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Sex differences may exist in opioid use disorder (OUD) treatment. This study examined the treatment effects of buprenorphine/naloxone (BUP/NX) and methadone (MET) on the Clinical Opiate Withdrawal Scale (COWS) score in individuals with OUD and tested whether the associations differ by sex. We performed a secondary analysis of the data from the National Drug Abuse Treatment Clinical Trials Network (CTN) protocol-0027. A total of 1269 participants (861 males and 408 females) being aged 18 or older with OUD were randomly assigned to receive BUP/NX (n = 740) or MET (n = 529). The paired t test was initially used to compare the COWS scores between pre-dose and post-dose for BUP/NX and MET treatments, separately. The linear mixed model was used to examine the changes in COWS score adjusted for baseline demographic, substance use, and mental health disorders. The interaction of sex and treatment was detected and stratified analysis by sex was conducted. The paired t test showed that both BUP/NX and MET treatments significantly reduced the COWS scores (p values <0.0001). BUP/NX revealed higher COWS scores than MET (p = 0.0008) and females demonstrated significantly higher COWS scores than males (p = 0.0169). Stratified by sex, BUP/NX compared with MET revealed higher COWS scores only in males (p = 0.0043), whereas baseline amphetamines use disorder and major depressive disorder were significantly associated with COWS scores in females (p = 0.0158 and 0.0422, respectively). Both BUP/NX and MET are effective in decreasing opioid withdrawal symptoms via COWS scores, however, treatment plans for OUD by clinical providers should consider sex differences. [ABSTRACT FROM AUTHOR]

Objectives: The trail making test part B (TMT‐B) evaluates executive functions, memory, and sensorimotor functions. No previous study was found to examine the longitudinal effect of APOE‐ε4 genotypes on the TMT‐B scores in Alzheimer's disease (AD) across racial groups. Methods: This study used the data from Alzheimer's Disease Neuroimaging Initiative (ADNI): 382 participants with AD, 503 with cognitive normal (CN), 1293 with mild cognitive impairment (MCI) at baseline and follow‐up of four years. The multivariable linear mixed model was used to investigate the effect of APOE‐ε4 genotypes on changes in TMT‐B scores. Results: Compared with Whites, African Americans (AA) and Hispanics had higher TMT‐B scores (poor cognitive function). Furthermore, Whites subjects with 1 or 2 APOE‐ε4 alleles had significantly higher TMT‐B scores compared with individuals without APOE‐ε4 allele at baseline and four follow‐up visits; however, no differences in TMT‐B were found between APOE‐ε4 alleles in the Hispanic and AA groups. No APOE‐ε4 by visit interactions was found for 3 racial groups. Stratified by AD diagnosis, the APOE‐ε4 allele was associated with TMT‐B scores only in the MCI group, while there were significant interactions for visit by education, APOE‐ε4 allele, and the Mini Mental State Examination (MMSE) score in the MCI group. In addition, TMT‐B was significantly correlated with the MMSE, AD Assessment Scale‐cognitive subscale 13 (ADAS13), tTau, pTau, Aβ42, and hippocampus. Conclusions: APOE‐ɛ4 allele is associated with TMT‐B scores in Whites subjects, but not in the Hispanic and AA groups. APOE‐ε4 showed interaction with visit in the MCI group. Key points: African American (AA) and Hispanic populations had higher TMT‐B scores than Whites.Individuals with 1 or 2 APOE‐ε4 alleles had significantly higher TMT‐B scores compared with individuals without APOE‐ε4 allele in the Whites but not in the AA and Hispanic subjects.APOE‐ε4 genotypes had significant interactions with visit on TMT‐B in the mild cognitive impairment (MCI) subjects.TMT‐B was significantly correlated with the MMSE, ADAS13, tTau, pTau, Aβ42 and hippocampus. [ABSTRACT FROM AUTHOR]

The objective of this research was to explore the perceptions of nurses regarding patients with substance use disorder (SUD), healthcare provided, and desired resources to care for this population properly. This study used a crosssectional, descriptive design. Data were collected via an anonymous 12-item survey and three open-ended questions. Data were analyzed using descriptive statistics and conventional content analysis. Nurses with less than 1 year of experience reported more significant challenges when caring for patients with SUD. These challenges included difficulties in managing pain, implementing alternative pain management techniques, and knowing who to contact when problems occur. The study revealed many needs of nurses to provide compassionate care for patients with SUD. Findings indicate a need for education for nurses, especially novice nurses, who care for patients with SUD. [ABSTRACT FROM AUTHOR]

