Background: Policy changes during the COVID-19 pandemic allowed buprenorphine to be prescribed for opioid use disorder (OUD) via telemedicine without an in-person visit. A recently proposed change will limit buprenorphine access to 30 days without an in-person visit. Given that people living in rural areas may be disproportionally impacted by this change, we sought to better understand how buprenorphine adherence may be impacted by requiring in-person visits.
View Article and Find Full Text PDFThe Yale-Brown Obsessive Compulsive Scale (Y-BOCS) is one of the most commonly used instruments for assessing and quantifying the presence and severity of obsessive-compulsive disorder (OCD) symptoms. Both the interview and self-report (SR) versions of the original Y-BOCS have demonstrated good psychometrics. However, areas for revision were noted regarding the measure's severity ceiling and a "resistance to obsessions" item that did not perform adequately in psychometric testing and was not consistent with theoretical models of OCD.
View Article and Find Full Text PDFThe Texas Christian University Hub of the Justice Community Opioid Innovation Network Project includes a partnership with state criminal justice (CJ) agencies with the goal of impacting state- and local-level policies and practices that will lead to increased access to and retention in community-based substance use treatment services among parole clients. This article outlines how we successfully fostered policy changes and includes a five-step process for how researchers can bridge the gap between research and CJ agencies to implement similar changes. This process included the use of various strategies to support the justice partners in their efforts to implement changes within their organization.
View Article and Find Full Text PDFBackground: Given the high prevalence of both mental health and acute pain conditions during pregnancy, use of antidepressants and analgesic opioids in this period is widespread. Whether single and combined use of these medications is associated with spontaneous preterm birth (sPTB) remains unclear.
Objectives: To investigate the association between maternal prescription opioid and antidepressant medication exposures for co-occurring mental health and acute pain management, either alone or in combination, and sPTB.
An international medical graduate (IMG) is a doctor who has received their basic medical qualification from a medical school located in a different country from that in which they practice or intend to practice. IMGs are known to face difficulties in their working lives, including differential attainment in assessment. The objective of this review is to map key concepts and types of evidence in academic and gray literature relating to international medical graduates' experiences of clinical competency assessment and to identify knowledge gaps on this topic by systematically searching, selecting, and synthesizing existing knowledge.
View Article and Find Full Text PDFTranscending Self Therapy (TST) is an integrative Cognitive Behavioral Therapy (CBT) for substance use disorders (SUD). Virtual reality (VR)-based enhancement of treatment for mental health disorders holds potential as an innovative and immersive adjunct to standards of care. However, outside of cue-conditioning applications, how VR may assist SUD treatment is not well understood.
View Article and Find Full Text PDFRes Child Adolesc Psychopathol
October 2024
J Acad Consult Liaison Psychiatry
October 2024
Background: Nonprescribed substance use (NPSU) is a recognized phenomenon exhibited by patients with substance use disorders while admitted to inpatient hospitals. What factors distinguish patients who engage in NPSU, or how their hospitalizations and outcomes differ, remains to be understood in full.
Objectives: Our study describes a cohort of medically admitted patients with substance use disorders with behaviors concerning for NPSU during their hospitalization.
Introduction: Existing data is often used for reproductive research and quality improvement. Electronic health records (EHRs) with a single data field for sex and gender conflate sex assigned at birth, genotype, gender identity, and the presence of anatomic tissue and organs. This is problematic for inclusion of transgender and gender-diverse populations in research.
View Article and Find Full Text PDFPurpose: Examine the concurrent validity of specific Anxiety Disorders Section of the Anxiety Disorder Interview Schedule for DSM-IV-Autism Spectrum Addendum (ADIS-ASA)-Parent Interview in a sample of 167 autistic youth who met diagnostic criteria for an anxiety-related disorder (M = 9.91; 78.4% male; 82% non-Hispanic; 77.
View Article and Find Full Text PDFTrauma Surg Acute Care Open
July 2024
Background: Non-opioid analgesics are prescribed in combination with opioids among patients with long bone fracture to reduce opioid prescribing needs, yet evidence is limited on whether they reduce the risk of serious opioid-related events (SOREs). We compared the risk of SOREs among hospitalized patients with long bone fracture discharged with filled opioid prescriptions, with and without non-opioid analgesics.
Design: We identified a retrospective cohort of analgesic-naïve adult patients with a long bone fracture hospitalization using the Merative MarketScan Commercial Database (2013-2020).
The current study examined the construct of State of Surrender (SoS)-defined as a willingness to accept, without resistance, what is to come-and investigated SoS as a statistical mediator of the relationship between engagement in substance use treatment and meaning in life (MIL). Using a cross-sectional design, participants were 123 people involved with the legal system participating in a 6-month residential treatment program for substance use. Results showed that measures of treatment engagement, including treatment participation, counselor rapport, and peer support, were all positively associated with SoS scores ( s ≥ 21.
