fibroblast growth factor (bFGF, beta = -0.628, <i>p</i> = .008) are linked to reduced risk. The sensitivity analyses support these robust causal relationships. Bioinformatics analyses around inflammatory cytokine-associated SNP loci suggest multiple pathways through which cytokines influence ALD.<i>Conclusion:</i> The genetic evidence from this study convincingly demonstrates that certain inflammatory cytokines play directional roles in ALD pathogenesis. These findings provide insights into the complex biological pathways involved and underscore the potential for developing targeted therapies that modulate these inflammatory responses, ultimately improving clinical outcomes for ALD patients.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142330584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-22DOI: 10.1080/00952990.2024.2386536
Cassidy Joyce, Alice R Richman, Melissa J Cox, Donald W Helme, J Todd Jackson, Mahdi Sesay, Kathleen L Egan
Background: Medication disposal programs have been promoted as one solution to the opioid crisis, but uptake by community members has been minimal.Objectives: To clarify perceptions of medication disposal options among people who have been prescribed an opioid analgesic in North Carolina to inform interventions that can facilitate the disposal of unused opioids.Methods: In 2022, we conducted focus groups with participants who received an opioid medication in the past year to gain information to develop an intervention related to the disposal of unused opioid medication (12 focus group discussions (FGDs); total N = 37; 30 identified as female, 6 as male, and 1 as another gender). Participants were shown a slide with the Food and Drug Administration's recommended disposal options and asked about their perceptions of each option. Themes were derived using an inductive, thematic, qualitative approach.Results: Seven themes about perceptions of medication disposal programs emerged from the data. Four of the themes reflect potential barriers to medication disposal: failed disposal attempts, lack of sufficient education on proper disposal, unclear meaning of specific disposal language, and concerns about existing disposal options. Three of the themes provide insight on potential facilitators of medication disposal: preference of low-cost disposal options, ease and accessibility among disposal methods, and preferred disposal methods.Conclusion: Patients should be provided clear and consistent guidance from prescribers and dispensing pharmacists on when and how to dispose of unused medications and opportunities to dispose of medications at no cost to the patient.
{"title":"Perceptions of disposal options for unused opioid analgesics among people who have been prescribed an opioid analgesic in North Carolina.","authors":"Cassidy Joyce, Alice R Richman, Melissa J Cox, Donald W Helme, J Todd Jackson, Mahdi Sesay, Kathleen L Egan","doi":"10.1080/00952990.2024.2386536","DOIUrl":"https://doi.org/10.1080/00952990.2024.2386536","url":null,"abstract":"<p><p><i>Background:</i> Medication disposal programs have been promoted as one solution to the opioid crisis, but uptake by community members has been minimal.<i>Objectives:</i> To clarify perceptions of medication disposal options among people who have been prescribed an opioid analgesic in North Carolina to inform interventions that can facilitate the disposal of unused opioids.<i>Methods:</i> In 2022, we conducted focus groups with participants who received an opioid medication in the past year to gain information to develop an intervention related to the disposal of unused opioid medication (12 focus group discussions (FGDs); total <i>N</i> = 37; 30 identified as female, 6 as male, and 1 as another gender). Participants were shown a slide with the Food and Drug Administration's recommended disposal options and asked about their perceptions of each option. Themes were derived using an inductive, thematic, qualitative approach.<i>Results:</i> Seven themes about perceptions of medication disposal programs emerged from the data. Four of the themes reflect potential barriers to medication disposal: failed disposal attempts, lack of sufficient education on proper disposal, unclear meaning of specific disposal language, and concerns about existing disposal options. Three of the themes provide insight on potential facilitators of medication disposal: preference of low-cost disposal options, ease and accessibility among disposal methods, and preferred disposal methods.<i>Conclusion:</i> Patients should be provided clear and consistent guidance from prescribers and dispensing pharmacists on when and how to dispose of unused medications and opportunities to dispose of medications at no cost to the patient.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-22DOI: 10.1080/00952990.2024.2387725
David M Ledgerwood, Milena C Stott, Stacey Quesada, Marci Sontag, Rachel M Beck, Michael G McDonell, David Johnson, Dominick DePhilippis, Sherrie Donnelly, Bryan Hartzler, Tammera Nauts, Matthew D Novak, James A Peck, Carla J Rash
