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Addressing the opioid epidemic across the United States and in West Virginia
Get PDFIntroduction: The opioid crisis had a profound impact on public health across the United States and West Virginia, with overdose deaths reaching unprecedented levels by 2021. Traditional abstinence-only rehabilitation programs demonstrated limited success, largely due to high relapse rates and insufficient mental health support. These programs often overlooked the complex relationship between opioid addiction and co-occurring mental health disorders such as depression and anxiety, which are common among those with substance use disorders. In contrast, Medication-Assisted Treatment (MAT), when supplemented with behavioral therapies and antidepressant medications, has shown greater success in improving recovery outcomes and reducing relapse rates. This study examined relevant literature and incorporated expert interviews to evaluate how integrated treatment approaches improve recovery rates and reduce opioid relapse.
Purpose of the Study: The purpose of this study was to evaluate the effectiveness of combining Medication-Assisted Treatment (MAT) with behavioral therapy and antidepressants in improving recovery rates, reducing relapse, and enhancing mental health outcomes among individuals with opioid use disorder.
Methodology: This study utilized a literature review combined with a semi-structured expert interview. Three university databases—PubMed, ProQuest, and EBSCOhost—were searched, which identified 3,636 sources. After applying inclusion criteria focused on the opioid epidemic in the United States and West Virginia, 36 sources were selected, with 14 included in the results section. The literature review was supplemented by expert insights to provide a comprehensive evaluation of Medication-Assisted Treatment and mental health therapy in opioid addiction recovery.
Results: The research demonstrated that combining Medication-Assisted Treatment (MAT) with behavioral therapy substantially improved recovery outcomes compared to MAT alone or traditional abstinence programs. Patients receiving both MAT and therapy demonstrated higher quality of life, greater reductions in opioid use, and better mental health outcomes, including decreased depression and anxiety symptoms. Treatment retention rates and recovery success were significantly higher in programs incorporating therapy, while abstinence-only approaches resulted in higher relapse rates.
Discussion/Conclusion: The findings demonstrated that combining Medication-Assisted Treatment (MAT) with behavioral therapy and antidepressants was associated with improved recovery rates, reduced relapse, and better mental health outcomes. However, outcomes varied depending on treatment duration and specific therapy components. Further research is needed to assess the long-term effectiveness of integrated treatment approaches as patient needs and healthcare practices continue to evolve
Systemic challenges in pediatric healthcare: exploring reimbursement disparities and their impact on healthcare equity
Get PDFIntroduction: Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP) have provided health coverage for over 135 million Americans, with Medicaid playing a significant role in financing pediatric healthcare. Medicaid covers a wide range of services for children, particularly those from low-income families or with special healthcare needs, including preventive care, immunizations, vision and dental services, and mental health treatments. However, Medicaid reimbursement rates are lower compared to Medicare and private insurance, in some cases 30.6% lower, and have often been insufficient to cover the full cost of care, contributing to financial losses for children\u27s hospitals. Despite these challenges, nearly 50% of children in the U.S. rely on Medicaid and CHIP for healthcare coverage, making adequate reimbursement rates essential for the viability of pediatric practices and children’s hospitals.
Purpose of the Study: The purpose of this research was to evaluate how lower Medicaid reimbursement rates for pediatric care, compared to adult Medicaid reimbursement and commercial payer rates, have affected pediatric healthcare delivery. Specifically, the study examined the impact on access to care, utilization of pediatric specialty services, health outcomes and sustainability of the pediatric workforce.
Methodology: This study used a qualitative literature review and semi-structured interview to test the hypothesis, utilizing databases such as PubMed, ProQuest, and Google Scholar, as well as the Google search engine. The research was limited to the English language and published between the years 2015-2025.
Results: Pediatric provider availability, inpatient units, and beds have declined, with a 13% drop in providers from 2022–2023 and a 19.1% decrease in units from 2008–2018. Four in ten children on Medicaid/CHIP faced access barriers like transportation, and those living over 90 minutes from referral centers were more likely to be treated by adult-trained subspecialists. The percentage of uninsured children who did not have a usual source of health care increased from 13% in 2020 to 21% in 2021. Pediatric lab services lack age-specific technologies and rely on adult testing standards, resulting in inaccurate results and suboptimal care. Broader pediatric research also lags, with only 12% of trials addressing high-burden pediatric conditions and less industry funding, leading to off-label drug use in up to 80% of hospitalized children. Pediatricians earn 25% less than adult physicians—about $1.2 million less over a career—with Medicaid’s lower reimbursement rates contributing to burnout, reduced participation. Declining interest in pediatric careers resulted in only 48% of pediatric residency positions filled in 2024 and nearly 30% of programs going unmatched.
