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Abstract Objective Marijuana use is increasingly common among patients with chronic non-cancer pain (CNCP) and long-term opioid therapy (LTOT). We determined if lifetime recreational and medical marijuana use were associated with more frequent and higher dose prescription opioid use. Design Cross-sectional Subjects Eligible patients (n=1,037), who had a new period of prescription opioid use lasting 30-90 days, were recruited from two midwestern health care systems to a study of long-term prescription opioid use and mental health outcomes. The present cross-sectional analyses uses baseline data from this on-going cohort study. Methods Primary exposures were participant reported lifetime recreational and medical marijuana use versus no lifetime marijuana use. Prescription opioid characteristics included daily versus non-daily opioid use and ≥50 morphine milligram equivalent (MME) dose per day vs.

Abstract Objective The aim was to develop and test a novel screen of adult ADHD, with a specific focus on clinical use. We designed a series of three studies to accomplish this aim. Method Study One (n = 155) and Study Two (n = 591) collected data via surveys to conduct exploratory and confirmatory factor analyses, respectively. Study Three analyzed the scale’s psychometrics in a clinical sample (n = 151). Results Study One and Study Two identified a 10-item scale with a two-factor structure. Study Three found good discriminant validity, sensitivity = 80.0%, specificity = 80.2%, and convergent validity with both the Brown Executive Function/Attention Scales, r (131) = .76, p

# Background Ghana had significant reductions in neonatal mortality during the Millennium Development Goal (MDG) era. Few studies have attempted to identify the interventions, programs and policies that contributed to this progress. To understand the underlying factors which contributed to the reduction in neonatal mortality and to inform strategies to reach the Sustainable Development Goal (SDG) target to end preventable neonatal deaths, we conducted a mixed-methods study in the Northern, Upper West, and Volta Regions of Ghana. # Methods The quantitative component consisted of an analysis of trends in coverage of key neonatal health interventions using subnational data from the Ghana Demographic and Health Surveys (DHS) and the Multiple Indicator Cluster Surveys (MICS). The Lives Saved Tool (LiST) was used to assess the contribution of various neonatal health interventions which resulted in reductions in neonatal mortality. Qualitative in-depth interviews (N=38) were conducted with government health officials, health workers, staff from non-government organizations, and community leaders, including traditional birth attendants and local chiefs from the Northern Region of Ghana. # Findings Multiple interventions and contextual factors contributed to declines in the neonatal mortality rate (NMR) in all three regions. The Volta and Upper West Regions improved labor and delivery management practices which accounted for approximately one-third of the decline in NMR. The Northern Region had a substantial decline in NMR; the greatest proportion of the decline was attributed to control and management of infections in newborns (sepsis and pneumonia). Qualitative interviews suggest that improvements in neonatal survival were achieved through the prioritization of neonatal health at community-based health planning (CHPS) compounds and the development of a national-level strategic plan, coupled with neonatal health-related training for health workers. The establishment of neonatal intensive care units and strong partnership with local leaders and women’s groups to increase facility births and promote clean birth practices were also considered important. # Conclusions The strategies that supported the reductions span from national-level policy intervention to facility-based quality improvement, to community level engagement. These strategies can be continued, strengthened, and scaled to improve neonatal survival in the SDG era.

Proper treatment of developmental disabilities requires health workers to have adequate knowledge of etiology and referral procedures. There is a dearth of research on knowledge of developmental disabilities among health workers in Ghana. The purpose of this study was to document knowledge about developmental disorders, causes, and referral procedures among health workers. Researchers used a successive free-listing method to interview 37 health workers. Developmental disabilities which present with physical symptoms were the most salient disorders identified among health workers, while learning disabilities and attention deficit disorder were largely overlooked. The most commonly listed developmental disabilities were cerebral palsy, Down syndrome, and autism spectrum disorder. Respondents had limited knowledge about the causes of and referral resources for developmental disabilities. Results show the need for continuing medical education, public awareness, and enhanced resources to support the identification and care of children with developmental disabilities in Ghana.