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Background: Currently, the capacity to provide buprenorphine treatment (BT) is not sufficient to treat the growing number of people in the United States with opioid use disorder (OUD). We sought to examine participant retention in care rates of primary care delivered BT programs and to describe factors associated with retention/attrition for participants receiving BT in this setting. Objectives: A PRISMA-guided search of various databases was performed to identify the articles focusing on efficacy of BT treatment and OUD. Method: A systematic literature search identified 15 studies examining retention in care in the primary care setting between 2002 and 2020. Random effects meta-regression were used to identify retention rates across studies. Results: Retention rates decreased across time with a mean 0.52 rate at one year. Several factors were found to be related to retention, including: race, use of other drugs, receipt of counseling, and previous treatment with buprenorphine. Conclusions: While we only investigate BT through primary care, our findings indicate retention rates are equivalent to the rates reported in the specialty care literature. More work is needed to examine factors that may impact primary care delivered BT specifically and differentiate participants that may benefit from care delivered in specialty over primary care as well as the converse. [ABSTRACT FROM AUTHOR]

Background: Increases in fatal synthetic opioid overdoses over the past 8 years have left states scrambling for effective means to curtail these deaths. Many states have implemented policies and increased service capacity to address this rise. To better understand the effectiveness of policy level interventions we estimated the impact of the presence of naloxone access laws (NALs) on synthetic opioid fatalities at the state level. Methods: A multivariable longitudinal linear mixed model with a random intercept was used to determine the relationship between the presence of NALs and synthetic opioid overdose death rates, while controlling for, Good Samaritan laws, opioid prescription rate, and capacity for medication for opioid use disorder (MOUD), utilizing a quadratic time trajectory. Data for the study was collected from the National Vital Statistics System using multiple cause-of-death mortality files linked to drug overdose deaths. Results: The presence of an NAL had a significant (univariate P -value =.013; multivariable p-value =.010) negative relationship to fentanyl overdose death rates. Other significant controlling variables were quadratic time (univariate and multivariable P -value <.001), MOUD (univariate P -value <.001; multivariable P -value =.009), and Good Samaritan Law (univariate P -value =.033; multivariable P -value =.018). Conclusion: Naloxone standing orders are strongly related to fatal synthetic opioid overdose reduction. The effect of NALs, MOUD treatment capacity, and Good Samaritan laws all significantly influenced the synthetic opioid overdose death rate. The use of naloxone should be a central part of any state strategy to reduce overdose death rate. [ABSTRACT FROM AUTHOR]

Background and Objectives: America's opioid epidemic has spawned an epidemic of neonatal abstinence syndrome (NAS). Studies have not tested approaches to promoting contraceptive services for women with opioid use disorder (OUD) along with treatment for this disorder. This pilot study examined the promotion of medication for OUD (MOUD) treatment and contraception use, primarily long‐acting reversible contraception (LARC), for women with OUD. Methods: In Appalachia, a peer‐delivered contraception and MOUD promotion intervention was delivered to a sample of 30 women with OUD. Primary outcomes were attendance of initial appointments to receive MOUD and counseling about contraceptive options. Peer recovery coaches also offered to help the women schedule appointments and attend the appointment with them or give them a ride if necessary and requested by the patients. Results: Two‐thirds experienced all seven symptoms of opioid dependence. Within 30 days of a brief counseling session, over one‐half of the women (56.7%) were referred to MOUD, with all of them initiating treatment within 30 days. Just under one‐half of the women (46.7%) were referred to a contraception consultation, with 85.7% of those receiving a LARC implant. Discussions and Conclusions: Study findings indicate the potential efficacy of a single‐session, peer‐delivered counseling intervention for linking women with OUD and at high risk of unintended pregnancy to MOUD and to services that provide women with highly reliable contraceptives. Scientific Significance: This study is unique in exploring the efficacy of linking high‐risk opioid‐using women to contraceptive options and treatment for MOUD to prevent NAS. [ABSTRACT FROM AUTHOR]

Author(s): Jeffrey S. Nico (corresponding author) [1]; Maynard S. Dewey [1]; Thomas R. Gentile [1]; H. Pieter Mumm [1]; Alan K. Thompson [1]; Brian M. Fisher [2]; Isaac Kremsky [2]; [...]

Pre-Exposure Prophylaxis (PrEP) has been shown to be an effective method of HIV prevention for men who have sex with-men (MSM) and -transgender women (MSTGWs), serodiscordant couples, and injection drug users; however fewer than 50 000 individuals currently take this regimen. Knowledge of PrEP is low among healthcare providers and much of this lack of knowledge stems from the lack or exposure to PrEP in medical school. We conducted a cross sectional survey of medical schools in the United States to assess the degree to which PrEP for HIV prevention is taught. The survey consisted Likert scale questions assessing how well the students were prepared to perform each skill associated with PrEP delivery, as well as how PrEP education was delivered to students. We contacted 141 medical schools and 71 responded to the survey (50.4%). PrEP education was only reported to be offered at 38% of schools, and only 15.4% reported specific training for Lesbian, Gay, Bisexual, and Transgender (LGBT) patients. The most common delivery methods of PrEP content were didactic sessions with 11 schools reporting this method followed by problem-based learning, direct patient contact, workshops, and small group discussions. Students were more prepared to provide PrEP to MSM compared to other high-risk patients. Few medical schools are preparing their students to prescribe PrEP upon graduation. Further, there is a need to increase the number of direct patient contacts or simulations for students to be better prepared. [ABSTRACT FROM AUTHOR]

Measurement (using Carol Chomsky's methodology) of the acquisition of five complex English structures by adult Israeli and Egyptian learners reveals that first and second language learners of English encounter similar difficulties. The creative construction hypothesis can be applied to second as well as first language acquisition. (PMJ)

The St. Joseph's Regional Medical Center in Paterson, New Jersey, initiated a methodology called The Organizational Huddle Process in the fall of 1999. This communication vehicle enhances operational performance through a fast, focused, and highly collaborative process. The results of this initiative have been most impressive. Hundreds of problems have been resolved before escalating to crisis levels, with an increase in stakeholder satisfaction. This process is appropriate for all levels within an organization, is effective for both interdisciplinary and departmental groups, and has minimal associated implementation costs. This article reviews the rationale and benefits of The Organizational Huddle Process, a recommended implementation strategy, and a nurse manager's review on the application of this methodology. [ABSTRACT FROM AUTHOR]