Background: Rural areas in the United States have been severely impacted by recent rises in substance use related mortality and psychosocial consequences. There is a dearth of treatment resources to address substance use disorder (SUD). Rural recovery houses (RRH) are important services that provide individuals with SUD with an environment where they can engage in recovery-oriented activities, but dropout rates are unacceptably high, and evidence-based interventions such as contingency management (CM) may reduce dropout and improve outcomes for RRH residents. In this paper, we describe the results of a national convening of experts that addressed important issues concerning the implementation of CM within the context of RRHs.Methods: Twelve experts (five female) in the areas of CM, RRH and rural health participated in a one-day facilitated meeting that used nominal group technique to identify expert consensus in three areas as they pertain to RRH: (a) facilitators and barriers to CM implementation, (b) elements necessary for successful program building based on group feedback, and (c) recommendations for future implementation of CM.Results: Several RRH- and system-level barriers and facilitators to implementing CM were identified by the panel, and these were categorized based on the level of importance for and ease of implementation. CM funding, staff and resident buy-in, set policies, education on CM, and consistent fidelity to CM procedures and tracking were identified as important requirements for implementing CM in RRH.Conclusions: We provide recommendations for the implementation of CM in RRH that may be useful in this context, as well as more broadly.
{"title":"Implementing contingency management into rural recovery housing: recommendations of a professional advisory expert panel.","authors":"David M Ledgerwood, Milena C Stott, Stacey Quesada, Marci Sontag, Rachel M Beck, Michael G McDonell, David Johnson, Dominick DePhilippis, Sherrie Donnelly, Bryan Hartzler, Tammera Nauts, Matthew D Novak, James A Peck, Carla J Rash","doi":"10.1080/00952990.2024.2387725","DOIUrl":"https://doi.org/10.1080/00952990.2024.2387725","url":null,"abstract":"<p><p><i>Background:</i> Rural areas in the United States have been severely impacted by recent rises in substance use related mortality and psychosocial consequences. There is a dearth of treatment resources to address substance use disorder (SUD). Rural recovery houses (RRH) are important services that provide individuals with SUD with an environment where they can engage in recovery-oriented activities, but dropout rates are unacceptably high, and evidence-based interventions such as contingency management (CM) may reduce dropout and improve outcomes for RRH residents. In this paper, we describe the results of a national convening of experts that addressed important issues concerning the implementation of CM within the context of RRHs.<i>Methods:</i> Twelve experts (five female) in the areas of CM, RRH and rural health participated in a one-day facilitated meeting that used nominal group technique to identify expert consensus in three areas as they pertain to RRH: (a) facilitators and barriers to CM implementation, (b) elements necessary for successful program building based on group feedback, and (c) recommendations for future implementation of CM.<i>Results:</i> Several RRH- and system-level barriers and facilitators to implementing CM were identified by the panel, and these were categorized based on the level of importance for and ease of implementation. CM funding, staff and resident buy-in, set policies, education on CM, and consistent fidelity to CM procedures and tracking were identified as important requirements for implementing CM in RRH.<i>Conclusions:</i> We provide recommendations for the implementation of CM in RRH that may be useful in this context, as well as more broadly.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-19DOI: 10.1080/00952990.2024.2377256
Bella M González-Ponce, Angelina Pilatti, Gabriela Rivarola Montejano, Adrian J Bravo, Fermín Fernández Calderón
Background: Longitudinal Measurement Invariance (LMI) is critically important to evaluate changes in alcohol expectancies over time. However, past research has not explored the longitudinal properties of the Spanish Expectancy Questionnaire Short Form (EQ-SF).Objectives: To examine the reliability, sources of validity (structural, invariance across sex, and concurrent validity), and LMI of the Spanish EQ-SF among young adults who engage in binge drinking.Methods: Participants (n = 279; 48.4% female) completed the EQ-SF and, two months later, completed it again along with measures of alcohol use, drinking motives, and protective behavioral strategies (PBS). We performed confirmatory factor analysis for structural validity and measurement invariance analysis for longitudinal and sex stability.Results: The eight-factor intercorrelated model (i.e. social facilitation, fun, sexual disinhibition, tension reduction, antisocial effects, negative emotional states, negative physical effects, and cognitive impairments) provided the best fit (χ2(df) = 497.29(224), CFI = .962, RMSEA = .064, SRMR = .049). This model was invariant across sex and time. Reliability coefficients (Ordinal alpha) for each dimension were consistently strong at both time points (from .72 to .93 at T1 and .73 to .91 at T2). Positive alcohol expectancies at baseline were positively related to alcohol use and drinking motives and negatively related to PBS at follow-up, demonstrating predictive validity.Conclusion: Our results support the temporal invariance of the EQ-SF scores among Spanish young adults who engage in binge drinking. The evidence supports the suitability of this measure for accurately assessing changes in alcohol expectancies over time in interventions aimed at preventing binge drinking in young adults.
