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MMWR. Morbidity and Mortality Weekly... Jun 2024In 2022, 81,806 opioid-involved overdose deaths were reported in the United States, more than in any previous year. Medications for opioid use disorder (OUD),...
In 2022, 81,806 opioid-involved overdose deaths were reported in the United States, more than in any previous year. Medications for opioid use disorder (OUD), particularly buprenorphine and methadone, substantially reduce overdose-related and overall mortality. However, only a small proportion of persons with OUD receive these medications. Data from the 2022 National Survey on Drug Use and Health were applied to a cascade of care framework to estimate and characterize U.S. adult populations who need OUD treatment, receive any OUD treatment, and receive medications for OUD. In 2022, 3.7% of U.S. adults aged ≥18 years needed OUD treatment. Among these, only 25.1% received medications for OUD. Most adults who needed OUD treatment either did not perceive that they needed it (42.7%) or received OUD treatment without medications for OUD (30.0%). Compared with non-Hispanic Black or African American and Hispanic or Latino adults, higher percentages of non-Hispanic White adults received any OUD treatment. Higher percentages of men and adults aged 35-49 years received medications for OUD than did women and younger or older adults. Expanded communication about the effectiveness of medications for OUD is needed. Increased efforts to engage persons with OUD in treatment that includes medications are essential. Clinicians and other treatment providers should offer or arrange evidence-based treatment, including medications, for patients with OUD. Pharmacists and payors can work to make these medications available without delays.
Topics: Humans; United States; Adult; Middle Aged; Male; Female; Opioid-Related Disorders; Young Adult; Adolescent; Buprenorphine; Aged; Opiate Substitution Treatment; Methadone
PubMed: 38935567
DOI: 10.15585/mmwr.mm7325a1 -
Animals : An Open Access Journal From... Jun 2024We investigated the evolving landscape of reptile pet ownership in Hong Kong. Employing a quantitative approach, a self-administered survey was distributed and over 200...
We investigated the evolving landscape of reptile pet ownership in Hong Kong. Employing a quantitative approach, a self-administered survey was distributed and over 200 reptile pet owners residing in Hong Kong responded. The survey instrument captured demographic data on pet ownership history, species preferences, husbandry practices, and veterinary care utilization. The findings revealed a strong interest in pet reptiles, with lizards being particularly popular (67%) among new owners. Turtles remain common (35%), likely due to cultural factors and perceived ease of care. However, a gap was noted between the awareness and the implementation of proper husbandry practices, with 51% of respondents expressing concerns about enrichment and 21% uncertain about appropriate enclosure size. Veterinary care utilization also showed a disconnect, with 50% of the respondents reporting no regular check-ups were performed, despite acknowledging its importance. Reptile behavior served as a well-being indicator. Over 90% of the respondents observed normal behaviors like locomotion and breathing. Interestingly, a positive correlation emerged between reptile behavior scores and duration of ownership (r = 0.200, < 0.01), suggesting improved well-being for reptiles that were in long-term care. These findings emphasize the need for educational initiatives promoting responsible pet ownership practices and fostering collaboration between reptile owners, veterinarians, and animal welfare organizations. By addressing these knowledge gaps and promoting a collaborative approach, our results aim to contribute to enhanced reptile welfare in the context of Hong Kong's evolving pet ownership trends.
PubMed: 38929386
DOI: 10.3390/ani14121767 -
Proceedings of the National Academy of... Jul 2024Immune checkpoint therapies (ICT) improve overall survival of patients with cancer but may cause immune-related adverse events (irAEs) such as myocarditis. Cytotoxic T...
Immune checkpoint therapies (ICT) improve overall survival of patients with cancer but may cause immune-related adverse events (irAEs) such as myocarditis. Cytotoxic T lymphocyte-associated antigen 4 immunoglobulin fusion protein (CTLA-4 Ig), an inhibitor of T cell costimulation through CD28, reverses irAEs in animal models. However, concerns exist about potentially compromising antitumor response of ICT. In mouse tumor models, we administered CTLA-4 Ig 1) concomitantly with ICT or 2) after ICT completion. Concomitant treatment reduced antitumor efficacy, while post-ICT administration improved efficacy without affecting frequency and function of CD8 T cells. The improved response was independent of the ICT used, whether CTLA-4 or PD-1 blockade. The frequency of Tregs was significantly decreased with CTLA-4 Ig. The resulting increased CD8/Treg ratio potentially underlies the enhanced efficacy of ICT followed by CTLA-4 Ig. This paradoxical mechanism shows that a CTLA-4 Ig regimen shown to reduce irAE severity does not compromise antitumor efficacy.
