Challenges to Implementing Screening, Brief Intervention, and Referral to Treatment (SBIRT) for Substance Use in Primary Care Settings at Rowan-Virtua

Background and Purpose: Implementing the SBIRT model for substance use in a primary care setting has many benefits including normalizing conversations about alcohol and other substance use into patients’ visits, thereby reducing harm, reducing consumption and its negative impact, and promoting system changes to overcome barriers to treatment access. The full scope of the current SBIRT project involves the recruitment, hiring, training, and integration of health educators in 9 primary care sites throughout South Jersey, as well as a project supervisor serving as implementation lead and liaison to medical and administrative staff at all 9 primary care sites. Initial barriers to implementation within sites included challenges regarding work-flow between providers, CMA’s, and health educators (integration-of-care challenges between allied health professionals from varying disciplines); and variations in administrative processes across 9 different primary care settings serving diverse patient demographics. Challenges to implementation with personnel included unexpected loss of key project personnel and changeover in project leadership. Additionally, legalization of medical and recreational cannabis in the state of New Jersey has made implementation of the grant (as written) challenging, as cannabis remains a Schedule 1 substance at the federal level and is included in the writing of this federally funded grant as an illicit substance. Due to Covid, a decrease of in-person visits in primary care settings as well as the normalization of telehealth visits have challenged the Health Educators’ ability to see potential pre-screen-positive patients. This lower volume of in-person patients has also subsequently resulted in more efficient processing of patient visits, affording less time to incorporate health education and brief intervention within each patient visit. There is a distinct need to develop a protocol for intervention with telehealth patients who screen positive for SBIRT services. Strategies for addressing these challenges, future directions of the project, and lessons learned will also be presented. References: Kamath, C. C., Kelpin, S. S., Patten, C. A., Rummans, T. A., Kremers, H. M., Oesterle, T. S., Williams, M. D., & Breitinger, S. A. (2022). Shaping the Screening, Behavioral Intervention, and Referral to Treatment (SBIRT) Model for Treatment of Alcohol Use Disorder in the COVID-19 Era. In Mayo Clinic Proceedings (Vol. 97, Issue 10, pp. 1774–1779). Elsevier Ltd. https://doi.org/10.1016/j.mayocp.2022.07.006 Substance Abuse Overview 2021 Statewide - NJ.GOV. (n.d.). Retrieved April 18, 2023, from https://nj.gov/humanservices/dmhas/publications/statistical/Substance%20Abuse%20Overview/2021/statewide.pd Moore, Ramey PhDa; Purvis, Rachel S. PhDa; Hallgren, Emily PhDa; Reece, Sharon MD, CCFPa; Padilla-Ramos, Alan MDa; Gurel-Headley, Morgan BSb,c; Hall, Spencer MAd; McElfish, Pearl A. PhD, MBAa,*. “I am hesitant to visit the doctor unless absolutely necessary”: A qualitative study of delayed care, avoidance of care, and telehealth experiences during the COVID-19 pandemic. Medicine 101(32):p e29439, August 12, 2022. | DOI: 10.1097/MD.000000000002943

Meta-analysis of genome-wide association studies for extraversion:Findings from the Genetics of Personality Consortium

Extraversion is a relatively stable and heritable personality trait associated with numerous psychosocial, lifestyle and health outcomes. Despite its substantial heritability, no genetic variants have been detected in previous genome-wide association (GWA) studies, which may be due to relatively small sample sizes of those studies. Here, we report on a large meta-analysis of GWA studies for extraversion in 63,030 subjects in 29 cohorts. Extraversion item data from multiple personality inventories were harmonized across inventories and cohorts. No genome-wide significant associations were found at the single nucleotide polymorphism (SNP) level but there was one significant hit at the gene level for a long non-coding RNA site (LOC101928162). Genome-wide complex trait analysis in two large cohorts showed that the additive variance explained by common SNPs was not significantly different from zero, but polygenic risk scores, weighted using linkage information, significantly predicted extraversion scores in an independent cohort. These results show that extraversion is a highly polygenic personality trait, with an architecture possibly different from other complex human traits, including other personality traits. Future studies are required to further determine which genetic variants, by what modes of gene action, constitute the heritable nature of extraversion

The Global Invertebrate Genomics Alliance (GIGA): Developing Community Resources to Study Diverse Invertebrate Genomes

Over 95% of all metazoan (animal) species comprise the invertebrates, but very few genomes from these organisms have been sequenced. We have, therefore, formed a Global Invertebrate Genomics Alliance (GIGA). Our intent is to build a collaborative network of diverse scientists to tackle major challenges (e.g., species selection, sample collection and storage, sequence assembly, annotation, analytical tools) associated with genome/transcriptome sequencing across a large taxonomic spectrum. We aim to promote standards that will facilitate comparative approaches to invertebrate genomics and collaborations across the international scientific community. Candidate study taxa include species from Porifera, Ctenophora, Cnidaria, Placozoa, Mollusca, Arthropoda, Echinodermata, Annelida, Bryozoa, and Platyhelminthes, among others. GIGA will target 7000 noninsect/nonnematode species, with an emphasis on marine taxa because of the unrivaled phyletic diversity in the oceans. Priorities for selecting invertebrates for sequencing will include, but are not restricted to, their phylogenetic placement; relevance to organismal, ecological, and conservation research; and their importance to fisheries and human health. We highlight benefits of sequencing both whole genomes (DNA) and transcriptomes and also suggest policies for genomic-level data access and sharing based on transparency and inclusiveness. The GIGA Web site (http://giga.nova.edu) has been launched to facilitate this collaborative venture. © 2013 The American Genetic Association 2013. All rights reserved

St. John's Daily Star, 1920-06-09

The St. John's Daily Star was published daily except Sunday between 17 April 1915 - 23 July 1921

Genetic and environmental influences on the relationship between flow proneness, locus of control and behavioral inhibition

Flow is a psychological state of high but subjectively effortless attention that typically occurs during active performance of challenging tasks and is accompanied by a sense of automaticity, high control, low self-awareness, and enjoyment. Flow proneness is associated with traits and behaviors related to low neuroticism such as emotional stability, conscientiousness, active coping, self-esteem and life satisfaction. Little is known about the genetic architecture of flow proneness, behavioral inhibition and locus of control - traits also associated with neuroticism - and their interrelation. Here, we hypothesized that individuals low in behavioral inhibition and with an internal locus of control would be more likely to experience flow and explored the genetic and environmental architecture of the relationship between the three variables. Behavioral inhibition and locus of control was measured in a large population sample of 3,375 full twin pairs and 4,527 single twins, about 26% of whom also scored the flow proneness questionnaire. Findings revealed significant but relatively low correlations between the three traits and moderate heritability estimates of .41, .45, and .30 for flow proneness, behavioral inhibition, and locus of control, respectively, with some indication of non-additive genetic influences. For behavioral inhibition we found significant sex differences in heritability, with females showing a higher estimate including significant non-additive genetic influences, while in males the entire heritability was due to additive genetic variance. We also found a mainly genetically mediated relationship between the three traits, suggesting that individuals who are genetically predisposed to experience flow, show less behavioral inhibition (less anxious) and feel that they are in control of their own destiny (internal locus of control). We discuss that some of the genes underlying this relationship may include those influencing the function of dopaminergic neural systems