scholarly journals Rural opioid treatment program patient perspectives on take-home methadone policy changes during COVID-19: a qualitative thematic analysis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ximena A. Levander ◽  
Kim A. Hoffman ◽  
John W. McIlveen ◽  
Dennis McCarty ◽  
Javier Ponce Terashima ◽  
...  
Keyword(s):  
Thematic Analysis ◽  
Addiction Treatment ◽  
The United States ◽  
Patient Perspectives ◽  
Transmission Risk ◽  
Normal Person ◽  
Policy Changes ◽  
Total N ◽  
Opioid Treatment ◽  
Individualized Care

Abstract Background In the United States, methadone for opioid use disorder (OUD) is highly regulated. Federal agencies announced guidelines in March 2020 allowing for relaxation of take-home methadone dispensing at opioid treatment programs (OTPs) to improve treatment access and reduce COVID-19 transmission risk during the public health emergency. We explored patient perspectives at three OTPs serving rural communities on how take-home policy changes were received and implemented and how these changes impacted their addiction treatment and recovery. Methods We completed semi-structured individual qualitative interviews in 2 phases: (1) August–October 2020 and (2) November 2020–January 2021 (total n = 46), anticipating possible policy changes as the pandemic progressed. We interviewed patients with OUD enrolled at 3 rural OTPs in Oregon. Participants received varying take-home methadone allowances following the COVID-19-related policy changes. All interviews were conducted via phone, audio-recorded, and transcribed. We conducted a thematic analysis, iteratively coding transcripts, and deductively and inductively generating codes. Results The 46 participants included 50% women and 89% had Medicaid insurance. Three main themes emerged in the analysis, with no differences between study phases: (1) Adapting to changing OTP policies throughout the pandemic; (2) Recognizing the benefits, and occasional struggles, with increased take-home methadone dosing; and (3) Continuing policies and procedures post-pandemic. Participants described fears and anxieties around ongoing methadone access and safety concerns prior to OTP policy changes, but quickly adapted as protocols soon seemed “natural.” The majority of participants acknowledged significant benefits to increased take-homes independent of reducing COVID-19 infection risk including feeling “more like a normal person,” improved recovery support, reduced time traveling, and having more time with family and for work. Looking to a post-pandemic future, participants thought some COVID-19-related safety protocols should continue that would reduce risk of other infections, make OTP settings less stressful, and result in more individualized care. Conclusions As the pandemic progressed, study participants adapted to rapidly changing OTP policies. Participants noted many unanticipated benefits to increased take-home methadone and other COVID-19 protocols including strengthened self-efficacy and recovery and reduced interpersonal conflict, with limited evidence of diversion. Patient perspectives should inform future policies to better address the ongoing overdose epidemic.

Political bullshit receptivity and its correlates: a cross-cultural validation of the concept

2020 ◽  
Author(s):  
Vukašin Gligorić ◽  
Allard Feddes ◽  
Bertjan Doosje
Keyword(s):  
The Netherlands ◽  
Political Ideology ◽  
Voting Behavior ◽  
Free Market ◽  
Meta Analysis ◽  
The United States ◽  
Persuasive Communication ◽  
Lower Probability ◽  
Left Wing ◽  
Total N

Frankfurt defined persuasive communication that has no regard for truth, knowledge, or evidence as bullshit. Although there has been a lot of psychological research on pseudo-profound bullshit, no study examined this type of communication in politics. In the present research, we operationalize political bullshit receptivity as endorsing vague political statements, slogans, and political bullshit programs. We investigated the relationship of these three measures with pseudo-profound bullshit, ideology (political ideology, support for neoliberalism), populism, and voting behavior. Three pre-registered studies in different cultural settings (the United States, Serbia, The Netherlands; total N = 534) yielded medium to high intercorrelations between political bullshit measures and pseudo-profound bullshit, and good construct validity (hypothesized one-factor solution). A Bayesian meta-analysis showed that all political bullshit measures positively correlated with support for the free market, while only some positively correlated with social (political statements and programs) and economic conservatism (programs), and populism (programs). In the U.S., higher receptivity to political bullshit was associated with a higher probability that one voted for Trump (vs Clinton) in the past and higher intentions to vote for Trump (vs Biden and Sanders). In the Netherlands, higher receptivity to political bullshit predicted the intention to vote for the conservative-liberal People's Party for Freedom and Democracy. Exploratory analyses on merged datasets showed that higher receptivity to political bullshit was associated with a higher probability to vote for right-wing candidates/parties and lower probability for the left-wing ones. Overall, political bullshit endorsement showed good validity, opening avenues for research in political communication, especially when this communication is broad and meaningless.

