Promoting Vermont Films in Vermont\u27s Libraries: Presenting Freedom & Unity - The Vermont Movie in a Small Vermont Library

This poster reviews steps taken to screen a recent Vermont movie (over a two month period, in six parts) at the Tunbridge (Vermont) Public Library, in an effort to promote Vermont films, at the same time provide provide programming for libraries. The filmmakers and librarians initiated post-screening discussions on topics explored in the film, with the goal of engaging audiences on local issues. A review of the audience attendance, funding and recommendations for future collaborations is included

Politiques et pratiques en santé mentale. Comment intégrer le concept du rétablissement

Avec la publication du Plan d’action en santé mentale 2005-2010, le Québec entend développer un système axé sur le concept de rétablissement. Cet article brosse à l’intention des planificateurs du Québec et d’ailleurs un tableau des questions relatives à l’implantation de ce concept. On y passe en revue des exemples de lignes directrices pour le système, des modèles de programme, les compétences des praticiens, et des instruments de mesure conçus en vue de promouvoir le rétablissement. On suggère aussi comment ces outils pourraient être utilisés par les responsables de l’implantation dans leur propre juridiction. Enfin, on soulève les questions plus difficiles de définition et de pouvoir à considérer lors de l’implantation.With the publication of Quebec’s Plan d’Action en Santé Mentale 2005-2010 the province announced an intent to develop a recovery-oriented mental health system. This article provides planners in Quebec, and elsewhere, with an overview of issues pertinent to recovery implementation. It reviews examples of system-level guidelines, program models, practitioner competencies, and measurement tools designed to promote a recovery orientation and suggests how these tools might be used by those charged with implementing recovery in their own jurisdictions. Finally, it raises some of the hard questions about meaning and power that must be addressed during the implementation process.Con la publicación del Plan de Acción de Salud Mental 2005-2010 (Plan d’action en santé mentale 2005-2010), el Quebec tiene la intención de desarrollar un sistema basado en el concepto de restablecimiento. Este artículo presenta un cuadro de las cuestiones relacionadas con la implantación de este concepto, destinado a los planificadores de Québec y de otras partes. Se revisan los ejemplos de directrices para el sistema, los modelos de programa, las competencias de los profesionales y los instrumentos de medida concebidos con el fin de promover el restablecimiento. Se sugiere también la forma en que estas herramientas podrían ser utilizadas por los responsables de la implantación en su propia jurisdicción. Finalmente, se resaltan los aspectos más difíciles de definir y de poder considerar en el momento de la implantación.Com a publicação do Plano de ação em saúde mental 2005-2010, o Quebec pretende desenvolver um sistema baseado no conceito de restabelecimento. Este artigo traça um quadro das questões relativas à implantação deste conceito, voltado para os planejadores de dentro e fora do Quebec. São revistos exemplos de linhas diretrizes para o sistema, modelos de programa, competências dos profissionais e instrumentos de medida concebidos para promover o restabelecimento. São sugeridas, também, maneiras de como os responsáveis da implantação podem utilizar estas ferramentas em sua própria jurisdição. Finalmente, são levantadas questões mais difíceis de definir e de considerar durante a implantação

What do peer support workers do? A job description.

BackgroundThe extant literature suggests that poorly defined job roles make it difficult for peer support workers to be successful, and hinder their integration into multi-disciplinary workplace teams. This article uses data gathered as part of a participatory evaluation of a peer support program at a psychiatric tertiary care facility to specify the work that peers do.MethodsData were gathered through interviews, focus groups, and activity logs and were analyzed using a modified grounded theory approach.ResultsPeers engage in direct work with clients and in indirect work that supports their work with clients. The main types of direct work are advocacy, connecting to resources, experiential sharing, building community, relationship building, group facilitation, skill building/mentoring/goal setting, and socialization/self-esteem building. The main types of indirect work are group planning and development, administration, team communication, supervision/training, receiving support, education/awareness building, and information gathering and verification. In addition, peers also do work aimed at building relationships with staff and work aimed at legitimizing the peer role. Experience, approach, presence, role modeling, collaboration, challenge, and compromise can be seen as the tangible enactments of peers' philosophy of work.ConclusionsCandidates for positions as peer support workers require more than experience with mental health and/or addiction problems. The job description provided in this article may not be appropriate for all settings, but it will contribute to a better understanding of the peer support worker position, the skills required, and the types of expectations that could define successful fulfillment of the role

Leveraging the Remake: The Role of the Arts in a Shifting Economy - 2012 Report and Recommendations

