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Background: Positive and Negative Syndrome Scale (PANSS) data from a pivotal phase 3 study in participants with schizophrenia of RBP-7000, a recently marketed long-acting subcutaneous injectable risperidone formulation, were examined to determine if dose-response relationships existed for different items of the PANSS. Methods: Changes in the 30 PANSS items were analyzed individually and using the 5 factor-analysis-derived dimensions defined by Marder and colleagues. Subgroups of patients who could benefit from the RBP-7000 120 mg dose were investigated. Results: 337 participants were randomized and received study medication (RBP-7000 90 mg n = 111, RBP-7000 120 mg n = 114, placebo n = 112). Dose-dependent responses were observed in items from the study-specified PANSS positive and general psychopathology exploratory subscales. Dose-dependent responses were observed across all 5 Marder dimensions, with the largest effect sizes observed with the 120 mg dose in the uncontrolled hostility/excitement (UHE) and anxiety/depression dimensions. Participants with baseline UHE dimension scores ≥ 9 demonstrated greater improvement in PANSS total score at the 120 mg dose compared to the 90 mg dose. Conclusions: RBP-7000 demonstrated efficacy across both the primary and exploratory PANSS study endpoints and the post hoc Marder dimensions. Schizophrenia patients with higher baseline Marder UHE scores may benefit from initiation of treatment at the 120 mg dose. Trial Registration: ClinicalTrials.gov identifier: NCT02109562.

Background and Objectives: Synthetic opioids, including fentanyl and fentanyl analogs, account for over 70,000 annual overdose deaths in the United States, but there is limited information examining methods of induction and maintenance outcomes for buprenorphine treatment of patients with opioid use disorder (OUD) using these opioids. Methods: A secondary analysis of results grouped by fentanyl use status was completed for an open‐label study with rapid induction of extended‐release buprenorphine in the inpatient research unit. Eligible participants received a single 4 mg dose of transmucosal buprenorphine (BUP‐TM) followed by an extended‐release buprenorphine 300 mg injection ([BUP‐XR]) after approximately 1 h. An extension study continued follow‐up up to 6 months (6 monthly injections). Results: Among participants with fentanyl‐positive urine samples (FEN+; n = 19), all received BUP‐TM, 17 received BUP‐XR, 13 elected to receive a second BUP‐XR injection, and 10 received all six scheduled injections. Among participants with fentanyl‐negative samples (FEN−; n = 7), all received BUP‐TM and BUP‐XR, four elected to receive a second injection, and two participants received all six scheduled injections. Induction day clinical opioid withdrawal scale (COWS) scores were similar for FEN+ and FEN− groups. In the FEN+ group, mean COWS scores fell to below 5 within 24 h of BUP‐XR injection. Discussion and Conclusions: The treatment of individuals with OUD using fentanyl with a rapid 1‐day induction to BUP‐XR 300 mg injection is feasible and well‐tolerated. Scientific Significance: A prospective trial of participants grouped by fentanyl use status at induction demonstrates comparable patient retention and clinical response following single‐day induction of BUP‐XR in participants who are FEN+ and FEN−. Answer questions and earn CME credit [ABSTRACT FROM AUTHOR]

This article provides teachers and parents with a description of the behavior chain interruption strategy (BCIS), an evidence-based intervention for increasing requesting behaviors in individuals with moderate to severe disabilities. A review of the relevant literature is provided, as well as a description of the behavioral principles that contribute to the utility of the intervention, and a step-by-step description of how to implement this strategy. In addition, several practical examples are presented illustrating how the BCIS can be implemented in a variety of settings to teach communicative requesting to individuals of various ages and ability levels. Finally, several suggestions are provided to help ensure effective implementation as well as approaches to problem solving if the BCIS is not initially successful.

Although research has investigated the impact of peer-mediated interventions and visual scripts on social and communication skills in children with autism spectrum disorders, no studies to date have investigated peer-mediated implementation of scripts. This study investigated the effects of peer-implemented scripts on a middle school student with autism, intellectual impairments, and speech-language impairment via a multiple baseline single-case research design across behaviors. The target student demonstrated improvements in three communicative behaviors when implemented by a trained peer; however, behaviors did not generalize to use with an untrained typically developing peer. (Contains 2 figures and 1 table.)