Restoring Damaged Relationships Through the Art of Invitation: Application with Addicted Incarcerated Women

2019 ◽  
Vol 46 (3) ◽  
Author(s):  
Katti J. Sneed ◽  
Debbie Teike
Keyword(s):  
Human Services ◽  
Addiction Treatment ◽  
The United States ◽  
Incarcerated Women ◽  
Relationship Building ◽  
Health And Human Services ◽  
Guiding Principle ◽  
Faith Based ◽  
Department Of Health ◽  
Complementary Approach

This article presents a description of Art of Invitation as a complementary approach to traditional addiction treatment through the alignment of Art of Invitation (AOI) with Substance Abuse and Mental Health Services Administration (SAMHSA) Ten Guiding Principles for Recovery.  AOI is a faith based relationship building approach that combines key Judeo/Christian teachings with relationship building tools, skills, and concepts for those seeking to build and restore relationships.  SAMHSA, as the leading agency within the U.S. Department of Health and Human Services, spearheads public health efforts to advance behavioral health within the United States.  Each Guiding Principle is presented along with a description of how AOI is shared with incarcerated women, an often neglected population, participating in an inpatient treatment program housed in a community corrections facility.

scholarly journals Verification of Healthcare Personnel Immunity as a Strategy for Measles Preparedness

2020 ◽  
Vol 41 (S1) ◽  
pp. s431-s432
Author(s):  
Rachael Snyders ◽  
Hilary Babcock ◽  
Christopher Blank
Keyword(s):  
Infectious Diseases ◽  
Multidisciplinary Team ◽  
The United States ◽  
Transmission Risk ◽  
Healthcare Personnel ◽  
Serological Tests ◽  
Preparedness Plan ◽  
Vaccine Preventable Diseases ◽  
Measles Outbreaks ◽  
Centralized Database

Background: Immunization resistance is fueling a resurgence of vaccine-preventable diseases in the United States, where several large measles outbreaks and 1,282 measles cases were reported in 2019. Concern about these measles outbreaks prompted a large healthcare organization to develop a preparedness plan to limit healthcare-associated transmission. Verification of employee rubeola immunity and immunization when necessary was prioritized because of transmission risk to nonimmune employees and role of the healthcare personnel in responding to measles cases. Methods: The organization employs ∼31,000 people in diverse settings. A multidisciplinary team was formed by infection prevention, infectious diseases, occupational health, and nursing departments to develop the preparedness plan. Immunity was monitored using a centralized database. Employees without evidence of immunity were asked to provide proof of vaccination, defined by the CDC as 2 appropriately timed doses of rubeola-containing vaccine, or laboratory confirmation of immunity. Employees were given 30 days to provide documentation or to obtain a titer at the organization’s expense. Staff with negative titers were given 2 weeks to coordinate with the occupational heath department for vaccination. Requests for medical or religious accommodations were evaluated by occupational heath staff, the occupational heath medical director, and the human resources department. All employees were included, though patient-interfacing employees in departments considered higher risk were prioritized. These areas were the emergency, dermatology, infectious diseases, labor and delivery, obstetrics, and pediatrics departments. Results: At the onset of the initiative in June 2019, 4,009 employees lacked evidence of immunity. As of November 2019, evidence of immunity had been obtained for 3,709 employees (92.5%): serological evidence of immunity was obtained for 2,856 (71.2%), vaccine was administered to 584 (14.6%), and evidence of previous vaccination was provided by 269 (6.7%). Evidence of immunity has not been documented for 300 (7.5%). The organization administered 3,626 serological tests and provided 997 vaccines, costing ∼$132,000. Disposition by serological testing is summarized in Table 1. Conclusions: A measles preparedness strategy should include proactive assessment of employees’ immune status. It is possible to expediently assess a large number of employees using a multidisciplinary team with access to a centralized database. Consideration may be given to prioritization of high-risk departments and patient-interfacing roles to manage workload.Funding: NoneDisclosures: None

“Doing Hope”: Ecofeminist Spirituality Provides Emotional Sustenance to Confront the Climate Crisis

Affilia ◽  
2021 ◽  
pp. 088610992098724
Author(s):  
Finn McLafferty Bell ◽  
Mary Kate Dennis ◽  
Glory Brar
Keyword(s):  
Thematic Analysis ◽  
Work Practice ◽  
The United States ◽  
Social Work Practice ◽  
Environmental Stewardship ◽  
Catholic Sisters ◽  
The World ◽  
Right Relationship ◽  
Environmental Work ◽  
Climate Crisis

