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Rationale, aims, and objectives: Chronic pain is a global public health problem that negatively impacts individuals' quality of life and imposes a substantial economic burden on societies. The use of medicinal cannabis (MC) is often considered by patients to help manage chronic pain as an alternative or supplement to more conventional treatments, given enabling legalization in a number of countries. However, healthcare professionals involved in providing guidance for patients related to MC are often doing so in the absence of strong evidence and clinical guidelines. Therefore, it is crucial to understand their perspectives regarding the clinical use and relevance of MC for chronic pain. As little is known about attitudes of HCPs with regard to MC use for chronic pain specifically, the aim of this review was to identify and synthesize the published evidence on this topic. Methods: A systematic search was conducted across six databases: MEDLINE, EMBASE, CINAHL, Scopus, Web of Science, and PubMed from 2001 to March 26, 2021. Three authors independently performed the study selection and data extraction. Thematic analysis was undertaken to identify key themes. Results: A total of 26 studies were included, involving the United States, Israel, Canada, Australia, Ireland, and Norway, and the perspectives of physicians, nurses, and pharmacists. Seven key themes were identified: MC as a treatment option for chronic pain, and perceived indicated uses; willingness to prescribe MC; legal issues; low perceived knowledge and the need for education; comparative safety of MC versus opioids; addiction and abuse; and perceived adverse effects; Conclusion: To support best practice in the use of MC for chronic pain, healthcare professionals require education and training, as well as clinical guidelines that provide evidence‐based information about efficacy, safety, and appropriate dosage of products for this indication. Until these gaps are addressed, healthcare professionals will be limited in their capacity to make treatment recommendations about MC for people/patients with chronic pain. [ABSTRACT FROM AUTHOR]

Educational practices to reduce negative attitudes toward persons with substance use disorders (SUD) are urgently needed for undergraduate nursing students, but few studies have examined their long term effectiveness. In this pilot, consenting students completed the Drug and Drug Problems Perception Questionnaire (DDPPQ) anonymously online, before and 1 year after integrated curricular content about SUD. Pretest scores were significantly higher than posttest, indicating higher negative attitudes toward persons with SUD before the integrated content. Time main effect was statistically significant. To our knowledge, this is the first report examining long-term effects of an educational intervention with reinforcement in multiple courses over time upon the attitudes of undergraduate nursing students toward persons with SUD. [ABSTRACT FROM AUTHOR]

Background: Methods to increase treatment compliance in adolescents with cystic fibrosis (CF) is of utmost importance to improve outcomes and survival. Motivational interviewing (MI) has gained momentum as an effective strategy to address ambivalence to change in a variety of chronic health conditions and remains a promising strategy to facilitate treatment adherence in adolescents with CF. Methods: The project utilized the Plan-Do-Study-Act cycle of quality improvement (QI). A repeated measure pretest-posttest design was used to evaluate the effectiveness of a MI training. An interactive, 4-hour MI workshop was executed within a single CF center. CF care providers (N = 12) from a single CF team completed surveys evaluating knowledge, perceived importance, usage, and confidence in using MI with adolescents before and after the training. Following the MI training, care providers engaged high-risk adolescent patients using MI techniques. To determine the effect of MI on patient adherence (N = 32), markers of lung function and weight were measured before and after MI exposure. Results: Quantitative analysis of provider surveys indicated enhanced MI-related knowledge and confidence after the training. Provider usage, perception of the usefulness, and importance of using MI was unchanged. Patient-specific outcomes indicated no significant change in patient-forced expiratory volume in 1 second (FEV1), a marker of lung function, or body mass index (BMI), five months after exposure of MI in the CF clinic setting. Conclusions: This QI project demonstrates the effectiveness of a brief MI training on CF care providers' knowledge and confidence in engaging adolescents using MI techniques. Though no statistically significant differences were found in patient-specific outcomes during this brief intervention period, it is critical that longer-term exposure to MI be explored further in adolescents with CF. This study adds to a growing body of evidence supporting team-based MI trainings for CF providers. Future research focusing on patient experience and perceived benefit of MI counseling is warranted. [ABSTRACT FROM AUTHOR]