Topics: Animals; Mice; Immunotherapy; CTLA-4 Antigen; Immune Checkpoint Inhibitors; CD8-Positive T-Lymphocytes; T-Lymphocytes, Regulatory; Cell Line, Tumor; Abatacept; Female; Humans; Mice, Inbred C57BL; Neoplasms; Programmed Cell Death 1 Receptor
PubMed: 38923991
DOI: 10.1073/pnas.2404661121 -
Tropical Medicine and Infectious Disease May 2024The World Health Organization (WHO) recommends the use of annual mass drug administration (MDA) as the strategy for controlling and eliminating the five preventive...
The World Health Organization (WHO) recommends the use of annual mass drug administration (MDA) as the strategy for controlling and eliminating the five preventive chemotherapy neglected tropical diseases (PC-NTDs). The success of MDAs hinges on community acceptance, active participation, and compliance. This study aimed to explore the experiences and perceptions of community members, to obtain a more thorough understanding of their openness and willingness to participate in MDA and other NTD elimination activities. A mixed-methods approach was employed, utilizing qualitative and quantitative methods for comprehensive data collection. Eighteen key informant interviews (KIIs) and sixteen focus group discussions (FGDs) were conducted to explore community engagement, participation, medication utilization, and programme perception. Triangulation of findings from interviews and discussions with household survey results was performed to gain a deeper understanding of emerging themes. The household survey involved interviewing 1220 individuals (Abaji: 687; Bwari: 533). Audio tapes recorded KIIs and FGDs, with interview transcripts coded using Nvivo 12.0 software based on predefined themes. Descriptive analysis using SPSS version 21 was applied to quantitative data. Results indicated high awareness of mass drug administration (MDA) campaigns in both area councils (Abaji: 84.9%; Bwari: 82.9%), with a small percentage claiming ignorance (15.1%), attributed to lack of information or absence during health campaigns. Respondents primarily participated by taking medication (82.5%), with minimal involvement in other MDA campaigns. Perception of medicines was generally positive, with a significant association between participation level and performance rating ( < 0.05). The study recommends leveraging high awareness and community responsiveness to enhance engagement in various MDA activities, ensuring sustainability and ownership of the programme.
PubMed: 38922038
DOI: 10.3390/tropicalmed9060126 -
European Journal of Investigation in... Jun 2024This research aimed to contribute to the literature on internet addiction (IA) and moral development among university students. Moral potency (MP) encompasses the...
This research aimed to contribute to the literature on internet addiction (IA) and moral development among university students. Moral potency (MP) encompasses the interconnected dimensions of moral courage, moral ownership, and moral efficacy. Studies on the relationships between students' problematic behaviors (e.g., IA) and cognitive processes like MP, mindfulness (MI), and psychological capital (PsyCap) are scarce in educational research. Therefore, this study investigated the relationships among IA, MP, MI, and PsyCap in university students. This study included 868 undergraduate students from a state university in Ethiopia, with 526 male students (60.6%) and 342 female students (39.4%). Participants' ages ranged from 21 to 29 years, with a mean age of 22.31 and a standard deviation of 4.03. The findings indicated that IA was negatively correlated with MI, PsyCap, and MP. Both MI and PsyCap showed positive correlations with MP. Importantly, this study revealed that IA had a direct and negative impact on MI, PsyCap, and MP. Further, MI and PsyCap partially mediated and fully mediated the relationship between IA and MP. These findings suggest that cultivating MI and positive PsyCap among university students could be an important strategy to reduce the risks of IA and enhance their moral development. This study contributes to the limited research on the complex relationships between technology use, psychological resources, and moral functioning in emerging adulthood.
PubMed: 38921081
DOI: 10.3390/ejihpe14060115 -
Behavioral Sciences (Basel, Switzerland) May 2024The relationship between diet and health is well-researched, and there is also information regarding the effects of diet on mental health. This study aimed to...
