1,721,059 research outputs found
"Chasing the pain relief, not the high": Experiences managing pain after opioid reductions among patients with HIV and a history of substance use.
Get PDFBackgroundOpioid overdose mortality continues to increase in the United States despite significant investments to reverse the epidemic. The national response to-date has focused primarily on reducing opioid prescribing, yet reductions in prescribing have been associated with patients reporting uncontrolled pain, psychological distress, and transition to illicit substances. The aim of this study is to qualitatively explore chronic pain management experiences among PLWH with a history of illicit substance use after long-term opioid therapy reductions or discontinuations.MethodsWe analyzed 18 interviews, stopping upon reaching thematic saturation, with HIV-positive participants with a history of substance use who were enrolled in a longitudinal cohort study to assess the impact of prescribing changes among patients with chronic pain. Participants in this nested qualitative study had been reduced/discontinued from opioid pain relievers (OPRs) within the 12 months prior to interview. Interviews were audio-recorded and transcribed verbatim. Two analysts coded all interviews, interrater reliability was measured, and coding discrepancies discussed. The study took place in San Francisco, California in 2018.ResultsEleven participants were male with a mean age of 55; 8 were African American and 8 were White. All participants were HIV-positive, actively engaged in primary care, and had a lifetime history of illicit substance use. Twelve reported using illicit substances within the past year, including non-prescription opioids/heroin (10), and stimulant use (10). After being reduced/discontinued from their long-term opioid therapy, patients reported developing complex multimodal pain management systems that often included both nonpharmacological approaches and illicit substance use. Participants encountered a range of barriers to nonpharmacological therapies including issues related to accessibility and availability. Participants often reported attempts to replicate their prior OPR prescription by seeking out the same medication and dose from illicit sources and reported transitioning to heroin after exhausting other options.ConclusionAfter being reduced/discontinued from OPRs, HIV-positive patients with a history of substance use reported experimenting with a range of pain management modalities including nonpharmacological therapies and illicit substance use to manage symptoms of opioid withdrawal and pain. Providers should consider that any change to a patients' long-term opioid therapy may result in experimentation with pain management outside of the medical setting and may want to employ patient-centered, holistic approaches when managing patients' opioid prescriptions and chronic pain
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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Evaluating the Implementation of Drug Decriminalization in Tijuana Mexico: Police and Public Health
Get PDFThis research seeks to evaluate the impact of drug policy reform in Mexico within the larger Latin American context. Through theoretical and statistical analyses, I use the case study of the municipal Police Department in Tijuana to understand the implementation of Mexico’s 2009 “narcomenudeo” drug policy reform that decriminalized drug possession for personal consumption. Using internal unpublished police data, I demonstrate that the policy shift did not appear to impact the policing of drug arrests over the five years following the implementation of the reform. Police education efforts designed to improve officer understanding of the reform and its street-level implementation found low baseline knowledge of the decriminalization policy, shedding light into the mechanisms impeding its application. Training evaluation suggested that officers increased their legal knowledge, but that training uptake was shaped by level of educational attainment. Ultimately, these findings add to the emerging implementation science literature on the importance of structural interventions to better align public health-oriented drug policy reforms with their intended impact in Latin America and elsewhere
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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Drivers, Facilitators and Practices of Substance Use Disorder Stigma within the Criminal Legal System: A Mixed Methods Study
Get PDFPurpose: Substance use is prevalent in U.S. criminal legal system (CLS) cases, yet court-ordered treatments rarely recommend effective treatments such as medications for addiction treatment (MAT). The stressful work coupled with lack of preparation among CLS professionals to support various pathways to recovery is theorized to drive and facilitate high rates of burnout, leading to stigma towards defendants with substance use disorder (DWSUD). This study aims to enhance our understanding of the connection between CLS occupational stress, substance use disorder (SUD) stigma, and to evaluate the impact of a tailored training on attitudes and practices concerning DWSUD within the CLS. Methodology: Using a mixed methods approach, we collected primary data. Qualitative data explored possible drivers, facilitators, and practices of substance use-related stigma among CLS professionals. We utilized various national trainings to collect pre-post-training survey data. Pre-training data assessed the relationship of burnout and attitudes towards DWSUD. Pre-post-training data assessed changes in behavioral intentions to refer to MAT for SUD-related cases, intentions to engage in self-care for managing occupational stress, and attitudes toward DWSUD.
Findings: CLS professionals experience complex and intense occupational stress, leading to manifestations of emotional, mental, and physical symptoms; driving and facilitating SUD stigma. There was a significant relationship between 2 of the 3 occupational burnout dimensions and attitudes towards DWSUD. The adapted SHIELD training significantly improved attitudes and behavioral intentions related to SUD cases and promoting well-being behaviors among CLS professionals.
Implications: These results highlight the urgent need for targeted interventions that provide resources increasing efficacy regarding SUD-related cases and addressing the demanding and stress-inducing nature of CLS professionals' work, as occupational stress contributes to SUD stigma. The adapted SHIELD training demonstrates the positive impact intervention has on attitudes and behavioral intentions, ultimately promoting well-being within the CLS profession. By identifying the nuanced relationships between burnout dimensions and attitudes, as well as the impact of an adapted training intervention, the study contributes valuable insights into improving the well-being of CLS professionals and promoting fair treatment for individuals with SUD. The study's findings advocate for enhanced curriculum, intervention strategies, and more resources to create a more empathetic and effective legal environment
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
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