Improving the Quality and Delivery of Substance Use Disorder Resource List

Introduction The state of New Mexico has numerous organizations that help individuals with substance use disorders (SUDs). University of New Mexico Hospital (UNMH) social workers had previously started a list of these resources; however, it was neither updated nor used often. We aim to improve the quality, awareness, and delivery of this list on UNMH internal medicine (IM) inpatient units. Methods To improve the quality of the list we developed a concise SUD resource document using the pre-existing list as a template. We modified the list after feedback from patients, providers and literacy specialists. The final list was organized alphabetically and categorized according to the services offered, with brief descriptions about each facility added. For baseline data on awareness of the list, we administered surveys to available inpatient IM providers. 31st increase the awareness of the list, we educated IM residents on clinical inpatient services at UNMH biweekly about its purpose and availability. We administered surveys before each education session for two months. To improve the accessibility of the list, we regularly supplied each resident workroom with the resource list. After receiving hospital approval, we uploaded the list onto the UNMH electronic medical record system. Results At baseline, we surveyed 37 IM providers. 89% viewed the delivery of resources to patients with SUD as important. Of this group, 55% were aware that the list was available to give patients and only 20% of them knew how to access it. After two months of education, 100% of surveyed providers viewed the delivery of resources to patients with SUD as important. We increased the awareness and knowledge of its accessibility by 18% and 60%, respectively, from baseline. Conclusion Our quality improvement project increased awareness and ease of access of the SUD resource list. These successes demonstrate that a simple delivery method for resource lists can be implemented in a short time. Our next steps include spreading awareness of how to access the list electronically through biweekly education sessions and ongoing surveying, as well as educating other hospital departments. We are currently assessing whether retrospective chart reviews may help determine the frequency of its use

2020-04-24 DAILY UNM GLOBAL HEALTH COVID-19 BRIEFING

Executive Summary: NYT praises NM. NM Governor update. NM cases. NM antibody tests. State hiring freeze. Navajo Nation sues. Navajo Nation CA doctors. Mental health funding. Balloon Fiesta proceeding. Trump Lysol remarks. $484B business relief. 50k US deaths. US no to WHO initiatives. US crime reductions. Moscow 10% infections. Quebec elderly deaths. Italy psychiatric sequelae. Global vaccines summit. French nicotine sales restrictions. Adaptive cyclic exit strategies. Mask reuse techniques. Mask steaming method. Legionnaire’s reopening risks. Youth mental health. US disease models. Covid phobia treatment avoidance. Nursing home testing. Home nursing demand. CDC home cleaning. Guidelines on: convalescent plasma transfusion, H2O2 nasal use, pre-op testing, respiratory distress, ophthalmological practice, GI department reopening. FDA hydroxychloroquine cautions. Chloroquine high-dose mortality. HCQ+azithromycin long-QT. Iron reduction adjuvant. Repurposing prioritization. Pediatric HCQ dosing. HCQ enrollment up. 107 trials registered. PPE skin injuries. LDL and severity. 32 ECMO patients. Worse outcomes older monkeys

2020-05-11 DAILY UNM GLOBAL HEALTH COVID-19 BRIEFING

Executive Summary: NM case counts. Navajo Nation documentary. Medicaid reimbursement increase. Excess NYC mortality. German R0\u3e1. Chile COVID-19 certificates. High female incidence in Quebec. Swab 3D printing. Evidence lacking school reopening. Cloth mask review. WHO 2nd wave warning. Higher mortality in minorities. Environmental transmission controls. Behavior change. Correctional environment guidelines. Wuhan hospital transformation. Maximizing GI training. Threat and conformity. Recommendations on managing COVID-19 (first Italian SARS patients), and obesity and metabolic syndrome. Guidelines for neurologists. Ethics of off-label drugs use. Abbott antibody test approval. CRISPR test FDA approval. Viral sample inactivation. HCQ+azithromycin no benefit. Public-Private partnership for clinical trials. Drug repurposing. Cancer patient considerations. 35 new COVID-19 trials. Hyperinflammatory shock in children. Symptom app

2020-05-04 DAILY UNM GLOBAL HEALTH COVID-19 BRIEFING

Executive Summary: NM convalescent plasma call. NM case counts. Gallup lockdown continues. Tribal federal relief delay. Childcare demand drops. Polling open for primaries. Non-US world funds R&D. South Korea eases more. Soft quarantine inefficiency. Chinese interventions. Transmission window. December French case. CDC on law enforcement, essential errands. NEJM on telemedicine. Practice guidelines for: ECMO, pneumonia, nuclear medicine SOP. FDA antibody test restrictions. Africa testing differences. PCR assay sensitivity. Wuhan antibody tracking. Hydroxychloroquine toxicity. Remdesivir mechanism. Tocilzumab study inconclusive. SARs-CoV-2 structure. 28 new trials. Immunology and exercise. Synthetic SARS-CoV-2. IgM and IgG responses. Bacterial and fungal coinfection. Youth mental health challenges

