Understanding MAT access in the context of unused MAT capacity in the United States: when increasing rural MAT capacity is not enough.

Background: Section 1262 Consolidated Appropriations Act of 2023 eliminates the federal DATA waiver registration requirement to prescribe buprenorphine for opioid use disorder (OUD), along with patient limits, perhaps as a way to increase provider capacity to prescribe buprenorphine. Understanding the factors that influence provider capacity, patient access, and whether community need for MAT is met could inform how to capitalize on DATA waiver eliminations in the United States.

Methods: This observational study utilized required reporting from two cohorts of the Rural Communities Opioid Response Program (RCORP).

DEVELOPING A PRACTICE-DRIVEN TAXONOMY OF IMPLEMENTATION STRATEGIES FOR HIV PREVENTION.

Background: Effective implementation of evidence-based HIV prevention interventions continues to be a challenge in the United States, and the field is increasingly turning to implementation science for solutions. As such, it is critical to expand the current implementation science vocabulary - and its taxonomy of implementation strategies - to increase its relevance and utility for front-line implementers.

Setting: Community-based health centers providing HIV prevention services in the Southeastern US.

The Adult Changes in Thought (ACT) Medical Records Abstraction Project: A Resource for Research on Biological, Psychosocial and Behavioral Factors on the Aging Brain and Alzheimer's Disease and Related Dementias.

Background: Adult Changes in Thought (ACT), a prospective cohort study, enrolls older adult members of Kaiser Permanente Washington. We describe an ambitious project to abstract medical records facilitating epidemiological investigation.

Methods: Abstracted data include medications; laboratory results; women's health; blood pressure; physical injuries; cardiovascular, neurological, psychiatric and other medical conditions.

Leveraging international stakeholders' experiences with oral PrEP costs to accelerate implementation of the monthly dapivirine vaginal ring: A qualitative study.

Background: Costing and financing systematic implementation are recognized barriers to human immunodeficiency virus (HIV) prevention. In the absence of empiric implementation and economic data, perspectives from international stakeholders involved in developing and supporting daily oral pre-exposure prophylaxis (PrEP) policy, and programs can provide critical insights for developing costed plans to support and accelerate the rollout of novel long-acting PrEP (LA-PrEP) methods, such as the monthly dapivirine vaginal ring (PrEP ring).

Methods: We interviewed stakeholders from purposively selected international organizations about anticipated PrEP-ring implementation costs, evidence gaps and key process steps for developing a costed rollout plan template (CRPT).

Religious Characteristics of Nurses Who Refer Patients to Chaplains at a Catholic Hospital in the Northwestern USA.

The purpose of this study was to assess the association between nurse religiosity and decision to consult spiritual care services at a hospital in the western USA. An anonymous survey was distributed to assess nurses' reports of whether they would request spiritual care services across different scenarios. Out of 171 nurses approached to participate in this survey, fifty-one nurses completed the survey and half of respondents considered themselves religious.

Evaluation of Antibiotic Use for Dental-Related Infections in Dental Clinics Associated With an Academic Safety Net Institution.

This retrospective study found lower antibiotic prescribing rates by outpatient dentists than previous literature, but with deviations from guideline recommendations in antibiotic indications and durations of treatment for oral pain and swelling. These findings will guide future stewardship interventions to promote guideline-directed therapy plans.

Integrated multimodal cell atlas of Alzheimer's disease.

Alzheimer's disease (AD) is the leading cause of dementia in older adults. Although AD progression is characterized by stereotyped accumulation of proteinopathies, the affected cellular populations remain understudied. Here we use multiomics, spatial genomics and reference atlases from the BRAIN Initiative to study middle temporal gyrus cell types in 84 donors with varying AD pathologies.

The Efficiency of Phosphate Removal via Shallow Wastewater Injection into a Saline Carbonate Aquifer.

Wastewater-derived phosphate contributes to eutrophication if the phosphate is not efficiently removed before it is discharged to surface waters. In the Florida Keys (USA), shallow injection of treated wastewater into saline limestone aquifers is a common mode of wastewater disposal. We assessed the possibility of efficient and permanent phosphate removal following injection at a wastewater treatment facility in Marathon, Florida.