{"title":"Psychometric properties and Longitudinal Measurement Invariance of the Spanish version of the Alcohol Expectancies Questionnaire Short Form among young adult binge drinkers.","authors":"Bella M González-Ponce, Angelina Pilatti, Gabriela Rivarola Montejano, Adrian J Bravo, Fermín Fernández Calderón","doi":"10.1080/00952990.2024.2377256","DOIUrl":"https://doi.org/10.1080/00952990.2024.2377256","url":null,"abstract":"<p><p><i>Background:</i> Longitudinal Measurement Invariance (LMI) is critically important to evaluate changes in alcohol expectancies over time. However, past research has not explored the longitudinal properties of the Spanish Expectancy Questionnaire Short Form (EQ-SF).<i>Objectives:</i> To examine the reliability, sources of validity (structural, invariance across sex, and concurrent validity), and LMI of the Spanish EQ-SF among young adults who engage in binge drinking.<i>Methods:</i> Participants (<i>n</i> = 279; 48.4% female) completed the EQ-SF and, two months later, completed it again along with measures of alcohol use, drinking motives, and protective behavioral strategies (PBS). We performed confirmatory factor analysis for structural validity and measurement invariance analysis for longitudinal and sex stability.<i>Results:</i> The eight-factor intercorrelated model (i.e. social facilitation, fun, sexual disinhibition, tension reduction, antisocial effects, negative emotional states, negative physical effects, and cognitive impairments) provided the best fit (<i>χ2</i>(df) = 497.29(224), <i>CFI</i> = .962, <i>RMSEA</i> = .064, <i>SRMR</i> = .049). This model was invariant across sex and time. Reliability coefficients (Ordinal alpha) for each dimension were consistently strong at both time points (from .72 to .93 at T1 and .73 to .91 at T2). Positive alcohol expectancies at baseline were positively related to alcohol use and drinking motives and negatively related to PBS at follow-up, demonstrating predictive validity.<i>Conclusion:</i> Our results support the temporal invariance of the EQ-SF scores among Spanish young adults who engage in binge drinking. The evidence supports the suitability of this measure for accurately assessing changes in alcohol expectancies over time in interventions aimed at preventing binge drinking in young adults.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-30DOI: 10.1080/00952990.2024.2370462
Zoe Lindenfeld, Jonathan H Cantor, Ji E Chang
Background: Little is known regarding the extent to which substance use disorder (SUD) treatment facilities adopt comprehensive services to meet patients' medical and social needs.Objective: To examine trends in the availability of comprehensive services within outpatient SUD treatment facilities from 2018 to 2022.Methods: We used data from the Mental Health and Addiction Treatment Tracking Repository, a national database of SUD treatment facilities (n = 13,793). We examined the availability of four domains of comprehensive services and four types of SUD treatment services from 2018 to 2022. We conducted bivariate and multivariate logistic regression predicting the availability of a comprehensive service model (defined as having at least one service from each service domain), controlling for organizational and community characteristics.Results: Comprehensive services were increasingly offered from 2018 to 2022. In unadjusted and adjusted models, facilities which were externally accredited (OR: 1.50; 95%CI: 1.30-1.74), accepted Medicaid (OR: 1.51; 95%CI: 1.30-1.74), performed community outreach (OR: 2.05; 95%CI: 1.80-2.33), provided naloxone and overdose education (OR: 3.50; 95%CI: 3.06-3.99), had a robust SUD treatment infrastructure (OR: 2.33; 95%CI; 2.08-2.62), and were located in a county with a lower percentage of White residents (OR: 0.99; 95%CI: 0.99-0.99), a higher percentage of residents in poverty (OR: 1.02; 95%CI: 1.00-1.03), and the Northeast compared with the South (OR: 1.21; 95%CI: 1.01-1.45), had significantly higher odds of adopting a comprehensive service model.Conclusion: Findings highlight the importance of factors reflecting experience with organizational change efforts and enhanced external support. Policymakers working to enhance the uptake of comprehensive services should focus on obtaining the financial and technical support necessary to develop these models.
