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Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The drug epidemic presents a major danger to society, with serious implications for the economy, culture, security, and defense. It not only harms individual health but also contributes to criminal activity, destabilizes countries, and endangers their stability, prosperity, and longevity. The study focuses on the historical and legal aspects of the compulsory detoxification process for juveniles in Vietnam. This research delves into the measure of sending juvenile drug addicts to mandatory detoxification facilities. It reveals that the measure is essentially to detain drug users in such facilities. A comparative analysis is drawn between Vietnam's Law and human rights in International Law, leading the authors to contend that the Vietnamese Government might violate human rights in "The Fight and Prevention about Drugs." In response to this threat, the Government of Vietnam has taken proactive measures to establish guidelines, mechanisms, and policies aimed at preventing, combating, and controlling drug-related issues. Compulsory Detoxification for Juveniles in Vietnam is one of the most important prevention drug provisions in Vietnam's Law. Through practical surveys, when the Vietnamese Government applied this stern measure, the number of juvenile drugs not only failed to reduce but also slightly increased when put into practice. This paradox requires further interdisciplinary research to investigate the issue thoroughly. [ABSTRACT FROM AUTHOR]

Background: Lung cancer is the leading cause of cancer death in the world. Non-small-cell lung cancer (NSCLC) accounts for 85% of primary lung tumors. Epidermal growth factor receptors (EGFRs) are found on the surface of tumor cells, and their role is to send a growth signal to the cell nucleus. Tumor cells with EGFR mutations are very sensitive to cancer treatments called "Targeted Therapies." The search for EGFR mutations requires lung biopsies. Some studies have shown a correlation between clinico-radiological characteristics and the EGFR mutation. In this study, an attempt was made to identify the relevant clinico-radiological characteristics associated with the EGFR mutation in patients with NSCLC. Objectives: The main objective of this study was to evaluate the clinico-radiological characteristics useful for predicting the risk of EGFR mutation in patients with NSCLC. Materials and methods: This is a retrospective cross-sectional study, carried out in 149 patients followed up for lung adenocarcinoma who benefited from an EGFR mutation study at the anatomopathology department of the University Hospital of Fez, spread over a period of 4 years (between January 2018 and December 2021). A database was compiled from this study, including sociodemographic, clinical, anatomopathological and radiological data. A statistical analysis was carried out in order to identify the factors associated with EGFR mutation. Results: According to the inclusion and exclusion criteria, of the 149 patients included, the mean age was 61.05 + / − 11.095 years. Males predominated with a percentage of 70.5% (n = 105). Fifty-seven point seven percent of patients were smokers or ex-smokers. Forty-one patients had an EGFR mutation, representing a percentage of 27.5%. Multivariate analysis by logistic regression revealed an association of the EGFR mutation with irregular contours (ORA = 6.43; CI95% 1.26;32.78), with the presence of spiculations (ORA = 5.81; CI95% 1.96;17.22), with pleural attachment (ORA = 3.53; CI95% 1.32;9.42), with heterogeneous enhancement (ORA = 30.679; CI95% 5.149;182.778), with absence of emphysema (ORA = 4.815; CI95% 1.966;17.220) and with presence of distant metastasis (ORA = 4.123; CI95% 1.373;12.383). Conclusions: This study provides substantial evidence to support the assertion that irregular contours, the presence of spiculations, pleural attachment, heterogeneous enhancement, the absence of emphysema and the presence of distant metastasis are statistically correlated with EGFR mutations. The model developed within this study, encompassing all relevant clinical and CT characteristics, has demonstrated its effectiveness as a reliable predictor for EGFR mutations (AUC: 0.7659) and consequently as a key determinant of EGFR-TKI treatment response. [ABSTRACT FROM AUTHOR]