Environmental crises caused by our changing global environment evoke intense and difficult emotions, particularly the paralysis that often results from despair. Understanding how people who are deeply engaged in environmental activism deal with their emotions can help in emotionally equipping people to address the climate crisis. Ecofeminist spirituality directly addresses these issues through an environmental stewardship that offers hope and healing for the world. This study includes 14 interviews with workers at an ecojustice center founded by an order of Catholic sisters in the United States. We used thematic analysis to identify three main themes that collectively describe the participants’ perspectives on (a) experiences of difficult feelings, (b) strategies for coping with those feelings, and (c) perspectives on cultivating hope. Participants shared how they were able to cope with difficult emotions and cultivate hope that the work they are doing matters, which was essential to sustaining their ecojustice work. As social workers respond to the changing environment, understanding how to sustain environmental work at the macro-level is essential to addressing largescale problems while also attending to difficult emotions at the microlevel. Further implications for social work practice include the importance of intergenerational organizing, living in “right relationship,” incorporating spirituality, and reinhabiting the profession.

22. Characteristics of Adolescent-Serving Addiction Treatment Facilities in the United States

2020 ◽  
Vol 66 (2) ◽  
pp. S12
Author(s):  
Rachel Alinsky ◽  
Scott Hadland ◽  
Pamela Matson ◽  
Magdalena Cerda ◽  
Brendan Saloner
Keyword(s):  
United States ◽  
Addiction Treatment ◽  
The United States ◽  
Treatment Facilities

Psychiatry’s “Chemical Imbalance” Fraud: Who Killed Rebecca Riley?

2008 ◽  
Vol 10 (2) ◽  
pp. 96-108 ◽  
Author(s):  
Fred A. Baughman
Keyword(s):  
The United States ◽  
Diagnosis And Treatment ◽  
Normal Person ◽  
Organic Disease ◽  
Health Care Fraud ◽  
Department Of Health ◽  
Congressional Hearing ◽  
The Difference ◽  
Chemical Imbalance ◽  
The Brain

All physicians attend medical school and learn of (a) all things physically normal; anatomy, physiology, and chemistry, (b) all things physically abnormal; pathology, disease, and (c) how to tell the difference. Diagnosis is the first obligation of every physician to every patient, and must precede treatment. Diagnosis first asks, “Is there a physical abnormality (physical abnormality = disorder = disease), yes or no?” Patients with no abnormality (no physical abnormality = no disorder = no disease = normal) are referred to as having “no evidence or disease” (NED) or “no organic disease” (NOD). Their problems may be psychological or psychiatric, but they are not medical or surgical. In patients found to have an abnormality, diagnosis now asks, “Which disease?” Psychiatrists are the only physicians who do not perform physical diagnosis. The absence of disease is determined for them by other physicians, usually referring physicians. In 1948 the previously conjoint specialty of neuropsychiatry was divided into neurology—responsible for the diagnosis and treatment or physical/organic disease of the nervous system—and psychiatry—responsible for the treatment of emotional and psychological problems, none of them due to organic diseases. Nor did psychiatry object to this scientific division of labor at the time. However, in the 1950s, with the advent of psychotropic drugs, psychiatry, increasingly in league with the pharmaceutical industry, began referring to psychological diagnoses as disorders/diseases/chemical imbalances of the brain, albeit with no proof or science. In a congressional hearing in 1970, psychiatrists and federal officials, including the Food and Drug Administration and the Department of Health, Education, and Welfare, represented hyperkinetic disorder (HKD) to be a disorder/disease of the brain leading to the appropriation of millions of dollars for research, diagnosis and treatment into the drug treatment of school children said to have the new disease HKD. HKD became ADD, then ADHD, a disorder/disease/chemical imbalance always in need of a “chemical balancer”—a pill. Without proof of an abnormality/disorder/disease, the ADHD epidemic grew from 150,000 in 1970 to 6 million to 7 million today, the most common childhood diagnosis in the United States, a multi-billion dollar industry, and a model for all 374 DSM–IV psychological/psychiatric diagnoses—none of them actual diseases. As such, psychiatry is not a legitimate branch of medicine deserving scientific-fiscal parity; rather, collectively, it is the greatest health care fraud in history. Every time a so-called chemical imbalance is diagnosed, a patient’s right to informed consent has been abrogated. Every time a medically normal person is treated with a psychotropic chemical balancer—a pill—their first and only abnormality is the iatrogenic intoxication: poisoning.

scholarly journals Qualitative research to explore the symptoms and impacts experienced by children with ulcerative colitis

