scholarly journals Student Athletic Therapists' Knowledge of Opioids and Other Pain-Relieving Medications

2021 ◽  
Vol 16 (2) ◽  
pp. 112-119
Author(s):  
Jacqueline Vandertuin ◽  
Dalya Abdulla ◽  
Stephanie Lowther
Keyword(s):  
Health Care Providers ◽  
Current Knowledge ◽  
Semistructured Interview ◽  
Care Providers ◽  
Opioid Use ◽  
Contributing Factors ◽  
Correct Information ◽  
News Organizations ◽  
Significant Burden ◽  
Considerable Pressure

Context In their role as health care providers, student athletic therapists (SATs) are responsible for the prevention and management of injuries. To fully understand an injury, SATs require knowledge of contributing factors, including medications and their use and misuse. Opioid misuse by athletes to manage pain has been documented in the literature, highlighting the importance of SATs being able to recognize opioid use and misuse. Opioids are known to alleviate pain, to impair cognition, and to have addictive qualities which prevents appropriate assessment and management of injuries. Objective The objective of this study was to understand SATs' knowledge of pain-relieving medication, particularly opioids. Design Qualitative study. Setting Semistructured interview. Patients or Other Participants SATs at an accredited institution in Canada. Data Synthesis Data were collected through interviews and transcribed. Themes were developed using triangulation that reflected the data Results Four themes were uncovered: (1) SATs had experienced both personal and professional use of opioids, which formulated their current knowledge; (2) SATs lacked appropriate knowledge of pain-relieving medications in general and of the potential consequences of their lack of knowledge; (3) SATs' knowledge stemmed from culture, social media, and news organizations; (4) SATs felt considerable pressure to provide correct information due to their autonomous role with a team. Conclusions SATs lacked enough knowledge to be able to appropriately recognize and advise athletes on pain-relieving medications, particularly opioids. SATs formulated their knowledge and opinions from sources that were not rooted in research and as such may transfer incorrect information to their athletes. SATs stigmatized athletes who were using pain-relieving medication, which may factor into inappropriate decisions regarding an athlete's care. Finally, SATs carried a significant burden to share correct information with their athletes and did not refer to outside sources (eg, physicians) when they were unsure of the information they were sharing with their athletes.

scholarly journals Concurrent Opioid and Alcohol Use Among Women Who Become Pregnant: Historical, Current, and Future Perspectives

2019 ◽  
Vol 13 ◽  
pp. 117822181985263
Author(s):  
Stacey L Klaman ◽  
Kim Andringa ◽  
Evette Horton ◽  
Hendrée E Jones
Keyword(s):  
Alcohol Use ◽  
Health Care Providers ◽  
Research Policy ◽  
Current Knowledge ◽  
The United States ◽  
Opioid Use Disorder ◽  
Care Providers ◽  
Opioid Use ◽  
Public Health Challenges ◽  
Current Context

The numbers of women using opioids who become pregnant have captured the attention of media, research, policy, and community. At the same time, there is an ever-growing use of alcohol among women who continue drinking during pregnancy that has received less focus. Although both untreated opioid use disorder and alcohol misuse pose risks for maternal, fetal, and child morbidities, alcohol is the substance with the most significant documentation of harms. As we focus on the opioid epidemic in the United States, it is critical that we do not overlook alcohol use during pregnancy. Both opioid use and alcohol use during pregnancy are important public health challenges and often happen concurrently. Thus, this commentary aims to (1) highlight the historical and current context of opioid and alcohol use during pregnancy; (2) summarize the current knowledge of opioids and alcohol use during pregnancy; and (3) detail future directions in how health care providers can help identify and therapeutically respond to women with concurrent opioid and alcohol use disorder.

Treatment Persistence Among Insured Patients Newly Starting Buprenorphine/Naloxone for Opioid Use Disorder

2018 ◽  
Vol 52 (5) ◽  
pp. 405-414 ◽  
Author(s):  
Natalia Shcherbakova ◽  
Gary Tereso ◽  
Jacqueline Spain ◽  
Robert J. Roose
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Care Delivery ◽  
Opioid Use Disorder ◽  
Prescription Opioid ◽  
Care Providers ◽  
Opioid Use ◽  
Treatment Persistence ◽  
Factors Associated ◽  
Insured Patients