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The mode of human immunodeficiency virus (HIV) transmission via injection drug use (IDU) still exists, and the recent shift in IDU-related transmission of HIV infection is largely unknown. The purpose of this study was to analyze the spatiotemporal sources and dynamics of HIV-1 transmission through IDU in Guangxi. We performed a molecular epidemiological investigation of infections across Guangxi from 2009 to 2019. Phylogenetic and Bayesian time-geographic analyses of HIV-1 sequences were performed to confirm the characteristics of transmission between IDUs in combination with epidemiological data. Among the 535 subjects, CRF08_BC (57.4%), CRF01_AE (28.4%), and CRF07_BC (10.7%) were the top 3 HIV strains; 72.6% of infections were linked to other provinces in the transmission network; 93.6% of sequence-transmitted strains were locally endemic, with the rest coming from other provinces, predominantly Guangdong and Yunnan; 92.1% of the HIV transmission among people who inject drugs tended to be transmitted between HIV-positive IDUs. HIV recombinants were high diversity, and circulating local strains were the transmission sources among IDUs in Guangxi. However, there were still cases of IDUs linked to other provinces. Coverage of traditional prevention strategies should be expanded, and inter-provincial collaboration between Guangxi, Yunnan, and Guangdong provinces should be strengthened. [ABSTRACT FROM AUTHOR]

Copyright of Saúde Coletiva is the property of MPM Comunicacao and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Colombiana de Psiquiatria is the property of Asociacion Colombiana de Psiquiatria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Saúde Coletiva is the property of MPM Comunicacao and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To compare the effect of ketamine, lidocaine, acetaminophen, and dexmedetomidine combined with morphine patient-controlled analgesia for opium addicts after tibial fracture surgery. Methods: This double-blind clinical trial included opium-addicted patients undergoing tibia fracture surgery. Patients were recruited and randomized to four different groups including the ketamine group, the lidocaine group, the acetaminophen group, and the dexmedetomidine group. The hemodynamic parameters such as heart rate (HR), mean arterial pressure, and arterial SaO2, alongside visual analog scale pain scores, sedation assessed by Ramsay score, nausea and vomiting, and opioid use were recorded and compared among the four groups. Results: This study included 140 patients, aged 37 (32, 41) years, with 92 males and 48 females, and each group had 35 patients. Dexmedetomidine-sedated subjects had the lowest blood pressure from 1 to 24 h after surgery, decreased HR at 12 and 24 h after surgery, and more satisfactory sedation (P<0.05). Notwithstanding no significant difference was noted in the pain scores, or nausea and vomiting among the groups (P>0.05). Conclusions: Dexmedetomidine has a better sedation effect compared to ketamine, lidocaine, and acetaminophen for pain control, but the final choice hinges on the patients' physical condition and the anesthesiologist's preference. [ABSTRACT FROM AUTHOR]

In China, although drug use is an administrative and not criminal offense, individuals detained by public security authorities are subject to coercive or compulsory "treatment," which can include community-based detoxification and rehabilitation and two years of compulsory isolation. Individuals are also entered into a system called the Drug User Internet Dynamic Control and Early Warning System, or simply the Dynamic Control System. The Dynamic Control System, run by the Ministry of Public Security, acts as an extension of China's drug control efforts by monitoring the movement of people in the system and alerting police when individuals, for example, use their identity documents when registering at a hotel, conducting business at a government office or bank, registering a mobile phone, applying for tertiary education, or traveling. This alert typically results in an interrogation and a drug test by police. This paper seeks to summarize, using published government reports, news articles, and academic papers, what is known about the Dynamic Control System, focusing on the procedures of (1) registration; (2) management; and (3) exit. At each step, people subject to the Dynamic Control System face human rights concerns, especially related to the right to privacy, rights to education and work, and right to health. [ABSTRACT FROM AUTHOR]

Date Presented 03/21/24 Phenomenological interviews and focus groups identified perceived causes of falls for people living with HIV and substance abuse. This lived-experience data informed the development of a virtual fall prevention OT intervention. Primary Author and Speaker: Christine Helfrich Additional Authors and Speakers: Danny Shin Contributing Authors: Simone V. Gill [ABSTRACT FROM AUTHOR]