Discussion/Conclusion: This study highlights the critical role that Medicaid reimbursement plays in shaping pediatric healthcare delivery. The findings suggest that lower reimbursement rates for pediatric services contribute to reduced access and utilization of pediatric specialty services, and diminished workforce sustainability. Addressing these disparities through policy reform is essential for ensuring the long-term viability of pediatric care and improving health outcomes for children
A rare case of parasomnia associated with Micronized Progesterone Therapy
Get PDFMicronized progesterone is commonly prescribed to manage hormonal imbalances and gynecological conditions, such as endometriosis. While its sedative effects are well-documented, the occurrence of parasomnias as an adverse effect is rare. This case documents a 48-year-old woman who developed complex parasomnia behaviors shortly after initiating micronized progesterone therapy. The symptoms resolved upon discontinuing the medication, suggesting a probable causal relationship. This case highlights the need for clinicians to be aware of potential sleep-related side effects associated with progesterone therapy
Participant 008: Reiki Practitioner with 20 years of experience (Mixed Race; Female; England, United Kingdom)
Get PDFThis is an interview about Reiki and its connection with overall well-being with a Reiki Practitioner holding 20 years of Reiki experience (Mixed Race; Female; England, United Kingdom). She was interviewed on May 7, 2025. The participant agreed to the terms outlined in the verbal informed consent form before this interview. Some of the broad conversations within this interview include the multiple modalities used alongside Reiki as tools for healing; the different types of Reiki and how one isn\u27t any better than another; how she uses Reiki to help Black and other marginalized communities; and how she experiences God/energy in everything. Lindsey Harper was the interviewer and the primary investigator for this project. Please download this document to read the full de-identified interview.https://mds.marshall.edu/reikiconversations/1009/thumbnail.jp
Participant 013: Reiki Master with five years of experience (Black; Female; Peru)
Get PDFThis is an interview about Reiki and its connection with overall well-being with a Reiki Master holding five years of experience (Black; Female; Peru). She was interviewed on May 27, 2025. The participant agreed to the terms outlined in the verbal informed consent form before this interview. Some of the broad conversations during this interview were about her family members\u27 experience with Black Magic; her own experiences staying with her grandmother when she was younger; her daily self-Reiki practice as a meditation and with everyday items like food and travels; the problematic use of the word Master with Reiki; and accounts of her lived experiences as a Black woman existing in predominantly white spaces. Lindsey Harper was the interviewer and the primary investigator for this project. Please download this document to read the full de-identified interview.https://mds.marshall.edu/reikiconversations/1014/thumbnail.jp
Honors College Policy Handbook, v. 11-2025
Get PDFThis handbook offers basic information about the policies and practices of the Honors College at Marshall University. The information here is subject to periodic revision. Because all students in the Honors College are students of the University, the Honors College operates under policies and guidelines as set for all undergraduate students at Marshall University.https://mds.marshall.edu/honorspublications/1000/thumbnail.jp
Cancer of Unknown Primary With Squamous Cell Carcinoma Phenotype Presenting as Isolated Axillary Mass
Get PDFCancer of unknown primary (CUP) is a rare metastatic malignancy where no primary tumor can be found. We report the case of a 71-year-old female with a strong family history of breast cancer presenting with isolated axillary lymphadenopathy after a tick bite. A biopsy of the axillary mass revealed poorly differentiated squamous cell carcinoma and after extensive evaluation, she was diagnosed with metastatic squamous cell carcinoma with unknown primary tumor. We present this case because of the role of confounding history complicating her initial diagnosis and bringing awareness to a rare disease
Organizational Predictors of Trauma-Informed Practices in Comprehensive School Counseling Programs
Get PDFIn the present study, we examined several variables related to school counselors working with students who experienced traumas. We studied the prevalence of traumas reported by students and by school characteristics, school counselors’ trainings on trauma-informed practices, and the relationships between organizational predictors and school counselors’ perceived trauma-informed practices in their schools. Participants were 278 practicing school counselors. Highlights of the various findings included: school counselors, on average, worked with students who reported 11 types of traumas, several trauma types were more- or less-often reported by students based upon the organizational variables of school district type and grade levels, and the majority (84.5%) of the sample received at least one trauma-informed training since graduate school. Perceived trauma-informed practices of school counselors in their schools were measured using the Trauma-Informed Practice Scales – School Counseling Programs. Of the organizational variables studied (Title 1 schools, district type, grade level, school counselor-to-student ratios, and implementation of comprehensive school counseling programs), the multiple linear regression analysis revealed a statistically significant and positive relationship between increased implementation of comprehensive school counseling programs and increased perceived trauma-informed practices, which was a medium effect size. Implications for the school counseling profession are discussed