These are changing, uncertain times -- times that require new ways of thinking and engaging with both the opportunities and challenges of a more diverse, technologically driven, and entrepreneurial world. When we talk about a changing world and the role America will play in shaping the "new normal," the idea of a competitive advantage naturally arises -- moreover, how such an advantage may be achieved. Education, innovation, engineering, technology. All of these are terms that have been imbued with particular significance as we attempt to position ourselves to move into the future. At the core of all of these, however, there is something much more fundamental at play: the recognition that the way forward is through creative thinking and nontraditional problem-solving. Both of which are inherent in -- and developed through -- the arts.The 2012 National Arts Policy Roundtable convened around the idea that the arts are fundamental to navigating our shifting economy and should be recognized as such. Communities all across America are grappling with changing structures in economics, education, demographics, and more, and the arts have an important place in every locale -- urban, rural, and everything in between. Thus, the charge for the 2012 National Arts Policy Roundtable was to grapple with the question of how best to navigate "the remake" through the lens of the arts, and develop a set of actionable steps to put the arts to work in providing sustainable, creative and innovative answers

Evaluation of the Wellspring Model for Improving Nursing Home Quality

Examines how successfully the Wellspring model improved the quality of care for residents of eleven nonprofit nursing homes in Wisconsin. Looks at staff turnover, and evaluates the impact on facilities, employees, residents, and cost

Prescribers\u27 Satisfaction with Delivering Medications for Opioid Use Disorder

BACKGROUND: Expanding access to medications for opioid use disorder (MOUD), such as buprenorphine and extended release (XR) naltrexone, is critical to addressing the US opioid epidemic, but little is known about prescriber satisfaction with delivering these two types of MOUD. The current study describes the satisfaction of prescribers delivering buprenorphine and XR-naltrexone while examining whether satisfaction is associated with current patient census and organizational environment. METHODS: As part of a cluster randomized clinical trial (RCT) focused on expanding access to medication for opioid use disorder, 41 MOUD prescribers in Florida, Ohio, and Wisconsin completed a web-based survey. The survey included measures of prescriber satisfaction with delivering buprenorphine treatment and XR-naltrexone. In addition, the survey measured several prescriber characteristics and their perceptions of the organizational environment. RESULTS: Prescribers were generally satisfied with their work in delivering these two types of MOUD. Prescribers reporting a greater number of patients (r = .46, p = .006), those who would recommend the center to others (r = .56, p \u3c .001), and those reporting positive relationships with staff (r = .56, p \u3c .001) reported significantly greater overall satisfaction with delivering buprenorphine treatment. Prescribers who more strongly endorsed feeling overburdened reported lower overall buprenorphine satisfaction (r = -.37, p = .02). None of the prescriber characteristics or perceptions of the organizational environment were significantly associated with overall satisfaction with delivering XR-naltrexone treatment. CONCLUSIONS: The generally high levels of satisfaction with both types of MOUD is notable given that prescriber dissatisfaction can lead to turnover and impact intentions to leave the profession. Future research should continue to explore the prescriber characteristics and organizational factors associated with satisfaction in providing different types of MOUD. REGISTRATION: ClinicalTrials.gov. NCT02926482. Date of registration: September 9, 2016. https://clinicaltrials.gov/ct2/show/NCT02926482

A Pilot Study of Decision Factors Influencing Over-the-Counter Medication Selection and Use by Older Adults

Background and objectives: Despite their availability without prescription, OTC medications pose a risk for significant harm for older adults due to higher likelihood of polypharmacy, drug interactions, and age-related physiological changes. The purpose of this study is to identify the individual decision factors that influence how older adults select and use over-the-counter medications. Methods: A pilot study was conducted with 20 community-dwelling older adults. Older adults met the interviewer at a regional mass merchandise store where they were given both pain and insomnia standardized scenarios. Participants described how they would select and then hypothetically use a given medication to treat the problem described in the scenario. Results: OTC medication selection and reported use were influenced by several person-level decision-making factors including: personal beliefs/knowledge about OTCs, assessment of the ailment, and medical constraints. Conclusion: The findings from this investigation provide direction for interventions to address unsafe OTC medication selection by older adults

Test of a Workforce Development Intervention to Expand Opioid Use Disorder Treatment Pharmacotherapy Prescribers: Protocol for a Cluster Randomized Trial