Brazilian drug policies have undergone changes over time, bearing marks for each historical period and experienced sanitary-political interests. Nowadays, an anti-reformist character was perceived in changes concentrated on Law no. 13,840, of June 5, 2019. The aim of this study is to analyze the key elements of a normative document on drugs based on the Critical Discourse Analysis. We analyzed the Law no. 13,840 using Fairclough's method for three-dimensional analysis and then discussed it with Foucault's notions of Biopower and Biopolitics. We consider that the emphasis on involuntary hospitalization, therapeutic communities and abstinence opposes the Brazilian psychiatric reform movement. The development of oppressive care practices are hidden by the so-called ideological neutrality and scientific evidence. [ABSTRACT FROM AUTHOR]

Copyright of Saúde Coletiva is the property of MPM Comunicacao and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The growth of Brazilian therapeutic communities points to a return to the asylum paradigm, with public funding for hospitalizations based on labor therapy and religious conversion. The relationship between these institutions and government sectors has expanded since 2013 in the state of Espírito Santo, Brazil. Given this scenario, we aimed to analyze, through this qualitative research, the role of religious therapeutic communities in the treatment of individuals with problematic drug use, focusing on the impact of the religious methods employed in these places. To this end, we conducted semi-structured interviews with 28 individuals who had been treated in these places. The interviews were held for six months and subsequently transcribed in full. The data were analyzed using the Discourse Analysis. The subjects’ statements widely differed: 13 reported that institutions had an essential role in their treatment and pointed out that religious methods helped them, while 15 argued that institutions were inefficient in their treatment and religious methods were ineffective. The study elucidated the need for inspection of these institutions and stirred a reflection concerning their suitability as publicly funded places to treat the drug user population. [ABSTRACT FROM AUTHOR]

We are sadly experiencing unprecedented levels of overdose mortalities attributed to the increased availability of synthetic opioids in illegal markets. While the majority of attention in North America has focused on preventing drug overdose cases through the distribution and administration of naloxone, in addition to stricter regulations of opioid prescriptions and greater law enforcement in illegal markets, little attention has been given to other alternative models and treatments for people who use drugs that are tailored specifically to the health care needs of this marginalized population. Through this analysis, the implications of task-shifting in health care via the distribution of naloxone for an already marginalized population are discussed. Alternatively, the role of pioneering harm-reduction programs – such as supervised injection/consumption sites, a variety of opioids maintenance therapies, and social-structural interventions – are highlighted as crucial interventions in the current ongoing opioid crisis. Moreover, people with lived experiences of illegal drug use are discussed as having a pivotal role but being ultimately overshadowed by public health partners. [ABSTRACT FROM AUTHOR]

Background: Studies of people who inject drugs (PWID) commonly use questionnaires to determine whether participants are currently, or have recently been, on opioid agonist treatment for opioid use disorder. However, these previously unvalidated self-reported treatment measures may be susceptible to inaccurate reporting.Methods: We linked baseline questionnaire data from 521 PWID in the Ontario integrated Supervised Injection Services cohort in Toronto (November 2018-March 2020) with record-level health administrative data. We assessed the validity (sensitivity, specificity, positive and negative predictive value [PPV and NPV]) of self-reported recent (in the past 6 months) and current (as of interview) opioid agonist treatment with methadone or buprenorphine-naloxone relative to prescription dispensation records from a provincial narcotics monitoring system, considered the reference standard.Results: For self-reported recent opioid agonist treatment, sensitivity was 78% (95% CI = 72, 83), specificity was 90% (95% CI = 86, 94), PPV was 90% (95% CI = 85, 93), and NPV was 79% (95% CI = 74, 84). For self-reported current opioid agonist treatment, sensitivity was 84% (95% CI = 78, 90), specificity was 87% (95% CI = 83, 91), PPV was 74% (95% CI = 67, 81), and NPV was 93% (95% CI = 89, 95).Conclusions: Self-reported opioid agonist treatment measures were fairly accurate among PWID, with some exceptions. Inaccurate recall due to a lengthy lookback window may explain underreporting of recent treatment, whereas social desirability bias may have led to overreporting of current treatment. These validation data could be used in future studies of PWID to adjust for misclassification in similar self-reported treatment measures. [ABSTRACT FROM AUTHOR]

