Adults With Opioid and Methamphetamine Co-use Have Lower Odds of Completing Short-Term Residential Treatment Than Other Opioid Co-use Groups: A Retrospective Health Services Study

Objective: There is an increase in persons entering substance use treatment who co-use opioids and methamphetamines in recent years. Co-using these substances may negatively impact treatment retention in the residential setting. We explored predictors of adults completing short-term residential treatment among persons with primary opioid use disorder (OUD) who co-use either alcohol, benzodiazepines, cocaine, or methamphetamines.Methods: This study used the 2019 de-identified, publicly available Treatment Episode Dataset-Discharges. The sample included adults discharged from short-term residential treatment with primary OUD who co-used either alcohol, benzodiazepines, cocaine, or methamphetamines. The final sample size included 24,120 treatment episodes. Univariate statistics were used to describe the sample. Two logistic regression models were used to predict completing treatment. The first logistic regression model included the co-use groups as predictors and the second model added other demographic and treatment-relevant covariates.Results: A slight majority (51.4%) of the sample prematurely discharged from treatment. Compared to the other three co-use groups, the opioid and methamphetamine co-use group had the highest proportion of individuals who were women (45.0%), unemployed (62.5%), current injection drug use (76.0%), living in the Midwest (35.9%), living in the south (33.5%), and living in the west (15.5%). The opioid and methamphetamine co-use group also had the highest proportion of individuals not receiving medications for OUD (84.9%), not having a prior treatment episode (28.7%), and not completing treatment (57.4%). In the final logistic regression model, which included covariates, the opioid and alcohol (OR = 1.18, 95% CI = 1.080–1.287, p < 0.001), opioid and benzodiazepine (OR = 1.33, 95% CI = 1.213–1.455, p < 0.001), and opioid and cocaine (OR = 1.16, 95% CI = 1.075–1.240, p < 0.001) co-use groups had higher odds of completing treatment than the opioid and methamphetamine co-use group.Conclusions: Opioid and methamphetamine co-use may complicate short-term residential treatment retention. Future work should identify effective strategies to retain persons who co-use opioids and methamphetamines in treatment.

The Use of Improvisation in a Student’s Music Therapy Practice with Older Adults in a Residential Setting

<p>As shown in the research literature, improvisation is a less common approach to music therapy practice than the use of familiar songs or group singing when working with elderly people in residential settings. This research explores the ways in which improvisation in music therapy could benefit elderly participants in a residential setting. A secondary analytic process was conducted involving a careful analysis of existing clinical data by the student music therapy researcher. Data was analysed using thematic analysis. The findings consisted of three core themes which captured the ways in which improvisation was included in music therapy sessions: these were improvisational approaches described as anchoring, reflecting and dialogue. These core themes were strongly influenced by writings on improvisation method by the late Tony Wigram. Results showed improvisation has potential in its use among older adults in a residential facility. Conclusions could be used to help other elderly residential facilities that are willing to implement similar models of practice.</p>

SARS-CoV-2 Distribution in Residential Housing Suggests Contact Deposition and Correlates with Rothia sp

Monitoring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on surfaces is emerging as an important tool for identifying past exposure to individuals shedding viral RNA. Our past work has demonstrated that SARS-CoV-2 reverse transcription-quantitative PCR (RT-qPCR) signals from surfaces can identify when infected individuals have touched surfaces such as Halloween candy, and when they have been present in hospital rooms or schools. However, the sensitivity and specificity of surface sampling as a method for detecting the presence of a SARS-CoV-2 positive individual, as well as guidance about where to sample, has not been established. To address these questions, and to test whether our past observations linking SARS-CoV-2 abundance to Rothia spp. in hospitals also hold in a residential setting, we performed detailed spatial sampling of three isolation housing units, assessing each sample for SARS-CoV-2 abundance by RT-qPCR, linking the results to 16S rRNA gene amplicon sequences to assess the bacterial community at each location and to the Cq value of the contemporaneous clinical test. Our results show that the highest SARS-CoV-2 load in this setting is on touched surfaces such as light switches and faucets, but detectable signal is present in many non-touched surfaces that may be more relevant in settings such as schools where mask wearing is enforced. As in past studies, the bacterial community predicts which samples are positive for SARS-CoV-2, with Rothia sp. showing a positive association.ImportanceSurface sampling for detecting SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), is increasingly being used to locate infected individuals. We tested which indoor surfaces had high versus low viral loads by collecting 381 samples from three residential units where infected individuals resided, and interpreted the results in terms of whether SARS-CoV-2 was likely transmitted directly (e.g. touching a light switch) or indirectly (e.g. by droplets or aerosols settling). We found highest loads where the subject touched the surface directly, although enough virus was detected on indirectly contacted surfaces to make such locations useful for sampling (e.g. in schools, where students do not touch the light switches and also wear masks so they have no opportunity to touch their face and then the object). We also documented links between the bacteria present in a sample and the SARS-CoV-2 virus, consistent with earlier studies.

