Search

The application of digital technologies to better assess, understand, and treat substance use disorders (SUDs) is a particularly promising and vibrant area of scientific research. The National Drug Abuse Treatment Clinical Trials Network (CTN), launched in 1999 by the U.S. National Institute on Drug Abuse, has supported a growing line of research that leverages digital technologies to glean new insights into SUDs and provide science-based therapeutic tools to a diverse array of persons with SUDs. This manuscript provides an overview of the breadth and impact of research conducted in the realm of digital health within the CTN. This work has included the CTN's efforts to systematically embed digital screeners for SUDs into general medical settings to impact care models across the nation. This work has also included a pivotal multi-site clinical trial conducted on the CTN platform, whose data led to the very first "prescription digital therapeutic" authorized by the U.S. Food and Drug Administration (FDA) for the treatment of SUDs. Further CTN research includes the study of telehealth to increase capacity for science-based SUD treatment in rural and under-resourced communities. In addition, the CTN has supported an assessment of the feasibility of detecting cocaine-taking behavior via smartwatch sensing. And, the CTN has supported the conduct of clinical trials entirely online (including the recruitment of national and hard-to-reach/under-served participant samples online, with remote intervention delivery and data collection). Further, the CTN is supporting innovative work focused on the use of digital health technologies and data analytics to identify digital biomarkers and understand the clinical trajectories of individuals receiving medications for opioid use disorder (OUD). This manuscript concludes by outlining the many potential future opportunities to leverage the unique national CTN research network to scale-up the science on digital health to examine optimal strategies to increase the reach of science-based SUD service delivery models both within and outside of healthcare.

Purpose: We designed this study to examine the end-of-life (EOL) experience in long-term care (LTC) based on input from key stakeholders. Design and Methods: The study consisted of 10 homogeneous focus groups drawn from a purposive sample of LTC residents (2 groups; total n = 11), family caregivers (2 groups; total n = 19), paraprofessional staff (3 groups; total n = 20), and licensed/registered staff (3 groups; total n = 15) from five nursing homes and eight residential care/assisted living communities in North Carolina. We analyzed data by using grounded theory techniques to elicit manifest and latent themes. Results: Five overarching themes emerged: (a) components of a good death in LTC, (b) normalcy of dying in LTC, (c) the role of relationships in the provision and receipt of care, (d) hospice contributions to care at the EOL in LTC, and (e) stakeholder recommendations for enhancing EOL care in these settings. Underlying these themes was one central category, closeness, based on physical proximity and frequency of contact. Implications: Findings suggest that promoting collaborative relationships among the four stakeholder groups, increasing social worker involvement, and removing barriers to hospice may enhance the EOL experience in LTC.

Rothman and Thomas' intervention research (IR) paradigm provides an alternative, developmental research method that is appropriate for practice research, especially at the early stages. It is more flexible than conventional experimental designs, capitalizes on the availability of small samples, accommodates the dynamism and variation in practice conditions and diverse populations, and explicitly values practitioners' insights. This article describes two studies to exemplify how the features of IR methodology are well suited to research on innovative group interventions. In one study, a face-to-face psychoeducational group for patients living with sickle cell anemia and chronic depression was used. The other study used an online job stress support group for social workers. The challenges and opportunities that can arise when applying the IR paradigm to develop new interventions are also discussed.

In the aftermath of Hurricane Floyd in 1999, a Community Advisory Committee requested assistance from its university partners (University of North Carolina) to address stress and increased risk for intimate partner violence (IPV). Collected from 12 study work sites, baseline data indicated that IPV rates were higher among blue-collar women in eastern North Carolina than national population-based rates suggest. IPV victims reported higher levels of perceived stress, psychological distress, somatic complaints, and post-traumatic stress disorder (PTSD) symptoms than did nonvictimized coworkers. As for the relationship of the flood to IPV, no significant increase in IPV incidence occurred after the flood. Regardless of their flood experience, however, IPV victims consistently reported greater stress, PTSD symptoms, and somatic and psychological problems. Moreover, IPV victims may be at higher risk for stress-mediated chronic illnesses and for using negative coping behaviors. This study uses an established trusting relationship between researchers and community members to explore community needs and inform intervention design. (Contains 6 tables.)