Copyright of Revista Eletrônica de Enfermagem is the property of Revista Eletronica de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Janus is the property of Sosiaalipoliittinen yhdistys and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

• Alcoholic hepatitis is associated with a significantly altered lipoprotein profile. • NMR lipoprotein profiling captures lipoprotein changes in alcoholic hepatitis. • HDL level is significantly reduced in alcoholic hepatitis. • HDL and total cholesterol levels are predictive of AH severity and mortality. Alcohol-associated liver disease (ALD) and alcoholic hepatitis (AH) significantly impact the liver, an organ central to the lipid and lipoprotein metabolism. To define changes in the lipid and lipoprotein profiles in subjects with alcoholic hepatitis (AH) versus heavy drinkers with normal liver function and to determine the association of the AH-mediated lipoprotein phenotype with AH severity and outcomes. AH cases (n=196) and a heavy drinker control group (n=169) were identified in a multicenter, prospective cohort. The relationships between lipid panels and lipoprotein profiles among AH and heavy drinkers were interrogated using three common measurements: the conventional lipid panel, extended lipid panel by NMR, and NMR-based direct lipoprotein profiling. Predictive values for AH severity and mortality were determined using Harrell's C-Index. Lipid and lipoprotein profiles were significantly different in AH compared to heavy drinkers. Among them, high density lipoprotein (HDL) particle concentration exhibited the most significant reduction in AH compared to heavy drinkers (5.3 ± 3.4 vs 22.3 ± 5.4 μmol/L, p < 0.001). Within AH patients, HDL particle concentration was inversely associated with Maddrey's Discriminant Function (DF) (p < 0.001), and independently associated with mortality at both 90 and 365 days even after adjustment for DF (p = 0.02, p = 0.05 respectively). HDL particle concentration less than 3.5 μmol/L and total cholesterol ≤ 96 mg/dL identified AH patients with higher 90-day mortality. Lipid and lipoprotein profiles are profoundly altered in AH and can help in prognosticating disease severity and mortality. [ABSTRACT FROM AUTHOR]

Copyright of Interface - Comunicação, Saúde, Educação is the property of Fundacao UNI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Human papillomavirus (HPV) is one of the most prevalent sexually transmitted infections (STI), which can cause cancer and genital warts. Drug abuse is associated with an increased risk of STIs, and drug users have poor awareness of HPV. This study aimed to examine the effect of an educational program based on the health belief model (HBM) on promoting protective behaviors among female drug abusers. Material and methods: This study was a randomized controlled trial. Eighty eligible female drug abusers from ten drop-in centers located in Tehran were included in the study using convenience sampling. Randomization was applied at the center level, and all centers were divided into intervention and control centers. Data were collected using a self-administered questionnaire at four stages (before intervention, immediately, one month, and three months after intervention). Data were analyzed using repeated measures ANOVA test. Results: The model-based health education program had a significant effect on perceived susceptibility, perceived severity, perceived benefits, cues to action, and self-efficacy scores (p < 0.001). The scores of perceived barriers did not change significantly (p > 0.05). Conclusions: The educational program based on HBM had a positive effect on the subjects' beliefs regarding HPV protective behaviors, but it was not significantly effective on reducing perceived barriers. [ABSTRACT FROM AUTHOR]

The increased consumption of drugs in India is alarming and literature reveals that there are many studies on substance abuse and on the current trends and factors responsible for its consumption across the globe but very few in the Indian context. Through this article, we intend to highlight the statistics of substance use in India in context of problem, causes, consequences, impact, intensity, solutions, measures taken and way forward. The study is useful to policy makers, common man and drug addicts. The study is based on compilation and analysis of secondary data collected from authentic sources. Through this study, we have made an attempt to cover A to Z of Substance abuse in India. Through this study, we found that the increased trend of Substance abuse is alarming and there is a severe need of interventions. The Narcotics department is seizing the drugs as and when they are getting the information but somehow the situation cannot be controlled only with the efforts of Narcotics department and the contribution of policy makers, parents, teachers, doctors, that is, of each and every one of us, is equally important to eradicate this evil from society and nation as a whole. [ABSTRACT FROM AUTHOR]