Background: Persistence with medication-assisted therapy among patients with opioid use disorder has been associated with reduced likelihood of illicit opioid use. Objective: We aimed to describe treatment persistence and identify factors associated with 1-year persistence among insured patients newly initiating buprenorphine-containing pharmacotherapy. Methods: The retrospective observational cohort included employer-sponsored and managed Medicaid patients newly started on buprenorphine-containing therapy between June 30, 2010, and January 1, 2015. Persistence was measured as both a continuous and dichotomous variable (proportion of patients persistent for 1 year). Multivariable logistic regression analysis was used to identify factors associated with 1-year persistence. Results: A total of 302 patients met inclusion criteria. The median [range] number of treatment episodes was 1 [1-4]. Mean number of days on therapy during the first episode was 206 (SD = 152) days, with 40.4% (n = 122) of patients persisting for 1 year. Presence of concomitant fills of prescription opioid analgesics (odds ratio [OR] = 0.25; 95% CI = 0.12-0.51), being in care of an addiction specialist (OR = 0.40; 95% CI = 0.21-0.76), and Medicaid insurance coverage (OR = 0.33; 95% CI = 0.13-0.84) were significantly and negatively associated with 1-year persistence. There was also a strong inverse relationship between persistence and inpatient hospitalization (OR = 0.30; 95% CI = 0.12-0.76). Conclusions: Several health care delivery and use variables were significantly associated with nonpersistence. Concomitant use of prescription opioids is the most easily modifiable risk factor that health care providers and policy makers may act on to improve treatment continuation.

scholarly journals Flavonoids and Their Anti-Diabetic Effects: Cellular Mechanisms and Effects to Improve Blood Sugar Levels

Biomolecules ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. 430 ◽  
Author(s):  
AL-Ishaq ◽  
Abotaleb ◽  
Kubatka ◽  
Kajo ◽  
Büsselberg
Keyword(s):  
Health Care Providers ◽  
Molecular Mechanisms ◽  
Glucose Transporter ◽  
Kinase Inhibitor ◽  
Current Knowledge ◽  
Care Providers ◽  
Hepatic Enzymes ◽  
Positive Role ◽  
Dietary Flavonoids

Diabetes mellitus (DM) is a prevailing global health metabolic disorder, with an alarming incidence rate and a huge burden on health care providers. DM is characterized by the elevation of blood glucose due either to a defect in insulin synthesis, secretion, binding to receptor, or an increase of insulin resistance. The internal and external factors such as obesity, urbanizations, and genetic mutations could increase the risk of developing DM. Flavonoids are phenolic compounds existing as secondary metabolites in fruits and vegetables as well as fungi. Their structure consists of 15 carbon skeletons and two aromatic rings (A and B) connected by three carbon chains. Flavonoids are furtherly classified into 6 subclasses: flavonols, flavones, flavanones, isoflavones, flavanols, and anthocyanidins. Naturally occurring flavonoids possess anti-diabetic effects. As in vitro and animal model’s studies demonstrate, they have the ability to prevent diabetes and its complications. The aim of this review is to summarize the current knowledge addressing the antidiabetic effects of dietary flavonoids and their underlying molecular mechanisms on selected pathways: Glucose transporter, hepatic enzymes, tyrosine kinase inhibitor, AMPK, PPAR, and NF-κB. Flavonoids improve the pathogenesis of diabetes and its complications through the regulation of glucose metabolism, hepatic enzymes activities, and a lipid profile. Most studies illustrate a positive role of specific dietary flavonoids on diabetes, but the mechanisms of action and the side effects need more clarification. Overall, more research is needed to provide a better understanding of the mechanisms of diabetes treatment using flavonoids.

scholarly journals Designing a Cocreated Intervention with African American Older Adults for Hypertension Self-Management

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Kathy D. Wright ◽  
Carolyn H. Still ◽  
Lenette M. Jones ◽  
Karen O. Moss
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
African American ◽  
Health Care Providers ◽  
Mode Of Delivery ◽  
Self Management ◽  
Semistructured Interview ◽  
Care Providers ◽  
Group Sessions ◽  
African American Older Adults

Hypertension is a lifelong disease that requires self-management. Additionally, there are disparities in hypertension self-management that disproportionately affect African Americans. Interventions designed in collaboration with older adults have the potential to improve hypertension self-management. The purpose of this design paper is to describe the process in which African American older adults and nurse researchers cocreated an intervention to address stress in the self-management of hypertension. A semistructured interview guide was used to elicit feedback on self-management behaviors to cocreate an intervention with the participants. Participants provided constant iterative feedback on the design used for the intervention. Participants prioritized the content and mode of delivery. African American older adults with hypertension (N=31; 87% women) participated in two focus group sessions. The primary stressors identified by the group that influenced their blood pressure self-management were as follows: (a) measuring blood pressure and using home blood pressure monitors; (b) difficulty communicating with family and friends; (c) sleep management and pain at night; and (d) healthy eating. Based on the participants’ feedback, we created four biweekly (2-hour) group sessions that incorporated their suggestions and addressed their concerns. Health care providers can use this technique to engage African American older adults in participant-centered hypertension self-management.