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Jason A. Randall ◽  
Aiste Guobyte ◽  
Laure Delbecque ◽  
Louise Newton ◽  
Tara Symonds ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ulcerative Colitis ◽  
Lived Experience ◽  
Thematic Analysis ◽  
Gastrointestinal Disease ◽  
The United States ◽  
Self Report ◽  
Related Quality ◽  
High Level

Abstract Background Ulcerative Colitis (UC) is a chronic gastrointestinal disease that often presents during one’s most productive years and is characterized by colon inflammation. Key symptoms and impacts in adults are well-known, however, experiences among pediatric populations have not been well documented. The purpose of this study was to understand the health-related quality of life and symptomatic experience of children (2–11 years) living with UC. Methods Qualitative, semi-structured face-to-face interviews were conducted. Children aged 5–11 years were interviewed, as well as their parents/caregivers in matched dyads. Parents/caregivers of children aged2–4 years were interviewed within a parent/caregiver-only cohort. All participants were recruited from the United States. Interviews were coded using thematic analysis. Results Key symptoms and impacts reflecting the lived experience of UC were identified following thematic analysis, generating a conceptual model. A total of 32 participants (20 parents/caregivers and 12 children) were interviewed. Results identified a substantial burden of UC in children. All children and parents/caregivers reported that they/their child experienced stomach/abdominal pain. Other symptoms discussed by over 75% were blood in stool, diarrhea/loose stools, stool urgency, incomplete evacuation, stool frequency, and feeling gassy/passing gas. The most frequently discussed impacts by over 75% of participants were on emotional and practical aspects, seriously affecting quality of life. Conclusions Qualitative analysis of the interviews identified a substantial burden of UC on children, with a profound impact on their lives. The symptomatic experience is reflective of adults and adolescents. A high level of agreement between parents/caregivers and children was demonstrated regarding the perception of the presence or absence of symptoms. Children aged 8–11 years showed higher levels of agreement with parents/caregivers than did younger children, indicating appropriateness of self-report of symptom data in the 8–11 years age group.

The Political Manipulation of Macroeconomic Policy

1990 ◽  
Vol 84 (3) ◽  
pp. 767-795 ◽  
Author(s):  
John T. Williams
Keyword(s):  
Interest Rates ◽  
The United States ◽  
Real Income ◽  
Policy Cycle ◽  
Presidential Approval ◽  
Policy Changes ◽  
Macroeconomic Policies ◽  
Monetary Policies ◽  
Economic Forces ◽  
Party Differences

Conventional wisdom and some research indicate that macroeconomic policies follow cycles corresponding to political, as well as economic, forces. Using vector autoregression analysis, I test three models of monetary policy determination for the United States, 1953–1984: the electoral cycle model (that reelection motivations on the part of presidents create a policy cycle), the party differences model (that policy changes reflect revolving presidential party administrations), and the referendum model (that changes in presidential approval create, in effect, a continuing referendum, allowing presidents to monitor their success and change macroeconomic policies when necessary). Analysis shows that monetary policies, as measured by the monetary base and short-term interest rates, respond to the election cycle and presidential approval (although the effect on macroeconomic outcomes is ambiguous). Party differences are found in real income but are not very significant in other variables.

Embracing Four Tensions in Human-Computer Interaction Research with Marginalized People

2021 ◽  
Vol 28 (2) ◽  
pp. 1-47
Author(s):  
Calvin A. Liang ◽  
Sean A. Munson ◽  
Julie A. Kientz
Keyword(s):  
United States ◽  
Human Computer Interaction ◽  
Thematic Analysis ◽  
The United States ◽  
New Paradigm ◽  
History Of ◽  
Interview Survey ◽  
Interaction Research ◽  
Oriented Approach ◽  
Computer Interaction

Human-computer interaction has a long history of working with marginalized people. We sought to understand how HCI researchers navigate work that engages with marginalized people and considerations researchers might work through to expand benefits and mitigate potential harms. In total, 24 HCI researchers, located primarily in the United States, participated in an interview, survey, or both. Through a reflexive thematic analysis, we identified four tensions—exploitation, membership, disclosure, and allyship. We explore the complexity involved in each, demonstrating that an equitable endpoint may not be possible, but this work is still worth pursuing when researchers make certain considerations. We emphasize that researchers who work with marginalized people should account for each tension in their research approaches to move forward. Finally, we propose an allyship-oriented approach to research that draws inspiration from discourse occurring in tangential fields and activist spaces and pushes the field into a new paradigm of research with marginalized people.

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