To assess a Change Laboratory (CL) intervention concerning the promotion of learning about the causes and prevention of workplace aggression in a Healthcare Service for Drug and Alcohol Users. It is estimated that one fourth of all healthcare professionals worldwide have already experienced some kind of workplace violence. In mental health facilities, aggressions have multiple origins, including moments when physical restraint is applied or situations when the patients' demands are not met. This problem is aggravated in facilities known for their practice of imposing disciplinary measures. Several studies have shown the need to reduce disciplinary means, as well as the importance of health service teams and user participation in designing strategies to prevent aggression. This study employed a qualitative approach with an exploratory and descriptive design. An intervention was conducted in a Healthcare Service for Drug and Alcohol Users, in Brazil. The COREQ guidelines were followed for reporting. This study is a qualitative analysis of nine sessions of a CL, which was conducted in 2022 with 12 healthcare professionals, mainly women from the nursing staff. These workers identified the main causes of aggression after a historical and empirical analysis of the nature of the work performed and the contradictions inherent within it. They also recognized the need for cooperative teams prepared to recognize potentially aggressive situations beforehand. This article brings practical contributions by showing a detailed analysis of how the CL intervention method, using the principle of Transformative Agency Double Stimulation, promotes a sequence of learning actions. The method helped participants to systematically understand the causes of the situations that give rise to workplace violence, examining the goal of the activity as something socially and historically constructed. Likewise, this method helped the professionals to collectively build the key components of a potential prevention program against aggression in the workplace. [ABSTRACT FROM AUTHOR]

Objectives: There is limited research on the attitudes of pharmacy technicians toward pharmacy naloxone provision, despite their widespread role in the pharmacy. We examined attitudes and perceptions of pharmacy technicians in the provision of naloxone in a sample of Massachusetts pharmacies.Design: Thirty-nine community retail pharmacies from 1 U.S. chain were purposely sampled in 13 municipalities across Massachusetts. Pharmacies were divided into high-risk municipalities (HRMs) versus low-risk municipalities (LRMs) based on the state average opioid-related death rate from 2011 to 2015.Setting and Participants: A pharmacy technician working in each pharmacy was administered an in-person survey. Survey topics included technician beliefs about current naloxone provision practices; patient groups at greater risk of overdose; whether individuals filling prescriptions would benefit from naloxone; and whether individuals purchasing syringes would benefit from naloxone.Outcome Measures: Closed-ended responses were analyzed by Mann-Whitney U, Fisher exact, and chi-square tests. Open-ended responses were summarized for themes and then contrasted by municipality risk status.Results: Technician participation was 100% (n = 39). Technicians in both groups believed they could identify patient groups at risk of overdose in their practice, but HRM technicians recognized the need for naloxone for more of their at-risk patients (81% in HRM vs. 33% in LRM believed > 25% of patients need naloxone, P < 0.01). A willingness to provide naloxone was high (> 89%) in both groups. Open-ended responses revealed commonalities between groups, including the belief that patients need lower-cost naloxone, and a lack of patient and technician awareness that naloxone could prevent overdose in individuals at risk through use of prescription opioids not just through use of illicit drugs.Conclusion: Pharmacy technicians would benefit from overdose prevention training and are well positioned to recognize overdose risk and offer preventive interventions, such as naloxone. Among technicians, there is a high willingness to be involved in implementing broader naloxone access in pharmacies. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate outcomes after in situ reconstruction using biological grafts in infected groin pseudoaneurysms in drug abusers. This was a single centre retrospective analysis of all patients undergoing in situ reconstruction with biological vascular grafts for infected groin pseudoaneurysms in drug abusers from 2000 to 2017. Outcome measures included wound healing problems, re-infection, graft patency, lower limb amputation, and mortality. Twenty-two patients (14 male) with a median age of 39 years (range 27–49) were identified. Fifteen patients (68%) underwent urgent in situ reconstruction with a xenograft, five patients (23%) with a homograft, and two patients (9%) with an autologous vein. There were no in hospital deaths, in hospital re-infections, or early major limb amputations. Four (18%) patients developed wound healing complications requiring re-operation. During a median follow up of 56 months (range 13–180 months), six patients (27%) developed re-infection requiring complete graft replacement with a new biological graft. Thereafter, three (14%) had re-re-infection. Seven patients (32%) had graft occlusions: two were treated endovascularly, two underwent re-operation, and three were treated conservatively. Two patients (9%) had patent grafts but significant stenosis: one had successful angioplasty and another one was left untreated. One patient required above knee amputation, resulting in an overall major amputation rate of 4%. Estimated primary patency was 87% after one year and 40% after five years. Six patients (27%) died during follow up from non-vascular causes. In situ reconstruction using biological grafts of infected groin pseudoaneurysms in drug abusers can be achieved with no peri-operative graft related complications, although rates of wound complications may be high. In the longer term, a significant number of patients develop re-infection, graft occlusion, or stenosis, although the amputation rate remains low. The management of this demanding group of patients remains a major challenge. [ABSTRACT FROM AUTHOR]