Systematic Review of Human Trafficking Educational Interventions for Health Care Providers

2019 ◽  
Vol 42 (2) ◽  
pp. 131-142 ◽  
Author(s):  
Hannah E. Fraley ◽  
Teri Aronowitz ◽  
Hanni M. Stoklosa
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Human Trafficking ◽  
Health Care Providers ◽  
Current Knowledge ◽  
Well Being ◽  
Educational Interventions ◽  
Care Providers ◽  
Negative Attitudes ◽  
Global Population

Human trafficking is a global population health threat. Trafficking minors threatens the safety and well-being of youth. Limited studies measure health care providers’ awareness and attitudes toward trafficking. This systematic review synthesized retrospective and current knowledge and identified gaps in educational interventions aimed at increasing providers’ awareness and attitudes toward trafficking. A systematic search of four databases identified peer-reviewed published papers between January 1, 2000 and September 1, 2018. The Cochrane Collaboration’s Preferred Reporting Items for Systematic Reviews was followed. Study quality was assessed using the Downs and Black checklist. The Psychometric Grading Framework was used to assess the validity of instruments. Findings across studies ( N = 7) reveal providers (mostly social workers and physicians) have low awareness of trafficking and can have negative attitudes toward victims. Multiphase educational approaches and use of content experts, including survivors, in developing interventions enhanced sustainability of outcomes. Targeting multidisciplinary health care teams, including nurses, enhanced interventions.

Reducing opioid utilization after urologic oncology surgery.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 269-269 ◽  
Author(s):  
Kerri Stevenson ◽  
Jessica Kee ◽  
Elizna Van Zyl ◽  
Anisia Dugala ◽  
Jay Bakul Shah
Keyword(s):  
Health Care Providers ◽  
High Volume ◽  
Robotic Prostatectomy ◽  
Care Providers ◽  
Opioid Use ◽  
Multiple Sources ◽  
Urologic Oncology ◽  
Surgical Department ◽  
Post Operative Pain ◽  
Opioid Medications

269 Background: Multiple sources have reported on widespread abuse of opioid pain medications among Americans. For many patients, the first encounter with these addictive substances happens when they are prescribed opioids for acute pain management after surgery. Unfortunately, 6% of opioid-naïve patients become newly addicted to opioid medications after surgery. As a high-volume surgical department, we aimed to reduce our reliance on opioid medications to manage post-operative pain by 50% from a baseline morphine equivalent daily dose (MEDD) of 95.1 to a target of 47.5 MEDD. Methods: We retrospectively reviewed daily opioid use, pain scores, and anxiety scores for inpatients recovering from surgery for urologic cancers at our institution over 4 months. We generated process maps, Ishikawa diagrams, and Pareto charts to identify causes contributing to excess opioid use. We designed opioid-sparing pain regimens (using varying combinations of acetaminophen, ketorolac, gabapentin, and local anesthetic) and we identified key drivers required to reliably decrease excess opioid use. Initial interventions were aimed at educating providers and nurses on availability and efficacy of non-opioid medications and later interventions sought to facilitate adoption of the novel pathways. Results: Over the course of this QI project involving 443 patients, the median opioid use per patient decreased 46% from 95.1 to 51.5 MEDD. This reduction in opioid requirements after implementation was successfully achieved across multiple surgery types ranging from robotic prostatectomy (55.1 MEDD) to open radical cystectomy (50.6 MEDD). There was no increase in 24- or 48-hour post-operative pain score associated with use of opioid-minimizing pathways (3.03 vs. 3.04 and 2.92 vs. 2.96, respectively; p > 0.05 for both). Similarly, there was no change in anxiety score at 24- or 48-hours after surgery (0.15 vs. 0.12 and 0.48 vs. 0.30, respectively; p > 0.05 for both). Conclusions: We decreased opioid use after surgery by 46% without compromising pain control. In the nationwide effort to combat the opioid epidemic, health care providers can play a pivotal role as gatekeepers by decreasing reliance on opioids in the post-operative period.

scholarly journals Cyberbullying Prevention and Intervention Efforts: Current Knowledge and Future Directions

2016 ◽  
Vol 62 (6) ◽  
pp. 374-380 ◽  
Author(s):  
Dorothy L. Espelage ◽  
Jun Sung Hong
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Current Knowledge ◽  
Online Communication ◽  
Health Concern ◽  
Current Status ◽  
Future Research ◽  
Care Providers ◽  
Prevention And Intervention ◽  
Technological Advances

Bullying is a serious public health concern that is associated with significant negative mental, social, and physical outcomes. Technological advances have increased adolescents’ use of social media, and online communication platforms have exposed adolescents to another mode of bullying— cyberbullying. Prevention and intervention materials, from websites and tip sheets to classroom curriculum, have been developed to help youth, parents, and teachers address cyberbullying. While youth and parents are willing to disclose their experiences with bullying to their health care providers, these disclosures need to be taken seriously and handled in a caring manner. Health care providers need to include questions about bullying on intake forms to encourage these disclosures. The aim of this article is to examine the current status of cyberbullying prevention and intervention. Research support for several school-based intervention programs is summarised. Recommendations for future research are provided.