The relationship between diet and health is well-researched, and there is also information regarding the effects of diet on mental health. This study aimed to investigate whether motivation to optimize lifestyles without regulations or restrictions could improve the health of rotating shift workers. In this pilot study, 18 male shift workers were randomly divided into two groups. All participants completed the Short Form Health Survey-36 questionnaire (SF-36) before the start and at the end of the study. Group I (n = 9, mean age 42 ± 6.6 y) received dietary and lifestyle information every other month for one year, and the other, Group II (n = 9 mean age 36 ± 7.3 y), one year later. All participants were motivated to follow the trained dietary recommendations and to engage in physical activity. Almost all scores had improved. Surprisingly, physical performance scores worsened, which was not expected. The impairment in mental health due to the change in ownership of the company could have been better explained. Nutritional advice over a longer period and the motivation to integrate more exercise into everyday life can potentially improve the health of rotating shift workers.
PubMed: 38920786
DOI: 10.3390/bs14060454 -
Frontiers in Digital Health 2024In the big data era, where corporations commodify health data, non-fungible tokens (NFTs) present a transformative avenue for patient empowerment and control. NFTs are...
INTRODUCTION
In the big data era, where corporations commodify health data, non-fungible tokens (NFTs) present a transformative avenue for patient empowerment and control. NFTs are unique digital assets on the blockchain, representing ownership of digital objects, including health data. By minting their data as NFTs, patients can track access, monetize its use, and build secure, private health information systems. However, research on NFTs in healthcare is in its infancy, warranting a comprehensive review.
METHODS
This study conducted a systematic literature review and thematic analysis of NFTs in healthcare to identify use cases, design models, and key challenges. Five multidisciplinary research databases (Scopus, Web of Science, Google Scholar, IEEE Explore, Elsevier Science Direct) were searched. The approach involved four stages: paper collection, inclusion/exclusion criteria application, screening, full-text reading, and quality assessment. A classification and coding framework was employed. Thematic analysis followed six steps: data familiarization, initial code generation, theme searching, theme review, theme definition/naming, and report production.
RESULTS
Analysis of 19 selected papers revealed three primary use cases: patient-centric data management, supply chain management for data provenance, and digital twin development. Notably, most solutions were prototypes or frameworks without real-world implementations. Four overarching themes emerged: data governance (ownership, tracking, privacy), data monetization (commercialization, incentivization, sharing), data protection, and data storage. The focus lies on user-controlled, private, and secure health data solutions. Additionally, data commodification is explored, with mechanisms proposed to incentivize data maintenance and sharing. NFTs are also suggested for tracking medical products in supply chains, ensuring data integrity and provenance. Ethereum and similar platforms dominate NFT minting, while compact NFT storage options are being explored for faster data access.
CONCLUSION
NFTs offer significant potential for secure, traceable, decentralized healthcare data exchange systems. However, challenges exist, including dependence on blockchain, interoperability issues, and associated costs. The review identified research gaps, such as developing dual ownership models and data pricing strategies. Building an open standard for interoperability and adoption is crucial. The scalability, security, and privacy of NFT-backed healthcare applications require further investigation. Thus, this study proposes a research agenda for adopting NFTs in healthcare, focusing on governance, storage models, and perceptions.
PubMed: 38919876
DOI: 10.3389/fdgth.2024.1377531 -
Frontiers in Health Services 2024Implementation and adoption of quality improvement interventions have proved difficult, even in situations where all participants recognise the relevance and benefits of...
INTRODUCTION
Implementation and adoption of quality improvement interventions have proved difficult, even in situations where all participants recognise the relevance and benefits of the intervention. One way to describe difficulties in implementing new quality improvement interventions is to explore different types of knowledge boundaries, more specifically the syntactic, semantic and pragmatic boundaries, influencing the implementation process. As such, this study aims to identify and understand knowledge boundaries for implementation processes in nursing homes and homecare services.
METHODS
An exploratory qualitative methodology was used for this study. The empirical data, including individual interviews ( = 10) and focus group interviews ( = 10) with leaders and development nurses, stem from an externally driven leadership intervention and a supplementary tracer project entailing an internally driven intervention. Both implementations took place in Norwegian nursing homes and homecare services. The empirical data was inductively analysed in accordance with grounded theory.