Background and objective The aim of this study was to investigate the clinical features of paraneoplastic limbic encephalitis (PLE) with small cell lung cancer (SCLC) and improve clinical diagnosis and treatment. Methods The clinical data of 15 patients with SCLC combined with PLE from January 1980 to May 2017 were collected from Beijing Union Hospital. Their symptoms and laboratory data were analyzed and the prognosis of the patients was followed. Results PLE is a rare disease, the incidence rate in SCLC is about 0.842%. The data may be underestimated because of misdiagnose or missed diagnosis; High incidence crowd of the disease is the middle-aged male smoker, the tumor-node-metastasis (TNM) stages of them are later than others; Typical neurological symptoms include varying degrees of short-term memory loss, seizures and varying degrees of mental disorders; neurological symptoms usually occur before the onset of cancer or respiratory symptoms appear, an average of about 2 months be taken from onset to diagnosis; Serum antibody (anti-Hu, GABA-R-Ab), cerebrospinal fluid, head magnetic resonance imaging (MRI) and electroencephalogram (EEG) of the patients has abnormalities; Videography, especially computed tomography (CT) is a good means of screening the primary tumor, pathology diagnosis mainly rely on bronchoscopy; The treatment of primary tumors can be more effective in alleviating the nervous system symptoms than immunotherapy. Conclusion Paraneoplastic limbic encephalitis is a rare paraneoplastic syndrome in nervous system caused by malignant neoplasms often characterized by facial neurological symptoms. The disease are usually associated with lung cancer (especially SCLC). Its nervous system symptoms occur earlier than the tumor diagnosis. Early diagnosis and treatment for primary tumors will increase the benefit. [ABSTRACT FROM AUTHOR]

Women with opioid use disorder may avoid visiting a family planning clinic or seeing a physician for contraceptive care and counseling because of their fear of stigma and judgment. The Sex and Female Empowerment (SAFE) intervention helps this at-risk group receive evidence-based contraceptive information safely and without risk of stigma. [ABSTRACT FROM AUTHOR]