背景:人们对药物使用障碍(SUD)治疗机构在多大程度上采用综合服务来满足患者的医疗和社会需求知之甚少:研究 2018 年至 2022 年期间门诊 SUD 治疗机构提供综合服务的趋势:我们使用了精神健康和成瘾治疗追踪库(Mental Health and Addiction Treatment Tracking Repository)中的数据,这是一个关于 SUD 治疗机构的全国性数据库(n = 13793)。我们考察了从 2018 年到 2022 年四个领域的综合服务和四种类型的 SUD 治疗服务的可用性。我们进行了双变量和多变量逻辑回归,预测综合服务模式(定义为每个服务领域至少有一项服务)的可用性,同时控制组织和社区特征:从 2018 年到 2022 年,提供的综合服务越来越多。在未调整和调整后的模型中,获得外部认证(OR:1.50;95%CI:1.30-1.74)、接受医疗补助(OR:1.51;95%CI:1.30-1.74)、开展社区外展(OR:2.05;95%CI:1.80-2.33)、提供纳洛酮和用药过量教育(OR:3.50;95%CI:3.06-3.99)、拥有强大的 SUD 治疗基础设施(OR:2.33;95%CI;2.结论:研究结果凸显了反映 SUD 治疗基础设施的重要因素,这些基础设施包括:白人居民比例较低(OR:0.99;95%CI:0.99-0.99);贫困居民比例较高(OR:1.02;95%CI:1.00-1.03);东北部与南部相比(OR:1.21;95%CI:1.01-1.45):研究结果凸显了反映组织变革工作经验和增强外部支持等因素的重要性。致力于提高综合服务普及率的政策制定者应将重点放在获得发展这些模式所需的资金和技术支持上。
{"title":"Trends in the availability of comprehensive services within outpatient substance use treatment facilities from 2018 to 2022.","authors":"Zoe Lindenfeld, Jonathan H Cantor, Ji E Chang","doi":"10.1080/00952990.2024.2370462","DOIUrl":"https://doi.org/10.1080/00952990.2024.2370462","url":null,"abstract":"<p><p><i>Background:</i> Little is known regarding the extent to which substance use disorder (SUD) treatment facilities adopt comprehensive services to meet patients' medical and social needs.<i>Objective:</i> To examine trends in the availability of comprehensive services within outpatient SUD treatment facilities from 2018 to 2022.<i>Methods:</i> We used data from the Mental Health and Addiction Treatment Tracking Repository, a national database of SUD treatment facilities (<i>n</i> = 13,793). We examined the availability of four domains of comprehensive services and four types of SUD treatment services from 2018 to 2022. We conducted bivariate and multivariate logistic regression predicting the availability of a comprehensive service model (defined as having at least one service from each service domain), controlling for organizational and community characteristics.<i>Results:</i> Comprehensive services were increasingly offered from 2018 to 2022. In unadjusted and adjusted models, facilities which were externally accredited (OR: 1.50; 95%CI: 1.30-1.74), accepted Medicaid (OR: 1.51; 95%CI: 1.30-1.74), performed community outreach (OR: 2.05; 95%CI: 1.80-2.33), provided naloxone and overdose education (OR: 3.50; 95%CI: 3.06-3.99), had a robust SUD treatment infrastructure (OR: 2.33; 95%CI; 2.08-2.62), and were located in a county with a lower percentage of White residents (OR: 0.99; 95%CI: 0.99-0.99), a higher percentage of residents in poverty (OR: 1.02; 95%CI: 1.00-1.03), and the Northeast compared with the South (OR: 1.21; 95%CI: 1.01-1.45), had significantly higher odds of adopting a comprehensive service model.<i>Conclusion:</i> Findings highlight the importance of factors reflecting experience with organizational change efforts and enhanced external support. Policymakers working to enhance the uptake of comprehensive services should focus on obtaining the financial and technical support necessary to develop these models.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-23DOI: 10.1080/00952990.2024.2380463
Jemar R Bather, Larry Han, Alex S Bennett, Luther Elliott, Melody S Goodman
Background: Innovative analytic approaches to drug studies are needed to understand better the co-use of opioids with non-opioids among people using illicit drugs. One approach is the Bayesian kernel machine regression (BKMR), widely applied in environmental epidemiology to study exposure mixtures but has received far less attention in substance use research.Objective: To describe the utility of the BKMR approach to study the effects of drug substance mixtures on health outcomes.Methods: We simulated data for 200 individuals. Using the Vale and Maurelli method, we simulated multivariate non-normal drug exposure data: xylazine (mean = 300 