Limitations With California Medicaid Data for Palliative and End of Life Care Quality Measures.

In 2014 the California legislature passed Senate Bill 1004 (SB 1004) that was designed to expand access to specialty palliative care for individuals served by California's Medicaid (known as Medi-Cal) Managed Care Plans (MCPs). The California Department of Health Care Services (DHCS) operationalized the legislation by developing minimum requirements for palliative care programs that all MCPs must meet or exceed. Quality and utilization data specific to California's Medicaid population are needed for stakeholders to identify care deficiencies and disparities, describe the end of life experience and utilization patterns of MCP members, compare these patterns to Medicare beneficiaries or other populations, and set appropriate targets to help monitor progress.

Expanding the opioid use disorder medication treatment workforce in rural communities through the RCORP initiative.

Purpose: The Rural Communities Opioid Response Program (RCORP) was funded to help rural communities improve prevention, treatment, and recovery services for Opioid Use Disorder (OUD), including increasing the supply of clinicians with a Drug Enforcement Administration (DEA) waiver to prescribe buprenorphine, which was required before 2023. This research investigates the impact of RCORP funding on the supply of DEA-waivered clinicians in rural communities.

Methods: We used 2017-2022 DEA lists of waivered clinicians to assign clinicians to US counties.

Long-acting injectable ART to advance health equity: a descriptive analysis of US clinic perspectives on barriers, needed support and programme goals for implementation from applications to the ALAI UP Project.

Introduction: Approval of the first long-acting injectable antiretroviral therapy (LAI ART) medication heralded a new era of HIV treatment. However, the years since approval have been marked by implementation challenges. The "Accelerating Implementation of Multilevel Strategies to Advance Long-Acting Injectable for Underserved Populations (ALAI UP Project)" aims to accelerate the systematic and equitable delivery of LAI ART.

Get2PrEP2-A Provider Messaging Strategy to Improve PrEP Uptake: A Randomized Controlled Quality Improvement Project.

Introduction: HIV preexposure prophylaxis (PrEP), a key strategy for preventing HIV transmission, requires awareness and access to PrEP services. Although all patients should be made aware of HIV PrEP; the diagnosis of bacterial sexually transmitted infections (STIs) is an important indicator of potential HIV PrEP need. In a previous evaluation of Get2PrEP (G2P), we found that an electronic medical record laboratory comments did not increase the frequency of PrEP discussions between patients and providers.

Nursing and Chaplain Partnership for Pain Management: A Survey of Nurses.

Purpose: Pain is a universal experience for hospitalized patients, with physical, psychological, spiritual, and cognitive implications. As hospitals seek to identify nonpharmaceutical options for managing acute pain, the role of chaplains has been overlooked. The purpose of this study was to evaluate the perceptions of nurses regarding chaplain involvement in pain management.

Sleep Duration and Blood Pressure in Youth Referred for Elevated Blood Pressure Evaluation.

Objectives: Sleep promotion is not specifically recommended as a target for hypertension management. We examined associations of sleep duration and timing with blood pressure parameters in patients referred to pediatric nephrology clinic for elevated blood pressure evaluation.

Methods: This is a retrospective study of initial ambulatory blood pressure monitoring data and self-report sleep data collected from patients referred to nephrology clinic for the evaluation of elevated blood pressure.

Biomechanical Motion Changes in Adjacent and Noncontiguous Segments Following Single-Level Anterior Cervical Discectomy and Fusion: A Computed Tomography-Based 3D Motion Capture Study.

Background: Anterior cervical discectomy and fusion (ACDF) is known to elicit adverse biomechanical effects on immediately adjacent segments; however, its impact on the kinematics of the remaining nonadjacent cervical levels has not been understood. This study aimed to explore the biomechanical impact of ACDF on kinematics beyond the immediate fusion site. We hypothesized that compensatory motion following single-level ACDF is not predictably distributed to adjacent segments due to compensation from noncontiguous levels.