Objective The aim of this study is to assess whether adding manual therapy to motor control exercises protocol with inspiratory muscle training (IMT) (combined intervention) resulted in a greater effect than IMT alone in enhancing maximum inspiratory pressure (MIP) in the short term. Methods This was a single-blind, randomized, controlled trial. Fifty-one healthy moderate smokers were randomized into 2 groups: (1) IMT and (2) combined intervention. All participants received 8 individual sessions, 2 per week during a 4-week period. The primary outcome (MIP) and the secondary outcome (pulmonary function, forward head posture, and thoracic kyphosis) were recorded at baseline and after the treatments. Results There were differences between groups in change score for MIP (mean, 23.8; 95% confidence interval [CI]: 16.48-31.12), forward head posture (−1.57; 95% CI: –2.79 to –0.35), and thoracic kyphosis (–0.92; 95% CI: –1.74 to –0.1). The combined intervention revealed statistically significant differences for MIP (mean, –34; 95% CI: –39.12 to –28.88) and for postural measures (forward head posture 2.31; 95% CI: 1.45-3.16; thoracic kyphosis, 1.39; 95% CI: 0.8-1.97), whereas the IMT was only observed for MIP (mean, –10.2; 95% CI: –15.42 to –4.98). In addition, the intraclass correlation coefficient and minimal detectable change for MIP were 0.96; 95% CI: 0.93-0.97, and 17.70, respectively. Conclusion Inspiratory muscle training protocol combined with manual therapy and motor control exercise had greater effect in enhancing MIP than did IMT in isolation in moderate smokers in the short term. In addition, both groups experienced changes in MIP but not in lung function. [ABSTRACT FROM AUTHOR]

Background: Neonatal intensive care units (NICUs) are caring for an increasing number of infants born with neonatal abstinence syndrome (NAS). The literature identifies the need for education for NICU nurses on NAS including skills for interacting with the mother with substance use disorder.Purpose: An evidence-based practice project was developed to offer an educational presentation targeting these topics to 206 NICU participants (93% registered nurses, 1% licensed vocational nurses, and 6% nursing assistants) at a level IV NICU.Methods: A pretest/posttest was developed to assess knowledge of the participants prior to and after completion of the educational presentation. A posteducational questionnaire was developed to evaluate the skills learned for interacting with the mother with substance use disorder and the participant's professional readiness.Results: The posttest demonstrated a statistically significant (P < .001) increase in knowledge of NAS. On the post-educational questionnaire, 96% of participants correctly identified 3 skills they would use clinically with mothers with substance use disorder and 84% of participants identified 2 personal strengths and 2 weaknesses that influence their care of infants with NAS and their families (professional readiness).Implications For Practice: These results demonstrate that this educational presentation was effective and should be replicated at other facilities to improve the knowledge and skills of NICU nurses to promote improved care for infants with NAS.Implications For Research: Future studies should examine the impact on patient outcomes by preforming post-discharge interviews with the mothers of infants with NAS in the NICU pre- and post-educational intervention. Expanding the presentation into an interprofessional educational opportunity would promote increased knowledge and care by the entire multidisciplinary team. [ABSTRACT FROM AUTHOR]

Background: As opioid abuse increases in the United States, the rate of neonatal abstinence syndrome (NAS) rises dramatically. Caring for infants with NAS and their families is a significant challenge to neonatal nurses.Purpose: The purpose of this survey study was to explore attitudes and practice trends among nurses caring for infants with NAS. The study also aimed to identify any gaps in knowledge about NAS.Method: An anonymous, cross-sectional survey study was conducted using a researcher-developed questionnaire. The survey questionnaire included 20 Likert-scale questions regarding nurses' attitudes, knowledge, and practice in care of infants with NAS, 1 case study with 3 questions, and 2 open-ended questions. Nurses, including advanced practice nurses and nurse leaders, were invited to participate at a regional neonatal nursing conference in the New England area.Results: A total of 54 participants responded, the majority being white, female, non-Hispanic, and bachelor's prepared. Many nurses shared concerns regarding the setting in which infants with NAS are cared for. Nurses expressed varying attitudes regarding interacting with the mothers but generally wanted to build a partnership with them. Nurses also reported a lack of standardized and consistent practice in care for infants with NAS. Three major themes were identified from open-ended questions, including environmental issues, relationship with the mother, and inconsistency in care.Implications For Practice: Further research is needed for nurses providing care to infants with NAS. Specific education programs are needed for nurses who are caring for infants with NAS.Implications For Research: Further research is needed regarding the effects of NAS on nurses and other healthcare providers. [ABSTRACT FROM AUTHOR]