ng/mL, SD = 100 ng/mL), fentanyl (mean = 200 ng/mL, SD = 71 ng/mL), benzodiazepine (mean = 300 ng/mL, SD = 55 ng/mL), and nitazene (mean = 200 ng/mL, SD = 141 ng/mL) concentrations. We performed 10,000 MCMC sampling iterations with three Markov chains. Model diagnostics included trace plots, r-hat values, and effective sample sizes. We also provided visual relationships of the univariate and bivariate exposure-response and the overall mixture effect.Results: Higher levels of fentanyl and nitazene concentrations were associated with higher levels of the simulated health outcome, controlling for age. Trace plots, r-hat values, and effective sample size statistics demonstrated BKMR stability across multiple Markov chains.Conclusions: Our understanding of drug mixtures tends to be limited to studies of single-drug models. BKMR offers an innovative way to discern which substances pose a greater health risk than other substances and can be applied to assess univariate, bivariate, and cumulative drug effects on health outcomes.
{"title":"Detecting univariate, bivariate, and overall effects of drug mixtures using Bayesian kernel machine regression.","authors":"Jemar R Bather, Larry Han, Alex S Bennett, Luther Elliott, Melody S Goodman","doi":"10.1080/00952990.2024.2380463","DOIUrl":"https://doi.org/10.1080/00952990.2024.2380463","url":null,"abstract":"<p><p><i>Background:</i> Innovative analytic approaches to drug studies are needed to understand better the co-use of opioids with non-opioids among people using illicit drugs. One approach is the Bayesian kernel machine regression (BKMR), widely applied in environmental epidemiology to study exposure mixtures but has received far less attention in substance use research.<i>Objective:</i> To describe the utility of the BKMR approach to study the effects of drug substance mixtures on health outcomes.<i>Methods:</i> We simulated data for 200 individuals. Using the Vale and Maurelli method, we simulated multivariate non-normal drug exposure data: xylazine (mean = 300 ng/mL, SD = 100 ng/mL), fentanyl (mean = 200 ng/mL, SD = 71 ng/mL), benzodiazepine (mean = 300 ng/mL, SD = 55 ng/mL), and nitazene (mean = 200 ng/mL, SD = 141 ng/mL) concentrations. We performed 10,000 MCMC sampling iterations with three Markov chains. Model diagnostics included trace plots, r-hat values, and effective sample sizes. We also provided visual relationships of the univariate and bivariate exposure-response and the overall mixture effect.<i>Results:</i> Higher levels of fentanyl and nitazene concentrations were associated with higher levels of the simulated health outcome, controlling for age. Trace plots, r-hat values, and effective sample size statistics demonstrated BKMR stability across multiple Markov chains.<i>Conclusions:</i> Our understanding of drug mixtures tends to be limited to studies of single-drug models. BKMR offers an innovative way to discern which substances pose a greater health risk than other substances and can be applied to assess univariate, bivariate, and cumulative drug effects on health outcomes.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-18DOI: 10.1080/00952990.2024.2361442
Montserrat Olivares-Costa, María Carolina Fabio, Erwin De la Fuente-Ortega, Paola A Haeger, Ricardo Pautassi