2020-05-14 DAILY UNM GLOBAL HEALTH COVID-19 BRIEFING

Executive Summary: NM restrictions loosen. NM case count. Navajo Nation case count. 9 state parks open. Sunport revenue loss. Trump projects vaccine delivery. Wisconsin court case. Smokers quit. Ireland reopening. Danish schools open. Philippine typhoon evacuation. PPE-induced pressure injuries and facial dermatoses. U.S. mask stockpile. PPE for surgeons. Intubation time with aerosol box. Consumer spending with social restrictions. Suicide increase expected. Undetected virus homeless. Chinese infection control. 5% Spain infected. Sanitizing booth. Healthcare worker infection routes. Kawasaki disease France. CDC Kawaski guidance. Italian deaths characterized. CDC reopening school guidance. COVID-19 and epistemology. Monitoring misleading claims. UN mental health policy brief. CDC vaccination schedules. Guidelines on managing endoscopy units. COVID-19 lab testing (for lab professionals). Cancer surgery triage. Operating room practices. Orthodontic treatment. 3D printed NP swabs effective. Salt-water irrigation reduces duration. Corticosteroids ineffectual. Vaccines require biomanufacturing infrastructure. French pharm giant promises fair vaccine distribution. 26 new trials registered. LDH, lymphocytes and hs-CRP predict mortality. Fibrinogen higher in SARS. Insulin resistance. Glycemic monitoring. Hemostasis abnormalities. New phobia scale. OR global consensus. Inpatient cognitive assessments are challenging. Loud speech increases transmission. Monkeys present similarly. Human-to-dog transmission. Cat transmission

Departmental leadership and peer pressure on academic research performance at universities in emerging countries: An empirical study in Vietnam

Research performance of lecturers in higher education institutions has become an important topic but many variables are still largely unexplored in current literature. The main objective of this study is to examine the impact of four leadership behaviors of department heads and coworkers on the lecturers’ research performance and the moderating effects of achievement value. A survey was conducted with a sample of 408 Vietnamese lecturers at economics and business management focused universities. Our findings contribute to the literature of job performance in higher education from an organizational behavior perspective by explaining the mid-level impacts of departmental factors affecting research performance. We also discuss potential implications and make recommendations for future research

COVID-19 Story Slam

The Office of Professional Wellbeing, Society of General Internal Medicine, American College of Physicians, and Native Health Initiative presents UNM HSC’s first Story Slam. Creatives in healthcare gather to share their stories of loss, resilience, and gratitude as they reflect on the COVID-19 pandemic through this one hour event.https://digitalrepository.unm.edu/hsc_covid19_reflections/1004/thumbnail.jp

The banned sunscreen ingredients and their impact on human health: a systematic review

Recent evidence of high systemic absorption of sunscreen ingredients has raised concerns regarding the safety of sunscreen products. Oxybenzone (BP-3) and octinoxate (OMC), two common sunscreen ingredients, were recently banned in Key West and Hawaii owing to their toxic effects on marine ecosystems. Their impact on human health requires a careful assessment. To summarize the current evidence on the association between the systemic level of BP-3 or OMC and its health impact, a primary literature search was conducted using PubMed database in February 2019. There are 29 studies that address the impact of these ingredients on human health. Studies show that elevated systemic level of BP-3 has no adverse effect on male and female fertility, female reproductive hormone level, adiposity, fetal growth, child's neurodevelopment, and sexual maturation. However, the association of BP-3 level on thyroid hormone, testosterone level, kidney function, and pubertal timing has been reported and prompts further investigations to validate a true association. The systemic absorption of OMC has no reported effect on thyroid and reproductive hormone levels. In conclusion, current evidence is not sufficient to support the causal relationship between the elevated systemic level of BP-3 or OMC and adverse health outcomes. There are either contradictory findings among different studies or an insufficient number of studies to corroborate the observed association. To accurately evaluate the long-term risk of exposure to BP-3 and OMC from sunscreen, a well-designed longitudinal randomized controlled trial needs to be conducted

Renal abnormalities in sickle cell disease

Sickle cell nephropathy is indicated by sickled erythrocytes, with the consequent effects of decreased medullary blood flow, ischemia, microinfarct and papillary necrosis. Impaired urinary concentrating ability, renal acidification, hematuria, and potassium secretion are also found. There may be a causal relationship between an increase in nitric oxide synthesis and experimental sickle cell nephropathy, and some studies have indicated that the progression of sickle cell nephropathy is hemodynamically mediated. Although there are many studies showing that proteinuria, nephrotic syndrome, chronic progressive renal failure, and acute renal failure syndromes are the outcome of this disease, the pathogenic mechanism(s) and potential therapies remain to be elucidated. Survival of patients with sickle cell nephropathy who progress to end-stage renal disease (ESRD) is equal to non-diabetic ESRD patients, and graft survival rates are also similar for those who undergo renal transplantation. This article presents a historical review of the glomerular and tubular disorders associated with sickle cell nephropathy, and reviews therapeutic indications to slow its progression. Further research is needed