Fentanyl Test Strip Use and Overdose History among Individuals on Medication for Opioid Use Disorder.

Background: The number of deaths from drug overdose in the United States has more than doubled in the past decade. In particular, drug overdose deaths involving fentanyl have doubled every year since 2013. Rapid fentanyl test strips (FTS) are a useful strategy for detecting traces of fentanyl in substances and have received overwhelming support from individuals with opioid-dependence. Methods: We investigated fentanyl use, knowledge of FTS, willingness to use FTS, and overdose history among a sample of 105 individuals currently on medication for opioid use disorder (MOUD). Results: Results showed that the majority (63%) of the sample had experienced a non-fatal overdose and that 85% of participants were willing to use FTS. The majority of participants reported concern about fentanyl in their drug supply (70%) and 77% reported likelihood of past unintentional fentanyl use. Of note, only about half (47%) of participants knew of FTS prior to being surveyed, and only 17% reported ever using FTS. Conclusion: These results expand on previous literature that documents high levels of willingness, yet low uptake of FTS among individuals on MOUD. Widespread education about FTS, in addition to the implementation of the use of FTS, is a highly promising and critical primary prevention alternative to overdose treatment and/or death due to fentanyl.

Advancing Behavioral HIV Prevention: Adapting an Evidence-Based Intervention for People Living with HIV and Alcohol Use Disorders.

Alcohol use disorders (AUDs) are highly prevalent among people living with HIV/AIDS (PLWHA) and are associated with increased HIV risk behaviors, suboptimal treatment adherence, and greater risk for disease progression. We used the ADAPT-ITT strategy to adapt an evidence-based intervention (EBI), the Holistic Health Recovery Program (HHRP+), that focuses on secondary HIV prevention and antiretroviral therapy (ART) adherence and apply it to PLWHA with problematic drinking. Focus groups (FGs) were conducted with PLWHA who consume alcohol and with treatment providers at the largest HIV primary care clinic in New Orleans, LA. Overall themes that emerged from the FGs included the following: (1) negative mood states contribute to heavy alcohol consumption in PLWHA; (2) high levels of psychosocial stress, paired with few adaptive coping strategies, perpetuate the use of harmful alcohol consumption in PLWHA; (3) local cultural norms are related to the permissiveness and pervasiveness of drinking and contribute to heavy alcohol use; (4) healthcare providers unanimously stated that outpatient options for AUD intervention are scarce, (5) misperceptions about the relationships between alcohol and HIV are common; (6) PLWHA are interested in learning about alcohol's impact on ART and HIV disease progression. These data were used to design the adapted EBI.

The development and validation of the attitude toward father scale. A tool for assessing the father's role in children's behavior problems.

Numerous measures assess how parental influences may relate to children's development of psychological difficulties. The majority of such measures focuses specifically on the mother-child relationship or assume both parents contribute equally and similarly to their children's psychological well-being. Previous research has largely ignored the need to assess the father-child relationship when examining parental influences on behavior problems. The goal of the present study was to develop and validate a self-report questionnaire to assess the father-child relationship. The Attitude Toward Father Scale was developed and validated using three independent samples of college undergraduates. The scale, which includes three subscales, was shown to have good psychometric properties. It was found effective in examining associations between father-child relationship scores and scores on adjustment measures. Findings showed total scale and subscale scores associated with measures of stress, alcoholism, hostility, depression, anxiety, and paranoia. Implications of findings and suggestions for future research are discussed.

Better late than never: of reminiscence and resolution.

My purpose in writing this article was to offer observations and helping strategies to nurse-colleagues who deal with depressed elderly. The process begins (as always) with careful assessment and a willingness to adapt strategies to changing needs. Change is expected--both in assessment data and in clients' behavior. This model is client-driven. The client defines her needs, her goals, her feelings, and her solutions. When the nurse offers suggestions, it is only to "prime the pump." The nurse must have no vested interest in the ultimate use of those suggestions. In fact, there is cause to rejoice when a client discards them in favor of her own. The nurse must avoid being cast in the role of referee or judge in working with Angry Depressed clients. Who is "to blame" in clients' ruptures with the family and/or friends is outside the nurse's area of concern. The focus is on healing those ruptures if the client wishes to do so and for the client's sake. Within the framework of Erikson's eighth stage, the client's task has been to resolve the tension between the polar extremes of integrity and despair. The tools at hand for accomplishing this task have been the client's intrinsic strengths and the nurse's professional skills. "Dorothy" and "Julia" have had some degree of success in this endeavor, placing them at positions closer to integrity on an integrity-despair continuum. Others have had less positive resolutions. Still others are "in process." One woman in her 80s has resumed telephone contact with her daughter after a long hiatus, but is still estranged from her son.(ABSTRACT TRUNCATED AT 250 WORDS)

Testing a social-cognitive model of intimate abusiveness among substance-dependent males.

Throughout history, the human race has been characterized by the use of physical and emotional aggression by individuals, particularly males, in their intimate relationships. Intimate abusiveness is particularly common among substance-dependent males. As a result of male intimate abusiveness, victims suffer a variety of problems, ranging from emotional trauma to death due to physical injury. Despite increased attention to this problem, our understanding of the process leading to intimate abusiveness is far from comprehensive. The primary purpose of the present study was to expand our understanding of intimate abusiveness through the application of a social-cognitive model of intimate abusiveness among substance-dependent males. Participants were 57 males from an inpatient substance abuse treatment program. Subjects completed questionnaires indicating their level of intimate abusiveness. In addition, they completed partner-related attribution measures, as well as coping response measures indicating how they would interpret and handle five ambiguous vignettes involving their partner. It was hypothesized that violent men would attribute greater negative intent and responsibility to their partner, and that they would choose to handle the ambiguous vignettes in less competent ways compared with nonviolent men. Further, it was predicted that the association between intimate abusiveness and competency of coping responses would be mediated by attributions made about the partner. Results of the study generally supported predictions. The implications of the results are discussed, and suggestions are made for future research.

A method of designing clinical trials for combination drugs.

Many pharmaceutical companies are now exploring combination drug therapies as an alternative to monotherapy. Consequently, it is of interest to investigate the simultaneous dose response relationship of two active drugs to select the lowest effective combination. In this paper, we propose a method for designing clinical trials for drug combinations that seems to offer several advantages over the 4 x 3 or even larger factorial studies that have been used to date. In addition, our proposed method provides a convenient formula for calculating the required sample size.

Effects of diabetes on protein synthesis in fast- and slow-twitch rat skeletal muscle.

The effects of acute (2-day) and long-term (7-day) diabetes on rates of protein synthesis, peptide-chain initiation, and levels of RNA were examined in rat skeletal muscles that are known to have differing proportions of the three fiber types: fast-twitch white, fast-twitch red, and slow-twitch red. Short-term diabetes resulted in a 15% reduction in the level of RNA in all the muscles studied and an impairment in peptide-chain initiation in muscles with mixed fast-twitch fibers. In contrast, the soleus, a skeletal muscle with high proportions of slow-twitch red fibers, showed little impairment in initiation. When the muscles were perfused as a part of the hemicorpus preparation, addition of insulin to the medium caused a rapid reversal of the block in initiation in mixed fast-twitch muscles but had no effect in the soleus. The possible role of fatty acids in accounting for these differences is discussed. Long-term diabetes caused no further reduction in RNA, but resulted in the development of an additional impairment to protein synthesis that also affected the soleus and that was not corrected by perfusion with insulin. The defect resulting from long-term diabetes may involve elongation or termination reactions.