MEDICATION-ASSISTED TREATMENT EQUITY FOR OPIOID USE DISORDERS: A PROGRAM EVALUATION

ABSTRACTMolly McGirt: Intersection: Promoting Equity in the Management of Substance Use Disorders(Under the direction of Carrie Palmer)Purpose: The goal of this project was to help create a sustainable infrastructure for treatment of substance use disorder (SUD) by evaluating a newly developed program that educates future prescribers on the urgency and inequity of access to substance use disorder treatment. This program is offered though Mountain Area Health Education Center (MAHEC) in Asheville, North Carolina and is titled, Intersection: Promoting Equity in the Management of (SUDs) with a focus on Opioid Use Disorder (OUD).Background: Individuals who live in rural areas and marginalized communities are more vulnerable to overdose because they lack the necessary resources to assist with opioid use treatment. A major contributing factor to this problem is the lack of providers with MAT waivers in these disadvantaged communities. Methods: A post- survey questionnaire was offered immediately after the online program through the platform Survey Monkey. Results/ outcomes: The anticipated results from the post- survey questionnaire were increased provider willingness to learn more about becoming a MAT waivered provider, increased awareness of the inequities that surround SUD treatment and increased interest to serve historically marginalized or rural communities. Implications/ conclusions: The results revealed promising information into the development of this program. The majority of respondents gained insight, knowledge and increased interest into working with individuals with SUD in historically marginalized communities. All anticipated outcomes were successfully achieved. Key Words: Equity, opioid use disorder, substance use disorder, medication-assisted treatment, marginalized/ rural communities.Doctor of Nursing Practic

An Object Oriented Software Bus

This paper describes a new approach to development of software for highly integrated software-hardware systems such as used for data acquisition and control. This approach, called the Object Oriented Software Bus (OSB), is a way to develop software according to a common specification similar to the way interface hardware has been developed since the advent of bus structures for minicomputers and microcomputers. Key concept of the OSB is extension of the common use of objects to support user interface and data analysis functions to the development of software objects that directly correspond to real- world hardware interfaces and modules

Patient satisfaction reported by in-visit and after-visit surveys

Patient experience measurement has become a basic requirement for every healthcare provider organization. Yet, when the timing and mode of survey administration are considered, there is skepticism about the usefulness of ‘after- visit’ patient experience surveys to measure satisfaction and identify opportunities to improve service or health care quality. The aim of this observational study was to compare patient satisfaction among those who rated the patient experience at the conclusion of their outpatient appointment while still in the office, to that among those who rated the patient experience up to one month after their outpatient appointment via a mailed survey. Two sampling strategies were used to collect patient experience data from patients of the University of Maryland Family and Community Medicine practice: a postal survey to collect data from patients approximately 30 days after their visit (the After-Visit survey), and a within-visit survey to collect data from patients during their visit (the In-Visit survey). Nineteen survey questions measured comparable constructs between the After-Visit and In-Visit. This study did not find any significant differences between the data sources for any of these questions. The study showed that patient satisfaction could be assessed within a visit or by mail 30 days later without a statistically significant effect on mean responses

Mannan-Binding Lectin Levels and Activity Are Not Altered in Atopic Dermatitis Patients with a History of Eczema Herpeticum

Background. Eczema herpeticum (EH) is a potentially serious, systemic complication in subjects with atopic dermatitis (AD) caused by herpes simplex virus (HSV). The innate immune dysregulation that predisposes these subjects to cutaneous viral infections is not well understood. We tested the hypothesis that defects in mannan-binding lectin (MBL) may be associated with an increased risk of EH. Methods. We evaluated serum MBL levels and functional activity in 13 AD subjects with a history of EH (EH+) and 21 AD subjects with no history of EH (EH−). MBL levels were detected by enzyme immunoassay. MBL pathway functional activity was evaluated by determining MBL C4b deposition capacity. Results. We found no statistical difference in MBL serum levels or function between EH+ and EH− groups. Conclusion. Considering the limitations of this study (e.g., small samples size) our findings suggest that MBL defects do not play a role in EH

miR-223 Regulates Cell Growth and Targets Proto-Oncogenes in Mycosis Fungoides/Cutaneous T-Cell Lymphoma

The pathogenesis of the cutaneous T-cell lymphoma (CTCL), mycosis fungoides (MF), is unclear. MicroRNA (miRNA) are small noncoding RNAs that target mRNA leading to reduced mRNA translation. Recently, specific miRNA were shown to be altered in CTCL. We detected significantly reduced expression of miR-223 in early-stage MF skin, and further decreased levels of miR-223 in advanced-stage disease. CTCL peripheral blood mononuclear cells and cell lines also had reduced miR-223 as compared with controls. Elevated expression of miR-223 in these cell lines reduced cell growth and clonogenic potential, whereas inhibition of miR-223 increased cell numbers. Investigations into putative miR-223 targets with oncogenic function, including E2F1 and MEF2C, and the predicted miR-223 target, TOX, revealed that all three were targeted by miR-223 in CTCL. E2F1, MEF2C, and TOX proteins were decreased with miR-223 overexpression, whereas miR-223 inhibition led to increased protein levels in CTCL. In addition, we showed that the 3′-UTR of TOX mRNA was a genuine target of miR-223. Therefore, reduced levels of miR-223 in MF/CTCL lead to increased expression of E2F1, MEF2C, and TOX, which likely contributes to the development and/or progression of CTCL. Thus, miR-223 and its targets may be useful for the development of new therapeutics for MF/CTCL

Does the quality of safetalk motivational interviewing counseling predict sexual behavior outcomes among people living with HIV?

Although past research has demonstrated a link between the quality of motivational interviewing (MI) counseling and client behavior change, this relationship has not been examined in the context of sexual risk behavior among people living with HIV/AIDS. We studied MI quality and unprotected anal/vaginal intercourse (UAVI) in the context of SafeTalk, an evidence-based secondary HIV prevention intervention