Implementing the Clinical Opiate Withdrawal Scale to Identify Acute Opiate Withdrawal: An Evidence-Based Practice Proposal

Opiate use disorder (OUD) has become an increasing problem causing undue strain on the emergency medical system (Carroll et al., 2023, American Psychiatric Association, 2013). Many members of the healthcare team cite difficulties working with this complex population, as substance abuse is often accompanied by other mental health diagnoses, and medical management is not widely taught in preparatory education but rather left to on-the-job training (Lindberg et al, 2022; Santo et al., 2022). Wang & Lee (2003) recognized this and developed a diagnostic tool meant to be administered by clinicians to assess acute opiate withdrawal: the Clinical Opiate Withdrawal Scale (COWS). This 11-point scale can be implemented into the electronic medical record to assess acute withdrawal symptoms, assign a severity based on the symptoms, and direct administration of medication to treat acute withdrawal (Williams et al., 2022)

Enhanced invertebrate activity-densities and weed seed predation in an integrated cropping system

Crop production with little to no tillage, permanent plant or residue soil cover, and diverse crop rotations are frequently mar- keted throughout the world as a way to sustainably produce crops. While these management techniques contribute a wide suite of ecosystems services to crop production systems, they typically come at the expense of increased reliance on herbicides for weed control, which is known to negatively impact ecosystems. This two-year study investigated three cropping systems (i.e., integrated, organic transition and no-till) to determine their effects on granivorous invertebrate activity-density, invertebrate weed seed predation and crop yield. A redundancy analysis (RDA) revealed significant effects of cropping system on inverte- brate community structure and associated seed predation rates. Specifically, species abundance and seed predation rates in the integrated treatment differed from those found in the organic and no-till systems (F = 6.97, p = 0.002). Secondarily, no-till sys- tems differed from organic systems (F = 3.09, p = 0.006). The analysis indicated that most invertebrate groups, and seed preda- tion rates for all weed species assessed, were more highly associated with the integrated system. Crop yields did not differ significantly between cropping systems (One-way ANOVAs, p\u3e0.05). This work shows that the application of an integrated crop management system results in an increase in beneficial invertebrate activity-densities and increases surface seed predation when compared to no-till and organic systems. These results suggest that integrated cropping systems can reduce herbicide application while effectively controlling weeds and thereby help to reduce the ecosystem impact of agricultural systems

Commentary: Is Wearable Fitness Technology a Medically Approved Device? Yes and No

Wearable technologies, i.e., activity trackers and fitness watches, are extremely popular and have been increasingly integrated into medical research and clinical practice. To assist in optimizing health, wellness, or medical care, these devices require collaboration between researchers, healthcare providers, and wearable technology companies in order to clarify their clinical capabilities and educate consumers on the utilities and limitations of the wide-ranging wearable devices. Interestingly, activity trackers and fitness watches often track both health/wellness and medical information within the same device. In this commentary, we will focus our discussions regarding wearable technology on (1) defining and explaining the technical differences between tracking health, wellness, and medical information; (2) providing examples of health and wellness compared to medical tracking; (3) describing the potential medical benefits of wearable technology and its applications in clinical populations; and (4) elucidating the potential risks of wearable technology. We conclude that while wearable devices are powerful and informative tools, further research is needed to improve its clinical applications

Ep. 70. In Local Hands

The New York Government Reorganization and Citizen Empowerment Act (the Empowerment Act) made it easier for New York State residents to initiate the dissolution or consolidation of village governments. On the latest episode of Policy Outsider, Rockefeller Institute Fellow and Daemen University Professor Lisa Parshall discusses her new book, In Local Hands, which examines the social, political, and narrative context surrounding municipal reorganization in the state, especially since the Empowerment Act went into effect in 2010. The conversation touches on questions explored in the book: why do village residents support or oppose dissolutions? How do residents initiate reorganizations? And how do dissolutions affect taxes and government services? Description from Rockefeller Institut

Directing the Whirlwind: Deconstruction, Distrust, and the Future of American Democracy

Donald J. Trump ran on a platform that, among other things, promised to drain the swamp that is Washington, DC. Part of that draining would entail what his chief strategist, Steve Bannon, would call the deconstruction of the administrative state. Set in the political environment of 2020, with a raging pandemic and nationwide protests, this work examines the philosophy that guides the Trump Administration’s approach and the mechanisms by which it seeks to accomplish the deconstruction. By combining journalistic accounts with presidential and public administration scholarship, the book raises questions about the impact of Trump’s approach on the future of public administration. As such, this work makes a strong contribution to public administration and presidential studies and casts a scholarly light on treatments of Trump’s contribution to governance and politics. This new edition brings the narrative up to date and speculates about the future of the administrative state and our democracy in the aftermath of January 6th under the new Biden Administration and future presidents

‘This woman who predominated in all things’ Alice Barber Stephens’s drawings of Dorothea in George Eliot’s Middlemarch, 1899

Alice Barber Stephens (1858–1932) was among the first to recognize Dorothea Brooke, the heroine of George Eliot’s Middlemarch (1872), as a modern woman, capable of asserting her own vision. Of the seventeen illustrations that Stephens contributed to the 1899 edition of Middlemarch, nearly half focus attention on key moments that chart Dorothea’s growing authority, from sisterhood through a difficult marriage to widowhood. These illustrations won Stephens a gold medal at the 1899 exhibition of Women’s Work at Earl’s Court, London, but the eight Dorothea drawings particularly highlight woman’s expanding sphere of experience. Importantly, the Middlemarch illustrations follow a very popular series on the ‘American Woman’ that Stephens had just completed for The Ladies Home Journal in 1897, a series in which she represented the growing freedom of the ‘New Woman’ to seek meaningful employment. This chapter provides close analysis of the Dorothea illustrations as they follow from the ‘American Woman’ series, arguing that Stephens’s drawings describe and advocate a progressive development of female agency. As such, Stephens offers one of the earliest feminist interpretations of Middlemarch

A Miserable Argument

In his arguments that science itself can answer moral questions, Sam Harris often appeals to our intuitions about the badness of suffering. If we share these intuitions, Harris argues, we’ve taken a significant step in conceding to a basically utilitarian worldview. In this chapter, I critically assess Harris’ arguments and find them deeply wanting

Comparing compound pairs and single stimuli during match-to-sample to establish arbitrary stimulus classes with adults of typical development

Equivalence classes are typically established by teaching arbitrary conditional discriminations with discrete single stimuli as samples and comparisons. The current study was the first to use compound stimuli as both samples and comparisons during training of conditional relations. We compared compound-to-compound stimuli MTS training with the more typical single-to-single stimuli training to establish two 4-member arbitrary stimulus classes with adults. A pretest-train-posttest between-groups experimental design was used. Compounds consisted of side-by-side pairs of individual (single) abstract symbols. A pretest and posttest consisting of MTS trials evaluating all single-to-single, single-to-compound, compound-to-single, and compound-to-compound relations were used to compare the effectiveness of the two training procedures. In addition, participants sorted cards depicting all single stimuli into piles both before and after MTS training. Results showed that stimulus classes were established with similar accuracy regardless of the training used. However, the compound-to-compound group participants required significantly fewer trials and training blocks to demonstrate class emergence than participants in the single-to-single group. In addition, the compound-to-compound group participants emitted significantly fewer errors during MTS training. We discuss how these results may inform use of stimulus equivalence procedures in mainstream settings (e.g., teaching academic content)