Background: Ethanol consumption during pregnancy induces enduring detrimental effects in the offspring, manifesting as a spectrum of symptoms collectively termed as Fetal Alcohol Spectrum Disorders (FASD). Presently, there is a scarcity of treatments for FASD.Objectives: To analyze current literature, emphasizing evidence derived from preclinical models, that could potentially inform therapeutic interventions for FASD.Methods: A narrative review was conducted focusing on four prospective treatments: nutritional supplements, antioxidants, anti-inflammatory compounds and environmental enrichment. The review also highlights innovative therapeutic strategies applied during early (e.g. folate administration, postnatal days 4-9) or late (e.g. NOX2 inhibitors given after weaning) postnatal stages that resulted in significant improvements in behavioral responses during adolescence (a critical period marked by the emergence of mental health issues in humans).Results: Our findings underscore the value of treatments centered around nutritional supplementation or environmental enrichment, aimed at mitigating oxidative stress and inflammation, implying shared mechanisms in FASD pathogenesis. Moreover, the review spotlights emerging evidence pertaining to the involvement of novel molecular components with potential pharmacological targets (such as NOX2, MCP1/CCR2, PPARJ, and PDE1).Conclusions: Preclinical studies have identified oxidative imbalance and neuroinflammation as relevant pathological mechanisms induced by prenatal ethanol exposure. The relevance of these mechanisms, which exhibit positive feedback loop mechanisms, appear to peak during early development and decreases in adulthood. These findings provide a framework for the future development of therapeutic avenues in the development of specific clinical treatments for FASD.
{"title":"New therapeutics for the prevention or amelioration of fetal alcohol spectrum disorders: a narrative review of the preclinical literature.","authors":"Montserrat Olivares-Costa, María Carolina Fabio, Erwin De la Fuente-Ortega, Paola A Haeger, Ricardo Pautassi","doi":"10.1080/00952990.2024.2361442","DOIUrl":"https://doi.org/10.1080/00952990.2024.2361442","url":null,"abstract":"<p><p><i>Background:</i> Ethanol consumption during pregnancy induces enduring detrimental effects in the offspring, manifesting as a spectrum of symptoms collectively termed as Fetal Alcohol Spectrum Disorders (FASD). Presently, there is a scarcity of treatments for FASD.<i>Objectives:</i> To analyze current literature, emphasizing evidence derived from preclinical models, that could potentially inform therapeutic interventions for FASD.<i>Methods:</i> A narrative review was conducted focusing on four prospective treatments: nutritional supplements, antioxidants, anti-inflammatory compounds and environmental enrichment. The review also highlights innovative therapeutic strategies applied during early (e.g. folate administration, postnatal days 4-9) or late (e.g. NOX2 inhibitors given after weaning) postnatal stages that resulted in significant improvements in behavioral responses during adolescence (a critical period marked by the emergence of mental health issues in humans).<i>Results:</i> Our findings underscore the value of treatments centered around nutritional supplementation or environmental enrichment, aimed at mitigating oxidative stress and inflammation, implying shared mechanisms in FASD pathogenesis. Moreover, the review spotlights emerging evidence pertaining to the involvement of novel molecular components with potential pharmacological targets (such as NOX2, MCP1/CCR2, PPARJ, and PDE1).<i>Conclusions:</i> Preclinical studies have identified oxidative imbalance and neuroinflammation as relevant pathological mechanisms induced by prenatal ethanol exposure. The relevance of these mechanisms, which exhibit positive feedback loop mechanisms, appear to peak during early development and decreases in adulthood. These findings provide a framework for the future development of therapeutic avenues in the development of specific clinical treatments for FASD.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-03Epub Date: 2024-08-19DOI: 10.1080/00952990.2024.2377262
Zheng Fang, Xiefeng Zhan, Bichao Ye
