Outcomes Measures for Sexual Minority Patients in an Opioid Treatment Program

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APHA Alcohol, Tobacco, & Other Drugs Section

This document summarizes a proposed study to evaluate outcomes for sexual minority patients participating in specialized groups at an opioid treatment program. The study would use a pre-post intervention design to assess changes in substance abuse and quality of life after participation in groups tailored for sexual minorities. Data would be collected through toxicology screens, interviews, and questionnaires to analyze differences statistically and determine if participation improves substance abuse and quality of life.

Health & Medicine

Outcomes Measures for Sexual Minority Patients in an Opioid Treatment Program C. John-Hull, S. Kritz, M. Chu, C. Madray, G. Dominguez, C. Bowers, R. Sumpter, J. Mitchell, L.S. Brown Addiction Research and Treatment Corp, Brooklyn, NY 11201 Submitted as R-21 application in response to NIDA PA-06-218: Health Research with Diverse Populations

ABSTRACT Studies of sexual minorities have overwhelmingly been cross-sectional and descriptive. Some of the findings are: (1) increased risk for mental health and substance abuse problems; (2) different substances of abuse; (3) engagement in riskier sexual practices; and, (4) unique healthcare access issues as compared to heterosexuals. The Addiction Research and Treatment Corporation is the largest non-hospital based Opioid Treatment Program in New York State, serving more than 3,000 patients annually. We provide a wide range of healthcare and social services to patients throughout Brooklyn and Manhattan. On the basis of anonymous surveys, there is clearly an interest in having programs geared towards this population. In response to a NIDA R-01 Program Announcement (PA-06-218), we propose to do a pre and post-intervention study that evaluates sexual minority patients participating in specialized groups in the following outcomes measures: (1) substance abuse; and, (2) quality of life. These particular outcomes were chosen because they will provide sufficient data for statistical analysis of significance, which is lacking in studies of this population.

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DOMAINS, MEASURES & DATA SOURCES Domain Measure Data Source Substance Abuse Toxicology screens Patient chart Breathalyzer Patient chart CIDI Patent interview Quality of Life WHOQOL-BREF Patient interview

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The paper intends to assess the level of utilization and socio-economic factors influencing adherence to utilization of Anti Retroviral Therapy (ART) for People Living with HIV/AIDS in Dodoma Municipality and Kongwa District in Tanzania. Documentary review, interview and Focus Group Discussion were used in collecting data. A total of 140 respondents (99 PLWHIV/AIDS and 41 key informants) from four hospitals, two health centers and one dispensary were selected and interviewed as representatives for the purpose of this study. Quantitative data were collected and analyzed by using SPSS version 16 software. The study revealed 100% of PLWHIV/AIDS used ART drugs in Dodoma General Hospital, Kongwa Hospital, Mkoka Health Center and Makole Health Center while 40% in St. Gemma Hospital. Also the study indicated there were high dropout from utilization of ART drugs among PLWHIV/AIDS, 60% in Mirembe hospital, (50%) in Mkoka health center and (44%) in St. Gemma hospital as compared to the rest health centers and hospitals. The drop out caused by ART drugs side effects such as vomiting (25.1%), frequently sickness (19.9%) and decrease in CD 4 (11.2%). Lastly the study revealed four main socio-economic factors influencing adherence to utilization of ART services among PLHIV/AIDS including lack of employment support (66.7 %,) lack of confidentiality (50 %,) patient’s preference to traditional medicines (30%) and cultural belief (29.3%). The study recommends all PLWHIV/AIDS with side effects should report their cases to health centers and hospitals because not all side effects require a change of drugs or discontinuation, PLWHIV/AIDS should be assisted by Government and Non-Government Organizations and family members to secure soft loans that will enable them to establish income generation activities, education on patients confidentiality should be provided to services providers in hospitals and health centers

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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva. Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade. Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal. Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural. Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis. É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais. O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada. Recomendamos muito. Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos. Esta publicação só está disponível em inglês até o momento. Prof. Marcus Renato de Carvalho www.agostodourado.com

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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?

bkling

Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.

The Normal Electrocardiogram - Part I of II

MedicoseAcademics

These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram. Learning objectives: 1. Define an electrocardiogram (ECG) and electrocardiography 2. Describe how dipoles generated by the heart produce the waveforms of the ECG 3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II) 4. Differentiate between intervals and segments 5. Enlist some common indications for obtaining an ECG Study Resources: 1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition 2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition 3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition 4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/ 5. ECG in Medical Practice by ABM Abdullah, 4th edition 6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics

Prix Galien International 2024 Forum Program

Levi Shapiro

June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels: - ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING - WOMEN’S HEALTH: FERTILITY PRESERVATION - WHAT’S NEW IN THE TREATMENT OF INFECTIOUS, ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES? - ARTIFICIAL INTELLIGENCE AND ETHICS - GENE THERAPY - BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE - ETHICAL CHALLENGES IN LIFE SCIENCES - Prix Galien International Awards Ceremony