There is a special need for a thorough examination of impacts of digitalization on small- and medium-sized enterprises due to their characteristic features. This paper aims to present a detailed picture of the current knowledge through a systematic literature review spanning across two decades and 99 journal contributions. The study results indicate a rather fragmented understanding, a lack of in-depth cause-effect analyses, and a prevalence of techno-centric approaches. By clustering the determinants, a perception shift is revealed. Drawing from critical realism the paper also suggests a definition of SME digitalization and conceptualizes a map of the research area where further avenues may be projected on. [ABSTRACT FROM AUTHOR]

Escape theory predicts that a prey should flee from an approaching predator at a point in which the cost of staying equals the cost of escape. We manipulated the cost of fleeing upon approaching human predators by providing the small mammal Octodon degus (Molina, 1782) with varying amounts of supplementary food likely to disappear while the animals are not in the food patch (e.g., hidden in their burrows). Simultaneously, we manipulated the risk of remaining in the patch by providing supplementary food at varying distances from the nearest burrow. Degus fled at a shorter distance to approaching predators when foraging in patches closer to the nearest burrow and supplied with relatively high abundance of food, but only when these rodents were foraging socially. Also, degus fled at a greater distance to approaching predators when foraging in patches far from the nearest burrow. Thus, functions linked to the loss of feeding opportunities and the risk of predation interact to influence flight initiation distance after a simulated attack. This study represented one of the few demonstrations of an interactive effect between cost and risks on antipredator behavior in a small, social prey mammal. La theorie de la fuite predit qu'une proie devrait fuir a l'approche d'un predateur au moment ou le cout de rester sur place equivaut a celui de la fuite. Nous avons manipule le cout de la fuite a l'approche de predateurs humains en procurant a le petit mammifere Octodon degus (Molina, 1782) des quantites variables de nourriture supplementaire susceptibles de disparaitre lorsque l'animal n'est pas present dans l'aire d'alimentation (par ex., lorsqu'il est cache dans sa taniere). Au meme moment, nous avons manipule le risque de demeurer sur place dans l'aire d'alimentation en placant de la nourriture supplementaire a diverses distances de la taniere la plus rapprochee. Les octodons prennent la fuite a l'approche des predateurs a des distances plus courtes lorsqu'ils s'alimentent plus pres de la taniere la plus proche et qu'ils sont approvisionnes avec des quantites relativement grandes de nourriture, mais seulement lorsque ces rongeurs s'alimentent en groupe. De plus, les octodons prennent la fuite a l'approche des predateurs a une distance plus grande lorsqu'ils s'alimentent dans des aires plus eloignees de la taniere la plus proche. Ainsi, les fonctions reliees a la perte des occasions des 'alimenter et le risque de predation interagissent pour influencer la distance d'initiation de la fuite apres une attaque simulee. Notre etude represente une des rares demonstrations des effets d'une interaction entre les couts et les risques sur le comportement antipredateur d'un petit mammifere social qui peut servir de proie. [Traduit par la Redaction] Can. J. Zool. 87: 1016-1023 (2009) doi: 10.1139/Z09-089 Published by NRC Research Press, Introduction A widespread antipredator response consists of fleeing from approaching predators until attaining a safe distance, or until entering and hiding into a refuge (Caro 2005). Since flight involves both [...]

Online support groups represent one of the many new forms of computer-mediated social interaction that have emerged on the Internet. These support groups are a new phenomenon and little is known about how this kind of communication affects group structure and process, or which formats will be most helpful for different client populations. This article describes a pilot study to test the technical feasibility and appropriateness of a six-week, online support group to help social workers manage stress. The implications of these findings for a study of a more comprehensive pilot study of a ten-week-long group are also discussed.

Caregivers of persons with AIDS experience numerous stressors in their caregiver role and could benefit from support groups. However, caregiving responsibilities make it difficult for many to attend face-to-face groups. This article describes experience with a telephone support group pilot project for this population. The time-limited, semi-structured groups used conference call technology; the eight session group protocol was designed to meet caregiver needs for information about resources and coping skills. Pilot data from interviews with group members from the first two completed groups on this project indicated that participants valued the group experience highly.