scholarly journals Walk the Talk: The Transforming Journey of Facility-Based Death Review Committee from Stillbirths to Neonates

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Yousef S. Khader ◽  
Nihaya A. Al-Sheyab ◽  
Khulood K. Shattnawi ◽  
Mohammad S. Alyahya ◽  
Anwar Batieha
Keyword(s):  
Focus Group ◽  
Health Care Providers ◽  
Healthcare Services ◽  
Power Dynamics ◽  
Care Providers ◽  
Review Committee ◽  
Contributing Factors ◽  
Neonatal Deaths ◽  
Modifiable Factors

Background. Facility-based death review committee (DRC) of neonatal deaths and stillbirths can encourage stakeholders to enhance the quality of care during the antenatal period and labour to improve birth outcomes. To understand the benefits and impact of the DRCs, this study was aimed at exploring the DRC members’ perception about the role and benefits of the newly developed facility-based DRCs in five pilot hospitals in Jordan, to assess women empowerment, decision-making process, power dynamics, culture and genderism as contributing factors for deaths, and impact of COVID-19 lockdown on births. Methods. A descriptive study of a qualitative design—using focus group discussions—was conducted after one year of establishing DRCs in 5 pilot large hospitals. The number of participants in each focus group ranged from 8 to10, and the total number of participants was 45 HCPs (nurses and doctors). Questions were consecutively asked in each focus group. The moderator asked the main questions from the guide and then used probing as needed. A second researcher observed the conversation and took field notes. Results. Overall, there was an agreement among the majority of DRC members across all hospitals that the DRC was successful in identifying the exact cause of neonatal deaths and stillbirths as well as associated modifiable factors. There was also a consensus that the DRC contributed to an improvement in health services provided for pregnant women and newborns as well as protecting human rights and enabling women to be more interdependent in taking decisions related to family planning. Moreover, the DRC agreed that a proportion of the neonatal deaths and stillbirths occurring in the hospitals could have been prevented if adequate antenatal care was provided and some traditional harmful practices were avoided. Conclusions. Facility-based neonatal death review audit is practical and can be used to identify exact causes of maternal and neonatal deaths and is a valuable tool for hospital quality indicators. It can also change the perception and practice of health care providers, which may be reflected in improving the quality of provided healthcare services.

scholarly journals Reducing Alcohol and Opioid Use Among Youth in Rural Counties: An Innovative Training Protocol for Primary Health Care Providers and School Personnel

10.2196/21015 ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. e21015
Author(s):  
Erica Francis ◽  
Kara Shifler Bowers ◽  
Glenn Buchberger ◽  
Sheryl Ryan ◽  
William Milchak ◽  
...  
Keyword(s):  
Primary Care ◽  
Substance Use ◽  
Alcohol Use ◽  
Substance Use Disorders ◽  
Health Care Providers ◽  
School Personnel ◽  
Primary Care Providers ◽  
School Nurses ◽  
Care Providers ◽  
Opioid Use

Background Given that youth alcohol use is more common in rural communities, such communities can play a key role in preventing alcohol use among adolescents. Guidelines recommend primary care providers incorporate screening, brief intervention, and referral to treatment (SBIRT) into routine care. Objective The aim is to train primary care providers and school nurses within a rural 10-county catchment area in Pennsylvania to use SBIRT and facilitate collaboration with community organizations to better coordinate substance use prevention efforts. Methods To build capacity to address underage drinking and opioid use among youth aged 9-20 years, this project uses telehealth, specifically Project ECHO (Extension for Community Healthcare Outcomes), to train primary care providers and school nurses to address substance use with SBIRT. Our project will provide 120 primary care providers and allied health professionals as well as 20 school nurses with SBIRT training. Community-based providers will participate in weekly virtual ECHO sessions with a multidisciplinary team from Penn State College of Medicine that will provide SBIRT training and facilitate case discussions among participants. Results To date, we have launched one SBIRT ECHO project with school personnel, enrolling 34 participants. ECHO participants are from both rural (n=17) and urban (n=17) counties and include school nurses (n=15), school counselors (n=8), teachers (n=5), administrators (n=3), and social workers (n=3). Before the study began, only 2/13 (15.5%) of schools were screening for alcohol use. Conclusions This project teaches primary care clinics and schools to use SBIRT to prevent the onset and reduce the progression of substance use disorders, reduce problems associated with substance use disorders, and strengthen communities’ prevention capacity. Ours is an innovative model to improve rural adolescent health by reducing alcohol and opioid use. International Registered Report Identifier (IRRID) DERR1-10.2196/21015

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