COVID-19 greatly impacted nursing education and required nursing faculty and students to quickly adapt to changes caused by disease mitigation. The purpose of this study was to examine the mediating effects of resilience between the influence of demographics and school-related risk factors and nursing faculty and student quality of life (QoL) during the COVID-19 pandemic. A secondary data analysis was conducted using structural equation modeling to examine the mediating role of resilience on latent variables. Resilience had a positive, direct effect on nursing faculty and student QoL. Having a designated home workspace and being well-prepared for online learning had positive, indirect effects on QoL, mediated through resilience. Assisting children with schoolwork had a negative impact on the psychological and environmental QoL domains. Remarkably, having a caregiver role positively influenced the psychological QoL domain. Supporting and promoting faculty and nursing students' health and well-being is imperative during and after the pandemic. [ABSTRACT FROM AUTHOR]

The study describes the design and implementation of an Internet-based, computed-assisted telephone survey about the care-planning process in 107 long-term care facilities in the Midwest. Two structured telephone surveys were developed to interview the care planning coordinators and their team members. Questionmark Perception Software Version 3 was used to develop the surveys in a wide range of formats. The responses were drawn into a database that was exported to a spreadsheet format and converted to a statistical format by the Information Technology team. Security of the database was protected. Training sessions were provided to project staff. The interviews were tape-recorded for the quality checks. The inter-rater reliabilities were above 95% to 100% agreement. Investigators should consider using Internet-based survey tools, especially for multisite studies that allow access to larger samples at less cost. Exploring multiple software systems for the best fit to the study requirements is essential. Keywords: long-term care; nursing homes; data collection; Internet; computer-assisted telephone interviewing

The study examined the associations of multiple psychiatric and chronic conditions with the self-reported history of major depressive disorder (MDD) among patients with opioid use disorder (OUD) and tested whether the associations differed by gender. We conducted a secondary data analysis of baseline data from a clinical trial including 1,646 participants with OUD, of which 465 had MDD. A variable cluster analysis was used to classify chronic medical and psychiatric conditions. Multivariable logistic regression analyses were used to estimate their associations with MDD in subjects with OUD. Nine variables were divided into three clusters: cluster 1 included heart condition, hypertension, and liver problems; cluster 2 included gastrointestinal (GI) problems and head injury, and cluster 3 included anxiety disorder, bipolar disorder, and schizophrenia. The overall prevalence of MDD in participants with OUD was 28.3% (22.8% for males and 39.5% for females). Gender, anxiety disorder, schizophrenia, liver problems, heart condition, GI problems, and head injury were significantly associated with MDD. Gender-stratified analyses showed that bipolar disorder, liver problems and individuals with one chronic condition were associated with MDD only in males, whereas heart condition, hypertension, and GI problems were associated with MDD only in females. In addition, anxiety disorder, head injury, individuals with one or more than two psychiatric conditions, and individuals with more than two chronic conditions were associated with MDD regardless of gender. Treatment plans in patients with OUD should not only address MDD but also co-morbid psychiatric and chronic medical conditions that occur with MDD. [ABSTRACT FROM AUTHOR]

Background: Many factors contribute to continuous positive airway pressure (CPAP) nonadherence, affecting health care burden. The original CPAP-SAVER study enrolled 66 CPAP-naive participants and showed high 1-month adherence and significantly higher apnea beliefs and CPAP attitude for the intervention group. Purpose and methods: Thirty-three participants from the original CPAP-SAVER study were recruited for a 3-year follow-up to determine adherence, examine the intervention effect, and identify adherence-associated factors. Results: Adherence rates dropped to 54.5% at 3 years, with a significant decrease in CPAP use hours (t = -2.37, p =.024) and nights (t = -4.05, p <.001). Group differences in beliefs and attitude were not sustained; however, beliefs (r = 0.57) and attitude (r = 0.44) were significant factors associated with adherence. Life satisfaction was significantly higher at present compared with before wearing CPAP (t = 5.17, p <.001). Implications for practice: The authors recommend intervention with a focus on apnea beliefs, CPAP attitude, and long-term support to promote CPAP adherence. Focus on CPAP attitude and beliefs and enhanced support early in the obstructive sleep apnea (OSA) treatment trajectory may promote long-term adherence and subsequently reduce the health care burden of OSA disease. [ABSTRACT FROM AUTHOR]