Australia's world-class drug monitoring systems have difficulty gathering metrics in rural communities for reasons due to, among other things, the size of the country and problems with recruiting sufficient sample sizes. Some rural communities in data shadows (where few metrics on substance use exist) may benefit from wastewater analysis ('WWA') as a means of estimating per capita drug consumption. Wastewater analysis could be employed when debates rise about the consumption of particular drugs in certain communities. Other ways to use WWA are examined, including long-term monitoring of community drug consumption and intervention studies to test the effectiveness of health or law enforcement drug strategies. To explore the utility of WWA, this article references media coverage of methylamphetamine consumption in a small Tasmanian town, Smithton, and presents the results of the first Tasmanian WWA pilot study of methylamphetamine consumption, conducted in 2014-15. [ABSTRACT FROM AUTHOR]

The interrelationship between victimization, violence, and substance use/abuse has been well established, yet those who experience victimization do not necessarily respond with violence or substance use or escalate to experiencing substance abuse symptoms. Drawing on literature from both the syndemic research from medical anthropology and the resilience research from psychology, this study examines the interaction between early childhood adversity and young adult violent victimization on later substance use/abuse and violent offending to provide insight into conditional effects. Data are derived from the Woodlawn Study, an African American cohort of men and women from a socioeconomically heterogeneous community in the South Side of Chicago, who were followed from first grade through age 42. Results indicate that those with lower levels of childhood adversity are more likely to suffer the negative consequences of violent victimization than those with higher childhood adversity, providing support for a "steeling" effect. [ABSTRACT FROM AUTHOR]

Opioid drugs, including prescription as well as heroin, have come to the national spotlight due to the unprecedented rate of overdose and addiction. The Centers for Disease Control and Prevention (CDC) has termed this problem as an "epidemic" that has reached record numbers of deaths in 2014. Approximately half of these deaths are the result from prescribed opioids. Also on the rise are the numbers of individuals who are diagnosed with chronic pain and are treated with opioids, methadone and buprenorphine. Individuals currently taking opioids for chronic pain confound the treatment of acute pain after traumatic injury. Goals of treatment include effective pain relief, prevention of opioid withdrawal, and managing the associated behavioral and psychological factors with drug addiction and dependence. The CDC has put forth guidelines on how to treat chronic pain but has yet to provide recommendations on how to treat acute pain in this unique population. The purpose of this literature review is to provide resources to treat pain, given a tolerant opioid-dependent patient. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to explore the recovering process of men who had abused alcohol and has lived in a therapeutic community. Methods: Individual in-depth interviews were used to collect data from 10 of these men who has lived in the therapeutic community for more than one year. Qualitative data from field notes and transcribed notes were analyzed using the grounded theory methodology developed by Strauss and Corbin. Results: The core category about the recovering process of the men who had abused alcohol and are now in the therapeutic community was identified as "reconstructing a broken life". The recovering process of these men in the therapeutic community consisted of four phases; 'self-awareness stage', 'unfreezing stage', 'readjustment stage', and 'challenging stage'. Conclusion: In this study "reconstructing a broken life", as the core category vividly showed joys and sorrows of men who had abused alcohol and has lived in the recovering process of managing the yoke of life-long disease. In this process of recovery from alcoholic dependence the men gradually adjusted themselves to their given condition. Also they gained coping strategies to care for, and protect themselves. Therefore health care providers can establish supportive programs in the clinical field to empower these men by reflecting their proactive coping strategies. [ABSTRACT FROM AUTHOR]

The article discusses a study which examined the effects of cannabis positivity at the time of severe injury on hospital outcomes compared with individuals negative for illicit substances. Topics covered include the retrospective chart review conducted by a Level I trauma center for patients over a two-year period with toxicology, the factors assessed in the study such as hospital length of stay and the Injury Severity Score (ISS) recorded for the patients.

A personal narrative is presented which explores the authors experience of being precipice of incarceration.