A Formative Evaluation of Diabetes Self-Management Education and Support Within the Virtual Medical Center.

The Diabetes Self-Management Education and Support (DSMES) program provides education and medical monitoring of diabetes to Veterans through the Virtual Medical Center (VMC). Qualitative interviews were conducted with 15 key stakeholders (4-DSMES VMC trainers, 5-clinical faculty, and 6-Veterans) from across Ohio urban and rural populations for up to 1h about their experiences using the program and suggestions for improvement. All the Veterans interviewed were able to access care within the DSMES VMC and reported a positive experience using the program, and improved diabetes self-management.

Evaluating Dual Process Decision-Making Along the PrEP Consumer Journey: New Insights for Supporting PrEP Use.

With the rise of new and emerging Pre-Exposure Prophylaxis (PrEP) modalities, greater attention is needed to better understand how people who could benefit from PrEP make decisions to initiate, stop, pause, or switch PrEP regimens. In this study we borrow from the field of consumer research to create a consumer-derived PrEP Consumer Journey Model that describes key decision-making touchpoints a PrEP consumer moves through within and outside of a clinical context. Using in-depth interviews (n = 29) with gay and bisexual men who have sex with men, we evaluate which system 1 (emotional) and system 2 (cognitive) attributes are used for decision-making at different touchpoints along the PrEP Consumer Journey.

Lessons learnt from daily oral PrEP delivery to inform national planning for PrEP ring introduction for women in low-income and middle-income countries: a qualitative inquiry of international stakeholders.

Introduction: Some African countries plan to introduce and scale-up new long-acting pre-exposure prophylaxis methods (LA-PrEP), like the monthly dapivirine vaginal ring (PrEP ring) and injectable cabotegravir. National costed implementation plans, roadmaps for successful product implementation, are often overlooked. International stakeholders engaged in oral PrEP planning, introduction and scale-up are an information resource of lessons learned to advise LA-PrEP planning.

Data on electroconvulsive seizure in mice, effects of anesthesia on immediate early gene expression.

Although electroconvulsive therapy (ECT) is one of the most effective treatments for severe mood and psychotic disorders, the mechanisms underlying its therapeutic effects remain unknown. Electroconvulsive stimulation (ECS), the animal model for ECT, can be used to investigate the potential therapeutic mechanisms of ECT in rodents. ECS produces numerous effects in the brain, such as increasing levels of growth factors, inducing dendritic sprouting, and stimulating neurogenesis.

Ambulatory Blood Pressure and Number of Subclinical Target Organ Injury Markers in Youth: The SHIP AHOY Study.

Background: Hypertension in adolescence is associated with subclinical target organ injury (TOI). We aimed to determine whether different blood pressure (BP) thresholds were associated with increasing number of TOI markers in healthy adolescents.

Methods: 244 participants (mean age 15.

Contribution of the Medial Iliofemoral Ligament to Hip Stability After Total Hip Arthroplasty Through the Direct Anterior Approach.

Background: Dislocation after total hip arthroplasty (THA) is a primary reason for THA revision. During THA through the direct anterior approach (DAA), the iliofemoral ligament, which provides the main resistance to external rotation (ER) of the hip, is commonly partially transected. We asked: (1) what is the contribution of the medial iliofemoral ligament to resisting ER after DAA THA? and (2) how much resistance to ER can be restored by repairing the ligament?

Methods: A fellowship-trained surgeon performed DAA THA on 9 cadaveric specimens.

Traumatic Brain Injury, Psychological Trauma Exposure, and Anxious and Depressive Symptoms in a Clinical Population.

Background: Approximately 90% of adults endorse psychological trauma exposure. However, barriers to assessment of psychological trauma and sequelae include limited access to care, lack of standardized assessments in nonpsychiatric settings, and comorbid diagnoses, such as traumatic brain injury (TBI), that may mimic psychiatric syndromes.

Objectives: This study aims to assess the prevalence rates of psychological trauma exposure and TBI to understand the relationship of these experiences with current psychiatric symptoms.