Background: Overdoses due to non-medical use of prescription opioids and other opiates have become the leading cause of accidental deaths in the USA. Buprenorphine and extended-release naltrexone are key evidence-based pharmacotherapies available to addiction treatment providers to address opioid use disorder (OUD) and prevent overdose deaths. Treatment organizations’ efforts to provide these pharmacotherapies have, however, been stymied by limited success in recruiting providers (physicians, nurse practitioners, and physician assistants) to prescribe these medications. Historically, the addiction treatment field has not attracted physicians, and many barriers to implementing OUD pharmacotherapy exist, ranging from lack of confidence in treating OUD patients to concerns regarding reimbursement. Throughout the USA, the prevalence of OUD far exceeds the capacity of the OUD pharmacotherapy treatment system. Poor access to OUD pharmacotherapy prescribers has become a workforce development need for the addiction treatment field and a significant health issue. Methods: This cluster randomized controlled trial (RCT) is designed to increase buprenorphine and extended-release naltrexone treatment capacity for OUD. The implementation intervention to be tested is a bundle of OUD pharmacotherapy capacity building practices called the Prescriber Recruitment Bundle (PRB), which was developed and piloted in a previous statewide buprenorphine implementation study. For this cluster RCT, organizational sites will be recruited and then randomized into one of two arms: (1) control, with treatment as usual and access to a website with PRB resources, or (2) intervention, with organizations implementing the PRB using the Network for the Improvement of Addiction Treatment organizational change model over a 24-month intervention period and a 10-month sustainability period. The primary treatment outcomes for each organizational site are self-reported monthly counts of buprenorphine slots, extended-release naltrexone capacity, number of buprenorphine patients, and number of extended-release naltrexone patients. This trial will be conducted in Florida, Ohio, and Wisconsin, resulting in 35 sites in each arm, for a total sample size of 70 organizations. Discussion: This study addresses three issues of substantial public health significance: (1) the pressing opioid misuse epidemic, (2) the low uptake of OUD treatment pharmacotherapies, and (3) the need to increase prescriber participation in the addiction treatment workforce. Trial Registration: ClinicalTrials.gov NCT02926482

Pathophysiological Role and Medicinal Chemistry of A2A Adenosine Receptor Antagonists in Alzheimer's Disease

The A(2A) adenosine receptor is a protein belonging to a family of four GPCR adenosine receptors. It is involved in the regulation of several pathophysiological conditions in both the central nervous system and periphery. In the brain, its localization at pre- and postsynaptic level in striatum, cortex, hippocampus and its effects on glutamate release, microglia and astrocyte activation account for a crucial role in neurodegenerative diseases, including Alzheimer's disease (AD). This ailment is considered the main form of dementia and is expected to exponentially increase in coming years. The pathological tracts of AD include amyloid peptide-beta extracellular accumulation and tau hyperphosphorylation, causing neuronal cell death, cognitive deficit, and memory loss. Interestingly, in vitro and in vivo studies have demonstrated that A(2A) adenosine receptor antagonists may counteract each of these clinical signs, representing an important new strategy to fight a disease for which unfortunately only symptomatic drugs are available. This review offers a brief overview of the biological effects mediated by A(2A) adenosine receptors in AD animal and human studies and reports the state of the art of A(2A) adenosine receptor antagonists currently in clinical trials. As an original approach, it focuses on the crucial role of pharmacokinetics and ability to pass the blood-brain barrier in the discovery of new agents for treating CNS disorders. Considering that A(2A) receptor antagonist istradefylline is already commercially available for Parkinson's disease treatment, if the proof of concept of these ligands in AD is confirmed and reinforced, it will be easier to offer a new hope for AD patients

A taxonomy of dignity: a grounded theory study

Abstract Background This paper has its origins in Jonathan Mann's insight that the experience of dignity may explain the reciprocal relationships between health and human rights. It follows his call for a taxonomy of dignity: "a coherent vocabulary and framework to characterize dignity." Methods Grounded theory procedures were use to analyze literature pertaining to dignity and to conduct and analyze 64 semi-structured interviews with persons marginalized by their health or social status, individuals who provide health or social services to these populations, and people working in the field of health and human rights. Results The taxonomy presented identifies two main forms of dignity–human dignity and social dignity–and describes several elements of these forms, including the social processes that violate or promote them, the conditions under which such violations and promotions occur, the objects of violation and promotion, and the consequences of dignity violation. Together, these forms and elements point to a theory of dignity as a quality of individuals and collectives that is constituted through interaction and interpretation and structured by conditions pertaining to actors, relationships, settings, and the broader social order. Conclusion The taxonomy has several implications for work in health and human rights. It suggests a map to possible points of intervention and provides a language in which to talk about dignity