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Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdf

Dr Jeenal Mistry

Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol that is rapidly distributed in the body and brain. Ethanol alters many neurochemical systems and has rewarding and addictive properties. It is the oldest recreational drug and likely contributes to more morbidity, mortality, and public health costs than all illicit drugs combined. The 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) integrates alcohol abuse and alcohol dependence into a single disorder called alcohol use disorder (AUD), with mild, moderate, and severe subclassifications (American Psychiatric Association, 2013). In the DSM-5, all types of substance abuse and dependence have been combined into a single substance use disorder (SUD) on a continuum from mild to severe. A diagnosis of AUD requires that at least two of the 11 DSM-5 behaviors be present within a 12-month period (mild AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria). The four main behavioral effects of AUD are impaired control over drinking, negative social consequences, risky use, and altered physiological effects (tolerance, withdrawal). This chapter presents an overview of the prevalence and harmful consequences of AUD in the U.S., the systemic nature of the disease, neurocircuitry and stages of AUD, comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and pharmacotherapies for AUD.

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Physiology of Chemical Sensation of smell.pdf

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Title: Sense of Smell Presenter: Dr. Faiza, Assistant Professor of Physiology Qualifications: MBBS (Best Graduate, AIMC Lahore) FCPS Physiology ICMT, CHPE, DHPE (STMU) MPH (GC University, Faisalabad) MBA (Virtual University of Pakistan) Learning Objectives: Describe the primary categories of smells and the concept of odor blindness. Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction. Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain. Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential. Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes. Key Topics: Olfactory Genes: 3% of the human genome accounts for olfactory genes. 400 genes for odorant receptors. Olfactory Membrane: Located in the superior part of the nasal cavity. Medially: Folds downward along the superior septum. Laterally: Folds over the superior turbinate and upper surface of the middle turbinate. Total surface area: 5-10 square centimeters. Olfactory Mucosa: Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell. Sustentacular Cells: Produce mucus and maintain ionic and molecular environment. Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months. Bowman’s Gland: Secretes mucus. Stimulation of Olfactory Cells: Odorant dissolves in mucus and attaches to receptors on olfactory cilia. Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve. Quality of a Good Odorant: Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble. Facilitated by odorant-binding proteins in mucus. Membrane Potential and Action Potential: Resting membrane potential: -55mV. Action potential frequency in the olfactory nerve increases with odorant strength. Adaptation Towards the Sense of Smell: Rapid adaptation within the first second, with further slow adaptation. Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system. Primary Sensations of Smell: Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid. Odor Detection Threshold: Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm). Some toxic substances are odorless at lethal concentrations. Characteristics of Smell: Odor blindness for single substances due to lack of appropriate receptor protein. Behavioral and emotional influences of smell. Transmission of Olfactory Signals: From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition. Primitive, less old, and new olfactory systems with different path

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Savita Shen $i11

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DR SETH JOTHAM

The prostate is an exocrine gland of the male mammalian reproductive system It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ). It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes It’s work is regulated by androgens which are responsible for male sex characteristics Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS

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New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...

i3 Health

i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource. This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and Associate Division Director for Ambulatory Operations The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma. STATEMENT OF NEED Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL. Target Audience Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL). Learning Objectives 1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL 2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults 3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection

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Outcomes Measures for Sexual Minority Patients in an Opioid Treatment Program

1. Outcomes Measures for Sexual Minority Patients in an Opioid Treatment Program C. John-Hull, S. Kritz, M. Chu, C. Madray, G. Dominguez, C. Bowers, R. Sumpter, J. Mitchell, L.S. Brown Addiction Research and Treatment Corp, Brooklyn, NY 11201 Submitted as R-21 application in response to NIDA PA-06-218: Health Research with Diverse Populations

2. ABSTRACT Studies of sexual minorities have overwhelmingly been cross-sectional and descriptive. Some of the findings are: (1) increased risk for mental health and substance abuse problems; (2) different substances of abuse; (3) engagement in riskier sexual practices; and, (4) unique healthcare access issues as compared to heterosexuals. The Addiction Research and Treatment Corporation is the largest non-hospital based Opioid Treatment Program in New York State, serving more than 3,000 patients annually. We provide a wide range of healthcare and social services to patients throughout Brooklyn and Manhattan. On the basis of anonymous surveys, there is clearly an interest in having programs geared towards this population. In response to a NIDA R-01 Program Announcement (PA-06-218), we propose to do a pre and post-intervention study that evaluates sexual minority patients participating in specialized groups in the following outcomes measures: (1) substance abuse; and, (2) quality of life. These particular outcomes were chosen because they will provide sufficient data for statistical analysis of significance, which is lacking in studies of this population.

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15. DOMAINS, MEASURES & DATA SOURCES Domain Measure Data Source Substance Abuse Toxicology screens Patient chart Breathalyzer Patient chart CIDI Patent interview Quality of Life WHOQOL-BREF Patient interview

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