The Use of Improvisation in a Student’s Music Therapy Practice with Older Adults in a Residential Setting

<p>As shown in the research literature, improvisation is a less common approach to music therapy practice than the use of familiar songs or group singing when working with elderly people in residential settings. This research explores the ways in which improvisation in music therapy could benefit elderly participants in a residential setting. A secondary analytic process was conducted involving a careful analysis of existing clinical data by the student music therapy researcher. Data was analysed using thematic analysis. The findings consisted of three core themes which captured the ways in which improvisation was included in music therapy sessions: these were improvisational approaches described as anchoring, reflecting and dialogue. These core themes were strongly influenced by writings on improvisation method by the late Tony Wigram. Results showed improvisation has potential in its use among older adults in a residential facility. Conclusions could be used to help other elderly residential facilities that are willing to implement similar models of practice.</p>

Living in the New Normal: Effect of Residential Setting on Perception of a Meaningful Life among Older Women

Perception of a meaningful life is related to depression, anxiety, and general well-being. The sense that one’s life is meaningful influences overall quality of life, which influences aging well. It is not clear whether differences in residential setting influence perception of a meaningful life. This study evaluated the effect of residential setting (community versus assisted living) on perception of a meaningful life in 48 older (79.7 ± 1.0 years) women living in the community (n=24) or assisted living (n=24) who were pair matched by age. They completed a one-time questionnaire regarding self-rated health and whether life has meaning. Both questions were scored on a 5-point scale with 0 indicating poor health or no life meaning and 4 indicating excellent health or strong life meaning. There were no significant differences in age between women in community living (CL) and assisted living (AL) (78.0 ± 09 vs. 81.5 ± 1.6 years, respectively; p=0.7). Both groups also reported similar self-rated health scores (CL: 2.4 ± 0.2; AL: 2.2 ± 0.2; p=0.4), indicating good-very good health. However, there were significant differences between groups in their perception of a meaningful life. Women in CL reported significantly lower scores compared to women in AL (2.9 ± 0.2 vs. 3.6 ± 0.1; p=0.006), indicating that women in CL perceived a less meaningful life. Based on our findings, it appears that the supportive infrastructure provided by AL residential settings may promote quality of life and successful aging by enhancing the perception of a more meaningful life.

Communicative Coping and Friendship Among Persons Living With Dementia: Findings From Long-Term Care

The study of identity is central to many disciplines, however there is a special link that connects language and discourse to identities. The way people speak reveals a lot about who they are. Through discourse and communication individuals convey and negotiate their sense of self (de Fina, 2020). Regardless of cognitive status, persons living with dementia (PLWD) use language to construct for themselves a social identity of being included in friendship networks (de Medeiros et al., 2011). This paper uses data from the Friendship Study to examine the use of such communicative coping behavior (CCB) for friendship formation. Ethnographic observations of PLWD were conducted in a Long-Term Care residential setting. Sociolinguistic discourse analysis of verbatim transcripts with reference to the CCB Checklist (Saunders et al., 2016) reveal evidence of CCB use. Results suggest that different types of CCBs were used to construct identity and negotiate friendship challenges in different contexts.

Risk of Injury Events in Patients With Visual Impairments: A Swedish Survey Study Among Hospital Social Workers

Introduction: People with visual impairments (those who are blind or have low vision) are exposed to risks in everyday life, especially injury risks. This study aimed to examine experiences and practical knowledge among hospital social workers in Sweden concerning meetings with patients with visual impairments who have been affected by injury events in residential environments. Methods: Swedish hospital social workers specializing in patients with visual impairments ( n=30) answered a questionnaire comprising 14 questions. Both fixed and open-ended questions were included, allowing an analysis of both comparable numeric data and subjectively perceived experiences and opinions. Results: A majority of the respondents had met patients who had been injured in the residential setting; the most common injury mechanism reported was tripping or falling on the stairs, or accidentally stumbling into furniture. The hospital social workers acknowledged that they could work more preventively in their professional role by encouraging patients to use orientation and mobility devices such as long canes, increasing collaboration with other professions, and conducting home visits to enable trustful dialogues with both patients and relatives. Discussion: According to these specialized hospital social workers, the provision of education and information to patients with visual impairments could potentially prevent future injury. However, in order to achieve this, there is a need to first enable a trustful dialogue between social workers and patients. Implications for practitioners: This study provides a better understanding of the importance of trustful dialogue between hospital social workers and patients with visual impairments, from the point of view injury prevention. It also offers a summary of the knowledge of hospital social workers about risks and injury events in residential settings for patients with visual impairments.