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Objectives. To examine trends in overdose deaths by intent and drug category to better understand the recent decrease in overdose suicides amid the overdose epidemic. Methods. We examined trends in rates of overdose deaths by intent (unintentional, suicide, or undetermined) across 9 drug categories from 1999 to 2022 using US National Vital Statistics System mortality data. Results. Unintentional overdoses involving synthetic opioids, polydrug toxicity involving synthetic opioids, psychostimulants, and cocaine increased exponentially with annual percentage changes ranging from 15.0% to 104.9% during 2010 to 2022. The death rates also increased for suicides involving these drugs, especially for psychostimulants (annual percentage change = 12.9% for 2010–2022; P <.001). However, these drugs accounted for relatively small percentages of overdose suicides. The leading drug categories among suicides were antidepressants, prescription opioids, and benzodiazepines, though these deaths have decreased or leveled off in recent years. Conclusions. Different drugs commonly involved in suicides and unintentional overdoses may contribute to their divergent trends. Public Health Implications. Amid the overdose epidemic, safe storage of medications remains a crucial strategy to prevent overdose suicides. The large increases in suicides involving psychostimulants warrant monitoring. (Am J Public Health. 2024;114(10):1081–1085. https://doi.org/10.2105/AJPH.2024.307745) [ABSTRACT FROM AUTHOR]

A strong professional organization has been associated with credibility and vitality of its profession. The field of recreational therapy (RT), however, has historically demonstrated poor membership on both national and state/regional levels. The purpose of this study was to examine what CTRSs identify as benefits as well as real/ perceived barriers to membership in professional RT organizations and examine the relationship between membership status and professional commitment. A 43-item Qualtrics electronic questionnaire addressing benefits and barriers of membership, professional commitment, and demographics was sent to all active CTRSs. Statistical analysis found that just over half of the 2003 respondents were members of national and/or state/ regional organizations. Differences existed regarding benefits of membership where members perceived more professional benefits and non-members perceived more personal benefits. Barriers were primarily financial and of "cost-benefit" concerns. In addition, professional commitment was higher among members than non-members. Recommendations are offered for practice, education, and research. [ABSTRACT FROM AUTHOR]

Background: Approximately 9,500,000 people in the United States misused opioids in 2020. Many people manage their opioid use disorder (OUD) with medication-assisted treatment (MAT). Using MAT to address OUD adds to the complexities and challenges of adequate acute pain control. Local Problem: Chart review indicated only 20% of trauma patients onMAT achieved adequate pain control on the trauma service at the University of LouisvilleHospital. This quality initiative aimedto increase patient pain control to 50%in 90 days. Methods: A rapid cycle quality improvement project with four plan-do-study-act (PDSA) cycles was conducted over 8 weeks. Four core interventions were implemented concurrently, with tests of change biweekly. Qualitative and qualitative data analyses were completed at each cycle. Interventions: The core interventions included a risk assessment tool, shared decision-making (SDM) tool, provider checklist, and a team engagement plan. Results: The number of patients with a pain score of#5 (scale 0-10) increased to 78% from 20%. The mean pain score decreased from 8 to 4.6. The fourth PDSA cycle results showed a 92% patient engagement with SDM and 100% utilization of the provider checklist. Team engagement scores greater than 4 on a 5-point Likert scale were 86%. Conclusions: Effective patient-centered acute pain control for trauma patients on MAT is achievable. The combined use of an SDM tool and a provider checklist was an efficient way to provide effective and patient-centered care and positively affected patient outcomes. [ABSTRACT FROM AUTHOR]

Animal-assisted interventions have been implemented by health care professionals because of the therapeutic value of animal interactions. The purpose of this study was to survey Certified Therapeutic Recreation Specialists (CTRSs) to (a) determine the prevalence of Animal Assisted Interventions (AAI) implemented by recreational therapists, and (b) understand the knowledge and barriers to AAT implementation that exist for recreational therapists. A total of 123 Certified Therapeutic Recreation Specialists participated in the study (a 6.2% response rate). A significant difference was found in the AAT goal of improving social interaction by population. Those working in physical medicine and rehabilitation reported less improvement than those in behavioral health, geriatrics and community agencies. CTRSs indicated there is a need for additional education and trainings on AAT practice. Many CTRSs surveyed identified the lack of registered animal/handler teams in the area as a major barrier to implement AAT. [ABSTRACT FROM AUTHOR]

Objective: College and university administrators have expressed concern that adoption of tobacco-free policies may reduce applications and enrollment. This study examines adoption and implementation of 100% tobacco-free campus policies by institutions of higher education on applications and enrollment. Participants: North Carolina private colleges and universities and public community colleges. Analysis was conducted in 2011. Methods: Student enrollment and application data were analyzed by campus type to determine (a) if there was a difference in student applications and enrollment before and after policy implementation, and (b) if there was a difference in student applications and enrollment for campuses with versus without a policy. Results: No significant differences were found in student enrollment or applications when comparing years prior to and following policy implementation or when comparing with institutions without 100% tobacco-free campus policies. Conclusions: The authors found no evidence that 100% tobacco-free policy adoption had an impact on student enrollment or applications. [ABSTRACT FROM AUTHOR]

Parents who have sons and daughters with disabilities usually have significant influences on their children's play, community participation, socialization, and overall quality of life. For several decades, parent-professional partnerships have been considered a recommended practice toward effective service provision for children with disabilities (Blue-Banning, Summers, Frankland, Nelson, & Beegle, 2004). Since parents know their children best and have much to share with service providers, it is essential that parents and professionals communicate often and clearly as programs and services are designed and implemented. In the current study, five focus groups were established to learn how parents feel about recreation service delivery systems, to provide a format to have them share their concerns, and inform us about what has been effective regarding their children's community inclusion. Focus groups offered parents a platform to voice concerns about opportunities for their children with intellectual and related developmental disabilities to successfully participate in recreation and social activities. Parents valued community recreation as an important aspect of their children's quality of life; however, they were distraught by the ongoing battle for access. Continually being required to provide direct supports to their children because program staff would not, along with negative attitudes of community members, left them fatigued and isolated. Parents had concerns for their children's safety and well-being due to poorly prepared program staff. Emanating from these focus groups was an understanding that family members and advocacy agencies have much to offer recreation providers in facilitating inclusive programming, but ultimately, recreation providers are responsible for meeting the needs of all children. [ABSTRACT FROM AUTHOR]

The purpose of the study was to assess whether trauma may be an independent risk factor for stroke. Evidence has shown that trauma patients experience a hypercoagulable state postinjury, increasing the risk of thrombotic events. A case-controlled, retrospective analysis was performed on admitted trauma patients over a 2-year period. Results revealed that trauma patients are 1.6 times more likely to have a cerebrovascular accident (CVA) during their hospital admission, when compared with nontrauma patients with similar CVA risk factors. Several statistically significant differences between the groups were identified. On the basis of these results, trauma appears to be an independent, nonmodifiable risk factor for CVA. [ABSTRACT FROM AUTHOR]