RESULTS
The findings showed that the syntactic boundary included boundaries like the lack of meeting arenas, and lack of knowledge transfer and continuity in learning. Furthermore, the syntactic boundary was mostly related to the dissemination and training of staff across the organisation. The semantic boundary consisted of boundaries such as ambiguity, lack of perceived impact for practice and lack of appropriate knowledge. This boundary mostly related to uncertainty of the facilitator role. The pragmatic boundary included boundaries related to a lack of ownership, resistance, feeling unsecure, workload, different perspectives and a lack of support and focus, reflecting a change of practices.
DISCUSSION
This study provides potential solutions for traversing different knowledge boundaries and a framework for understanding knowledge boundaries related to the implementation of quality interventions.
PubMed: 38919829
DOI: 10.3389/frhs.2024.1294299 -
Plastic and Reconstructive Surgery.... Jun 2024The landscape of modern aesthetic medicine has witnessed a paradigm shift from traditional doctor-led care to a consumer-driven model, presenting a plethora of ethical...
BACKGROUND
The landscape of modern aesthetic medicine has witnessed a paradigm shift from traditional doctor-led care to a consumer-driven model, presenting a plethora of ethical challenges. This review discusses the ethical dimensions of medical aesthetics, exploring the implications of consumer demand, societal influences, and technological advancements on patient care and well-being.
METHODS
Drawing upon a comprehensive analysis of existing literature, this review synthesizes evidence regarding the rise of aesthetic medicine, ethical challenges encountered in practice, and the implications of social media and marketing in shaping patient perceptions and decision-making.
RESULTS
Aesthetic medicine confronts unique ethical challenges stemming from its elective nature and the pervasive influence of societal beauty standards. Concerns include the commodification of beauty, conflicts of interest, limited evidence-base of treatments, and the rise of nonphysician providers. Moreover, the evolving role of social media influencers and medical marketing raises ethical dilemmas regarding transparency, patient autonomy, and professional integrity.
CONCLUSIONS
The ethical landscape of aesthetic medicine necessitates a proactive approach to address emerging challenges and safeguard patient well-being. Guided by principles of autonomy, beneficence, nonmaleficence, and justice, recommendations are proposed to enhance informed consent practices, mitigate appearance anxiety, facilitate shared decision-making, and promote responsible use of social media. Professional societies are urged to establish clear ethical guidelines and standards to uphold professionalism and patient trust in the field of aesthetic medicine.
PubMed: 38919517
DOI: 10.1097/GOX.0000000000005935 -
Frontiers in Nutrition 2024Human milk, due to its unique composition, is the optimal standard for infant nutrition. Osteopontin (OPN) is abundant in human milk but not bovine milk. The addition of... (Review)
Review
Human milk, due to its unique composition, is the optimal standard for infant nutrition. Osteopontin (OPN) is abundant in human milk but not bovine milk. The addition of bovine milk osteopontin (bmOPN) to formula may replicate OPN's concentration and function in human milk. To address safety concerns, we convened an expert panel to assess the adequacy of safety data and physiological roles of dietary bmOPN in infancy. The exposure of breastfed infants to human milk OPN (hmOPN) has been well-characterized and decreases markedly over the first 6 months of lactation. Dietary bmOPN is resistant to gastric and intestinal digestion, absorbed and cleared from circulation within 8-24 h, and represents a small portion (<5%) of total plasma OPN. Label studies on hmOPN suggest that after 3 h, intact or digested OPN is absorbed into carcass (62%), small intestine (23%), stomach (5%), and small intestinal perfusate (4%), with <2% each found in the cecum, liver, brain, heart, and spleen. Although the results are heterogenous with respect to bmOPN's physiologic impact, no adverse impacts have been reported across growth, gastrointestinal, immune, or brain-related outcomes. Recombinant bovine and human forms demonstrate similar absorption in plasma as bmOPN, as well as effects on cognition and immunity. The panel recommended prioritization of trials measuring a comprehensive set of clinically relevant outcomes on immunity and cognition to confirm the safety of bmOPN over that of further research on its absorption, distribution, metabolism, and excretion. This review offers expert consensus on the adequacy of data available to assess the safety of bmOPN for use in infant formula, aiding evidence-based decisions on the formulation of infant formula.
PubMed: 38919388
DOI: 10.3389/fnut.2024.1404303