Background: X-ray absorption spectroscopy (XAS) is a widely used substance analysis technique. It bases on the different absorption coefficients at different energy level to achieve material identification. Additionally, the combination of spectral technology and deep learning can achieve auto detection and high accuracy in material identification.Objectives: Current methods are difficult to identify drugs quickly and nondestructively. Therefore, we explore a novel approach utilizing XAS for the detection of prohibited drugs with common X-ray tube source and photon-counting (PC) detector.Method: To achieve automatic, rapid, and accurate detection of drugs. A CdTe detector and a common X-ray source were used to collect data, then dividing the data into training and testing sets. Finally, the improved transformer encoder model was used for classification. LSTM and ResU-net models are selected for comparation.Result: Fifty substances, which are isomers or compounds with similar molecular formulas of drugs, were selected for experiment substances. The results showed that the improved transformer model achieving 1.4 hours for training time and 96.73% for accuracy, which is better than the LSTM (2.6 hours and 65%) and ResU-net (1.5 hours and 92.7%).Conclusion: It can be concluded that the attention mechanism is more accurate for spectral material identification. XAS combined with deep learning can achieve efficient and accurate drug identification, offering promising application in clinical drug testing and drug enforcement.
背景:X 射线吸收光谱(XAS)是一种广泛应用的物质分析技术。它基于不同能级的不同吸收系数来实现物质识别。此外,光谱技术与深度学习相结合,可实现自动检测,实现物质识别的高准确性:目前的方法难以快速、无损地识别药物。因此,我们利用普通的 X 射线管源和光子计数(PC)探测器,探索一种利用 XAS 检测违禁药物的新方法:方法:实现自动、快速、准确地检测毒品。方法:为了实现自动、快速、准确地检测毒品,使用碲化镉探测器和普通 X 射线管源收集数据,然后将数据分为训练集和测试集。最后,使用改进的变压器编码器模型进行分类。结果:实验物质选取了 50 种物质,它们是药物的同分异构体或分子式相似的化合物。结果表明,改进后的变压器模型训练时间为 1.4 小时,准确率为 96.73%,优于 LSTM(2.6 小时和 65%)和 ResU-net(1.5 小时和 92.7%):可以得出结论,注意力机制在光谱材料识别方面的准确率更高。XAS与深度学习相结合,可以实现高效、准确的药物识别,在临床药物检测和禁毒执法中具有广阔的应用前景。
{"title":"X-ray absorption spectroscopy combined with deep learning for auto and rapid illicit drug detection.","authors":"Zheng Fang, Xiefeng Zhan, Bichao Ye","doi":"10.1080/00952990.2024.2377262","DOIUrl":"10.1080/00952990.2024.2377262","url":null,"abstract":"<p><p><i>Background:</i> X-ray absorption spectroscopy (XAS) is a widely used substance analysis technique. It bases on the different absorption coefficients at different energy level to achieve material identification. Additionally, the combination of spectral technology and deep learning can achieve auto detection and high accuracy in material identification.<i>Objectives:</i> Current methods are difficult to identify drugs quickly and nondestructively. Therefore, we explore a novel approach utilizing XAS for the detection of prohibited drugs with common X-ray tube source and photon-counting (PC) detector.<i>Method:</i> To achieve automatic, rapid, and accurate detection of drugs. A CdTe detector and a common X-ray source were used to collect data, then dividing the data into training and testing sets. Finally, the improved transformer encoder model was used for classification. LSTM and ResU-net models are selected for comparation.<i>Result:</i> Fifty substances, which are isomers or compounds with similar molecular formulas of drugs, were selected for experiment substances. The results showed that the improved transformer model achieving 1.4 hours for training time and 96.73% for accuracy, which is better than the LSTM (2.6 hours and 65%) and ResU-net (1.5 hours and 92.7%).<i>Conclusion:</i> It can be concluded that the attention mechanism is more accurate for spectral material identification. XAS combined with deep learning can achieve efficient and accurate drug identification, offering promising application in clinical drug testing and drug enforcement.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}