The study examined potential psychosocial determinants of male condom use in steady heterosexual relationships among Somali and Ethiopian immigrants in Minnesota in two sequential phases: the elicitation (Phase I) and cross-sectional quantitative studies (Phase II). Information from Phase I was used to develop the instrument for Phase II. Study participants who self-identified as Somali and Ethiopian immigrants (n = 205) responded to questions on demographic characteristics, attitudes (affective and instrumental), norms (subject and descriptive), perceived behavioral control, self-efficacy, and intention to use male condoms. Hierarchical regression models were used to assess the relationship between the main independent variables (attitude norms, perceived behavioral control, and self-efficacy, and the dependent variable, the intention to use male condoms. Overall, participants showed low intention and slightly favorable (affective and instrumental) attitudes toward condom use; had experienced weak, but positive social influence as measured by injunctive and descriptive norms. Moreover, study participants had shown slight perceived behavioral control, but had fairly moderate positive self-efficacy. The Theory of Planned Behavior was moderately effective in predicting condom use; however, the Integrated Behavioral Model, explained nearly 40% of the variations in the intention to use male condoms. Among men, self-efficacy had the strongest influence (β = .44, p < .001) on behavioral intention. Among women, descriptive norms (β = .22,p < .05) exerted the strongest effect (model 3). Improving self-efficacy, specifically, among older men, and fostering desirable normative influence among women, are suggested as main components of public health interventions to promote condom use among Somali and Ethiopian immigrants. [ABSTRACT FROM PUBLISHER]

Objectives: To determine the effectiveness of a statewide telephone service in identifying low-income women at risk for hereditary breast and ovarian cancer and referring them to free genetic counseling. Methods: From June 2010 through August 2011, eligible callers to California's toll-free breast and cervical cancer telephone service were screened for their family histories of breast and ovarian cancer. High-riskwomenwere identified and called for a baseline survey and randomization to an immediate offer of genetic counseling or a mailed brochure on how to obtain counseling. Clinic recordswere used to assess receipt of genetic counseling after 2 months. Results: Among 1212 eligible callers, 709 (58.5%) agreed to answer family history questions; 102 (14%) were at high risk (25% Hispanic, 46% White, 10% Black, 16% Asian, 3% of other racial/ethnic backgrounds). Of the high-risk women offered an immediate appointment, 39%received counseling during the intervention period, as compared with 4.5% of those receiving the brochure. Conclusions: A public health approach to the rare but serious risk of hereditary breast and ovarian cancer can be successful when integrated into the efforts of existing safety net organizations. [ABSTRACT FROM AUTHOR]

Racial, ethnic and economic disparities in cancer rates, outcomes, and clinical trials participation persist despite significant research. We examined barriers to clinical trials enrollment among Chinese patients, and developed a navigation program for Chinese gynecologic and breast cancer patients. Six bilingual navigators were trained and a navigator assigned to each patient for at least 2 months. All patients received a clinical trials booklet in Chinese and English. Data collection included pre-and post-navigation surveys, intake forms, and documentation of navigation encounters. Between July 2010 and May 31, 2011, we recruited 28 breast and gynecologic cancer patients. Patients averaged 317 min of navigation (range 63-1,852) during 8 sessions (range 3-28). They improved in 4 of 10 true-false knowledge statements about clinical trials. A patient navigation program for Chinese-speaking cancer patients is feasible. It results in high patient satisfaction rates and modest improvements in clinical trials knowledge and participation. [ABSTRACT FROM AUTHOR]

Australian data suggest up to 15% of people with intellectual disability (ID) have asthma. The inhaled route of administration is optimal for the management of obstructive airways diseases; however, correct inhaler use requires dexterity and particular breathing patterns and potentially represents a problem in this population due to physical and cognitive deficits. Understanding the nature and extent of inhaler use in persons with ID is important, as correct inhaler technique is imperative for optimal clinical outcomes; however, currently no evidence base exists to inform health professionals. This study describes respiratory medication use, reported prevalence of asthma, and asthma management practices undertaken in a clinic sample of Australian adults with ID. Results showed a prevalence of retrospectively reported asthma of 6%, with 86% of asthma patients prescribed inhaled medication. A review of patient records also indicated omission of some recommended asthma management strategies. [ABSTRACT FROM AUTHOR]

Many factors can be attributed to successful substance abuse treatment completion. The purpose of this research is to examine employment status as a factor that contributes to successful treatment outcomes. Traditional substance abuse treatment is discussed and shown to lack an employment component to counseling. Research is discussed and illustrates the benefits employment has on not only successful treatment completion but also reduction in substance use as well as many other benefits. This study utilized extant data from a rural substance abuse treatment program. Data was collected from the program using the Government Results and Performance Act (GPRA) tool. A binary logistic regression analysis was used to determine the relationship between the predictor variable of employment and the dichotomous dependent variable of treatment completion while controlling for the variables of gender, criminal justice status, and educational level. The Omnibus Tests of Model Coefficients for Block One was not significant (p > .05). The Omnibus Tests of Model Coefficients of Block Two was significant (p < .05) as was employment status (p < .05). Implications and suggestions for further research are discussed. [ABSTRACT FROM AUTHOR]

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