Adaptation of a Standard Extended-Release Naltrexone (XR-NTX) Protocol for Rural Re-Entering Offenders with OUD

BACKGROUND: Despite a growing body of empirical support for the effectiveness of extended-release naltrexone (XR-NTX) to reduce opioid relapse among people with opioid use disorder (OUD) transitioning from a correctional facility to the community, continuity of care following release remains challenging. This paper describes a research-based adaptation of a state\u27s standard of care XR-NTX protocol using the ADAPT-ITT framework for delivery in a non-traditional, non-treatment, community criminal justice setting (P&P office), as well as the expansion of services by a local Federally Qualified Health Center (FQHC) provider who would, for the first time, be going to the jail and P&P office to provide XR-NTX and related treatment. METHOD: The present study focuses on the first seven phases (Assessment through Training) of the ADAPT-ITT framework in the adaptation of the Department of Corrections (DOC) protocol in preparation for a pilot trial for induction in a rural jail and during the transition to a rural community. Expert clinical review and focus groups with key stakeholders in criminal justice supervision and the local providers in the FQHC informed the needed adaptations to the existing XR-NTX protocol for initiation at the jail and ongoing administrations in the community. RESULTS: Findings from stakeholder focus groups, study team review, topical expert review, and a theater test suggested that there were critical adaptations needed in both content and context at the patient and clinic level. CONCLUSION: Health and justice officials should consider the need to tailor and adapt evidence-based approaches for real-world locations that high-risk, justice-involved individuals visit in order to reduce barriers and increase access to critically needed treatment for OUD

Brass Happenings

Presenting a student recital for brass students in USU\u27s Music Department.https://digitalcommons.usu.edu/music_programs/1107/thumbnail.jp

How can students-as-partners work address challenges to student, faculty, and staff mental health and well-being?

Mental health has emerged as a critical area of attention in higher education, and educational research over the last 15 years has focused increasingly on emotions and wellbeing at all stages of education (Hill et al., 2021). While definitions of well-being vary, most are premised on “good quality of life” (Nair et al., 2018, p. 69). Within the last few years, we have experienced an intersection of several forces that undermine or threaten good quality of life. These include the uncertainties prompted by the COVID-19 pandemic (Hews et al., 2022, U.S. Surgeon General, n.d.), climate change (Charlson et al., 2021), racism and social injustices (Williams & Etkins, 2021), the cost-of-living crisis (Montacute, 2023), and the lack of motivation and higher incidence of mental health issues associated with growing concerns about job prospects and income (Chowdhury et al., 2022). This fifth iteration of Voices from the Field explores some of the ways in which students-as-partners work can address challenges to the mental health and well-being of students, faculty, and staff. This focus, proposed by members of the IJSaP Editorial Board, both responds to the intersecting realities named above and remains true to the goal of this section of the journal, which is to offer a venue for a wide range of contributors to address important questions around and aspects of students-as-partners work without going through the intensive submission, peer-review, and revision processes. The prompt we included in the call for this iteration of Voices was: “In what ways can students-as-partners work address challenges to the mental health and well-being of students, staff, and faculty posed by the current realities in the wider world (socio-political, environmental, economic, etc.) that affect higher education?

Cloquet Forestry Center Management Plan 2016-2025

1 electronic resource (PDF; 38 pages)Reinikainen, Mike R.; Nagel, Linda; Pike, Carrie; Olesiak, Rachael; Cuomo, Greg. (2015). Cloquet Forestry Center Management Plan 2016-2025. Retrieved from the University Digital Conservancy, https://hdl.handle.net/11299/202220

Applying a natural language processing tool to electronic health records to assess performance on colonoscopy quality measures

BACKGROUND: Gastroenterology specialty societies have advocated that providers routinely assess their performance on colonoscopy quality measures. Such routine measurement has been hampered by the costs and time required to manually review colonoscopy and pathology reports. Natural Language Processing (NLP) is a field of computer science in which programs are trained to extract relevant information from text reports in an automated fashion. OBJECTIVE: To demonstrate the efficiency and potential of NLP-based colonoscopy quality measurement DESIGN: In a cross-sectional study design, we used a previously validated NLP program to analyze colonoscopy reports and associated pathology notes. The resulting data were used to generate provider performance on colonoscopy quality measures. SETTING: Nine hospitals in the UPMC health care system. PATIENTS: Study sample consisted of the 24,157 colonoscopy reports and associated pathology reports from 2008-9 MAIN OUTCOME MEASUREMENTS: Provider performance on seven quality measures RESULTS: Performance on the colonoscopy quality measures was generally poor and there was a wide range of performance. For example, across hospitals, adequacy of preparation was noted overall in only 45.7% of procedures (range 14.6% to 86.1% across nine hospitals), documentation of cecal landmarks was noted in 62.7% of procedures (range 11.6% to 90.0%), and the adenoma detection rate was 25.2% (range 14.9% to 33.9%). LIMITATIONS: Our quality assessment was limited to a single health care system in Western Pennsylvania CONCLUSIONS: Our study illustrates how NLP can mine free-text data in electronic records to measure and report on the quality of care. Even within a single academic hospital system there is considerable variation in the performance on colonoscopy quality measures, demonstrating the need for better methods to regularly and efficiently assess quality

Prospective evaluation of body size and breast cancer risk among BRCA1 and BRCA2 mutation carriers

BACKGROUND:Although evidence suggests that larger body size in early life confers lifelong protection from developing breast cancer, few studies have investigated the relationship between body size and breast cancer risk among BRCA mutation carriers. Therefore, we conducted a prospective evaluation of body size and the risk of breast cancer among BRCA mutation carriers. METHODS:Current height and body mass index (BMI) at age 18 were determined from baseline questionnaires. Current BMI and weight change since age 18 were calculated from updated biennial follow-up questionnaires. Cox proportional hazards models were used to estimate the hazard ratio (HR) and 95% confidence interval (CI). RESULTS:Among 3734 BRCA mutation carriers, there were 338 incident breast cancers over a mean follow-up of 5.5 years. There was no association between height, current BMI or weight change and breast cancer risk. Women with BMI at age 18 ≥22.1 kg/m2 had a decreased risk of developing post-menopausal breast cancer compared with women with a BMI at age 18 between 18.8 and 20.3 kg/m2 (HR 0.49; 95% CI 0.30-0.82; P = 0.006). BMI at age 18 was not associated with risk of pre-menopausal breast cancer. CONCLUSIONS:There was no observed association between height, current BMI and weight change and risk of breast cancer. The inverse relationship between greater BMI at age 18 and post-menopausal breast cancer further supports a role of early rather than current or adulthood exposures for BRCA-associated breast cancer development. Future studies with longer follow-up and additional measures of adiposity are necessary to confirm these findings