A national study of the retention of Irish opiate users in methadone substitution treatment.

Retention in treatment is a key indicator of methadone treatment success. The study aims to identify factors that are associated with retention. Objectives: To determine retention in treatment at 12 months for Irish opiate users in methadone substitution treatment and to indicate factors that increase the likelihood of retention. Methods: National cohort study of randomly selected opiate users commencing methadone treatment in 1999, 2001, and 2003 (n = 1269). Results: Sixty-one percent of patients attending methadone treatment remained in continuous treatment for more than 1 year. Retention in treatment at 12 months was associated with age, gender, facility type, and methadone dose. Age and gender were no longer significant when adjusted for other variables in the model. Those who attended a specialist site were twice as likely to leave methadone treatment within 12 months compared with those who attended a primary care physician. The most important predictor of retention in treatment was methadone dose. Those who received <60 mg of methadone were three times more likely to leave treatment. Conclusion: Retention in methadone treatment is high in Ireland in a variety of settings. The main factors influencing retention in methadone treatment was an adequate methadone dose and access to a range of treatment settings including from primary care physicians. Scientific Significance: Providing an adequate dose of methadone during treatment will increase the likelihood of treatment retention. Methadone treatment by the primary care physician is a successful method of retaining opioid users in treatment

Factors predicting completion in a cohort of opiate users entering a detoxification programme.

AIM: To determine the outcome and factors influencing outcome among a cohort of drug users commencing detoxification from opiate use. METHODS: National cohort study of randomly selected opiate users commencing methadone detoxification treatment in 1999, 2001 and 2003 (n = 327). RESULTS: One quarter 62 (25.6%) of opiate users had a successful detoxification within the 3-month study criteria. Receiving some inpatient treatment as part of detoxification programme resulted in completion by 56.3% drug users compared to outpatient only treatment (21%). The factors independently influencing detoxification are as follows: having some inpatient treatment AOR 5.9 (2.63-13.64) and never having injected AOR 2.25 (1.20-4.25). An additional 31 (9%) opiate users had a detoxification between 3 months and 1 year and 27 (8%) moved into methadone maintenance. CONCLUSIONS: This study finds that having some inpatient treatment increases the likelihood of a detoxification within 3 months. Offering a detoxification early in a drug using career pre-injecting drug use should be considered for suitable and motivated patients

Exploration of evaluation practices in social prescribing services in Ireland: a cross-sectional observational study

National health services in Ireland and the UK fund the majority of social prescribing services and have issued recommendations for evaluation. However, it is not known what outcomes are prioritised for evaluation within individual services and what evaluation methods are used to capture recommended outcomes. A survey was carried out to examine evaluation practices of social prescribing services on the island of Ireland. This study used a cross-sectional observational design. The sample was all the staff involved in delivering and/or managing SP services on the island of Ireland. Questionnaires were distributed at a national SP conference and online. Closed-response questions were analysed using descriptive statistics. Content analysis was used for open-ended questions. Eighty-four usable surveys were returned (50% from the Republic of Ireland and 50% from Northern Ireland). All respondents (100%) agreed on the importance of measuring SP outcomes. The most frequently measured outcomes were health and well-being (89.2%) and loneliness (84%). The least frequently measured outcome was the satisfaction of healthcare professionals referring to SP: 78.4% of respondents never measured this outcome. The most frequently used measurement tool was the Short Warwick Edinburgh Mental Well-Being Scale, with 38/76 (50%) respondents using this measure. There was a lack of standardised measures identified for some outcomes. For example, 70% of respondents reported always measuring physical activity (PA), but only four respondents identified a specific PA measure. In open-ended questions, respondents recommended flexibility in evaluation methods to reflect the complexity and individualised focus of SP. They also identified the need for protected time to complete evaluations and recommended a national strategy to inform priorities in evaluations. This study demonstrates a wide variation on the island of Ireland on how SP services are measuring outcomes, with many outcomes rarely or never measured using standardised measures. Agreement is needed on a core outcome set for social prescribing in order to guide service delivery and evaluations

Effectiveness of SARS-CoV-2 testing strategies: a scoping review

This scoping review aims to map the available evidence on the effectiveness of SARS-CoV-2 testing strategies for suspected cases and asymptomatic populations. The review will inform the development of WHO recommendations for “national SARS-CoV-2 testing strategies and diagnostic capacities” of SARS-CoV-2 testing strategies to mitigate community transmission of SARS-CoV-2, morbidity, and mortality in a cost-efficient manner

Knowledge translation interventions for facilitating evidence-informed decision-making amongst health policymakers

No abstract available

Site Environmental Report for 2022

The annual Site Environmental Report documents Lawrence Berkeley National Laboratory’s performance in reducing its environmental impacts, progress toward cleaning up groundwater contamination, and compliance with applicable Department of Energy, federal, state, and local environmental regulations

Site Environmental Report for 2021

The annual Site Environmental Report documents Lawrence Berkeley National Laboratory’s performance in reducing its environmental impacts, progress toward cleaning up groundwater contamination, and compliance with applicable Department of Energy, federal, state, and local environmental regulations