View Article and Find Full Text PDFPharmacoepidemiological studies commonly examine the association between drug dose and adverse health outcomes. In situations where no safe dose exists, the choice of modeling strategy can lead to identification of an apparent safe low dose range in the presence of a non-linear relationship or due to the modeling strategy forcing a linear relationship through a dose of 0. We conducted a simulation study to assess the performance of several regression approaches to model the drug dose-response curve at low doses in a setting where no safe range exists, including the use of a (1) linear dose term, (2) categorical dose term, and (3) natural cubic spline terms.
View Article and Find Full Text PDFBackground: Adopting high-value, cost-conscious care (HVCCC) principles into medical education is growing in importance due to soaring global healthcare costs and the recognition that efficient care can enhance patient outcomes and control costs. Understanding the current opportunities and challenges doctors face concerning HVCCC in healthcare systems is crucial to tailor education to doctors' needs. Hence, this study aimed to explore medical students, junior doctors, and senior doctors' experiences with HVCCC, and to seek senior doctors' viewpoints on how education can foster HVCCC in clinical environments.
View Article and Find Full Text PDFPurpose: The aim of this qualitative study was to investigate resilience among adults with Osteogenesis Imperfecta (OI).
Materials And Methods: Semi-structured interviews were conducted with 15 adults with OI. Transcripts were coded and subsequently abstracted, yielding themes specific to resilience and coping.
Cognitive-behavioral therapy (CBT) is an effective treatment for a variety of psychiatric disorders. However, historic underrepresentation, misapplication of techniques, and neglected consideration for the unique experiences of marginalized groups-including racial, ethnic, sexual, and gender minorities-have led to mistrust of mental health treatment among these communities and decreased access to quality, evidence-based care. Although these treatments are not inherently harmful to individuals with marginalized identities, clinicians can cause harm if they do not consider the role of culture in their conceptualization, assessment, and treatment of individuals with marginalized identities.
View Article and Find Full Text PDFResearch specific to obsessive-compulsive disorder (OCD) among individuals of Hispanic and Latin American (H/L) ancestry is limited, as are culturally relevant assessment and treatment recommendations. This article discusses the implications of underrepresentation of H/L populations in OCD research and emphasizes the need to consider issues related to assessment, treatment, and structural barriers that hinder delivery of culturally appropriate first-line psychotherapy. Recommendations for assessment and treatment are provided to aid clinicians in distinguishing culturally normative thoughts and behaviors from OCD, as well as to inform the implementation of psychotherapeutic interventions with cultural humility.
View Article and Find Full Text PDFObjective: Observational studies examining outcomes among opioid-exposed infants are limited by phenotype algorithms that may under identify opioid-exposed infants without neonatal opioid withdrawal syndrome (NOWS). We developed and validated the performance of different phenotype algorithms to identify opioid-exposed infants using electronic health record data.
Methods: We developed phenotype algorithms for the identification of opioid-exposed infants among a population of birthing person-infant dyads from an academic health care system (2010-2022).
Background And Objectives: Addiction consultation services provide access to specialty addiction care during general hospital admission. This study assessed opioid use disorder (OUD) outcomes associated with addiction consultation.
Methods: Retrospective cohort study of individuals with OUD admitted to an academic medical center between 2018 and 2023.
As Arabidopsis flowers mature, specialized cells within the anthers undergo meiosis, leading to the production of haploid microspores that differentiate into mature pollen grains, each containing two sperm cells for double fertilization. During pollination, the pollen grains are dispersed from the anthers to the stigma for subsequent fertilization. Transcriptomic studies have identified a large number of genes expressed over the course of male reproductive development and subsequent functional characterization of some have revealed their involvement in floral meristem establishment, floral organ growth, sporogenesis, meiosis, microsporogenesis, and pollen maturation.
View Article and Find Full Text PDFImportance: Opioid exposure during pregnancy has been associated with preterm birth, but prior studies have not differentiated between spontaneous and indicated preterm birth or fully investigated these associations as functions of opioid dose.
Objective: To determine whether prescription opioid use during pregnancy is associated with spontaneous preterm birth and whether the association is dose-dependent.
Design, Setting, And Participants: This case-control study examined a retrospective cohort of pregnant patients enrolled in Tennessee Medicaid.
J Clin Psychol Med Settings
September 2024
Osteogenesis imperfecta (OI) is a genetic disorder characterized by bone fragility and fractures, short stature, dental abnormalities, hearing loss, scoliosis, and chronic pain. Despite a growing literature on the functional outcomes of OI, limited research has explicitly examined the psychosocial outcomes of pain within OI. Adults with OI (N = 15) were interviewed to understand pain-related experiences through a thematic analysis of semi-structured interview data.
View Article and Find Full Text PDFAm J Med Genet B Neuropsychiatr Genet
June 2024
Background: Despite the heightened risk for substance use (SU) among youth in the juvenile justice system, many do not receive the treatment that they need.
Objectives: The purpose of this study is to examine the extent to which youth under community supervision by juvenile justice agencies receive community-based SU services and the factors associated with access to such services.
Methods: Data are from a nationally representative sample of Community Supervision (CS) agencies and their primary behavioral health (BH) partners.