Many individuals with autism cannot speak or cannot speak intelligibly. A variety of aided augmentative and alternative communication (AAC) approaches have been investigated. Most of the research on these approaches has been single-case research, with small numbers of participants. The purpose of this investigation was to meta-analyze the single case research on the use of aided AAC with individuals with autism spectrum disorders (ASD). Twenty-four single-case studies were analyzed via an effect size measure, the Improvement Rate Difference (IRD). Three research questions were investigated concerning the overall impact of AAC interventions on targeted behavioral outcomes, effects of AAC interventions on individual targeted behavioral outcomes, and effects of three types of AAC interventions. Results indicated that, overall, aided AAC interventions had large effects on targeted behavioral outcomes in individuals with ASD. AAC interventions had positive effects on all of the targeted behavioral outcome; however, effects were greater for communication skills than other categories of skills. Effects of the Picture Exchange Communication System and speech-generating devices were larger than those for other picture-based systems, though picture-based systems did have small effects.

Background: For patients with opioid use disorder, buprenorphine extended-release injection (BUP-XR) achieves sustained therapeutic plasma concentrations, controls craving and withdrawal symptoms, and improves patient outcomes. Given retention challenges during transmucosal buprenorphine (BUP-TM) induction, assessing methods to quickly achieve sustained buprenorphine concentrations is important. Objectives: This open-label, single-group, single-center pilot study (NCT03993392) evaluated safety and tolerability of initiating BUP-XR following a single BUP-TM 4 mg dose. Methods: Eligible participants abstained from short and long-acting opioids for 6 and 24 hours, respectively. If the Clinical Opiate Withdrawal Scale (COWS) was ≥8, BUP-TM 4 mg was administered. Participants not exhibiting hypersensitivity, precipitated opioid withdrawal (POW), or sedation symptoms within 1 hour received BUP-XR 300 mg (assessed as inpatients for 48 hours and outpatients to Day 29). Endpoints were COWS score increase ≥6, independent adjudication of POW, and opioid use. Results: Twenty-six participants (14 male) received BUP-TM, 24 received BUP-XR, and 20 completed the study. After injection, COWS scores decreased from pre-BUP-TM baseline of 14.6 ± 4.1 to 6.9 ± 4.1 at 6 hours and 4.2 ± 3.2 at 24 hours. Most participants (62.5%) experienced maximum COWS scores pre-BUP-XR; 2 experienced a COWS score increase ≥6, occurring at 1 and 2 hours post-BUP-XR. By adjudication, 2/24 participants experienced POW. Irritability, anxiety, nausea, and pain were the most frequent adverse events (AEs) with no serious AEs. Conclusions: Results support increased flexibility for initiating BUP-XR. Initiating BUP-XR 300 mg following a single BUP-TM 4 mg dose was well tolerated. Although some participants initially experienced withdrawal symptoms after injection, significant symptomatic improvement was observed in all participants within 24 hours. [ABSTRACT FROM AUTHOR]

Purpose To investigate how incorporating regular safety rounds in the radiation oncology department supports a culture of safety. Methods Hospital safety rounds conducted by organizational leaders were completed 2 times per year before the implementation of radiation oncology--specific safety rounds. A survey was distributed to all staff members of a radiation oncology department to gather data regarding safety rounds and safety culture in the department. The survey was distributed via email before and after implementation of radiation oncology--specific safety rounds. Radiation oncology--specific safety rounds were completed by 2 members of the radiation oncology quality improvement committee; they visited 2 workspaces per month until all areas were visited. Results The baseline survey had a 52.2% completion rate, and the follow-up survey had a 41.7% completion rate. Survey results showed that department safety rounds had a positive effect on the culture of safety. After radiation oncology--specific rounds were completed, 86.1% of respondents reported that results from the safety rounds were shared with them compared with 27.6% at baseline. The number of staff who responded that changes likely or very likely would be implemented based on their improvement ideas increased from 48.3% in the baseline survey to 57.8% after safety rounds. Discussion In addition to showing improvements in safety culture, changes made because of the safety rounds demonstrate the usefulness of conducting these rounds. They are a valuable tool to gather feedback from frontline staff regarding radiation therapy quality and safety and to demonstrate leadership's support of staff and their opinions. Conclusion Radiation oncology departments should consider adding department-specific safety rounds to improve the culture of safety in their department. Leadership support and staff buy-in are necessary for the success of safety rounds. [ABSTRACT FROM AUTHOR]

The article discusses about importance of research cycles in students. Topics discussed include that due recent legislative reforms there is structural changes in students study plan where they could only focus on reading, writing, and math; the article highlights student's interest in science and social studies and also the concept of research cycle for independent student's research and learning and it presents six-steps apprenticeship of research cycle which will help students learn.