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Intra-arterial chemo with regard to retinoblastoma therapy in Chile: Knowledge and also benefits 2013-2020.
ers encounter more obstacles in accessing mental health care services.Although recent advances in early treatment of people with serious mental illness have brought new hope to family members, parents of service users are still often left to worry about their loved one's future care. Without judicious planning, a parent''s death can be a catastrophic event that leaves an adult with serious mental illness without supports. This Open Forum emphasizes the benefits of mental health professionals being proactive and helping families and service users address concerns with future care planning. The active involvement of all stakeholders, including the person with mental illness, relatives, friends, mental health professionals, lawyers, and financial planners, can ensure proper care planning and promote better long-term outcomes.
The authors examined the prevalence of co-occurring opioid use disorder and willingness to engage in treatment among clients of eight Los Angeles County Department of Mental Health outpatient clinics.

Adults presenting for an appointment over a 2-week period were invited to complete a voluntary, anonymous health survey. Clients who indicated opioid use in the past year were offered a longer survey assessing probable opioid use disorder. Willingness to take medication and receive treatment also was assessed.

In total, 3,090 clients completed screening. Among these, 8% had a probable prescription (Rx) opioid use disorder and 2% a probable heroin use disorder. Of the clients with probable Rx opioid use or heroin use disorder, 49% and 25% were female, respectively. Among those with probable Rx opioid use disorder, 43% were Black, 33% were Hispanic, and 12% were White, and among those with probable heroin use disorder, 24% were Black, 22% were Hispanic, and 39% were White. Seventy-eight percent of those with Rx opioid use disorder had never received any treatment, and 82% had never taken a medication for this disorder; 39% of those with heroin use disorder had never received any treatment, and 39% had never received a medication. The strongest predictor of willingness to take a medication was believing that it would help stop opioid use (buprenorphine, β=13.54, p=0.003, and naltrexone long-acting injection, β=15.83, p<0.001).

These findings highlight the need to identify people with opioid use disorder and to educate clients in mental health settings about medications for these disorders.
These findings highlight the need to identify people with opioid use disorder and to educate clients in mental health settings about medications for these disorders.
The authors aimed to describe the development and testing of quality measures included in a public-facing addiction treatment facility search engine.

An addiction treatment facility survey was created that queried providers in six U.S. states about whether they offered the services and used the processes identified by federal agencies and nonprofit organizations as signs of higher-quality addiction treatment. Four insurance claims-based quality measures were created to capture the percentage of a provider's patients with opioid use disorder receiving opioid use disorder medications, who filled prescriptions for such medication for at least 180 days, who received follow-up care after treatment for substance use disorder in inpatient or residential settings, or who had a substance use disorder-related hospitalization or emergency department visit. A patient experience-of-care survey captured patients' perceptions of the quality of the addiction treatment. The project was undertaken from November 2018 through July 2020.

The authors tested the measures by using 1,245 facility surveys, 7,970 patients' experience-of-care surveys, and four claims-based measures submitted by 129, 136, 283, and 408 addiction treatment providers. Statistical testing demonstrated that the quality measures were reliable and valid. The quality measure scores varied among providers, capturing a wide performance range. A public website containing quality measures launched in July 2020 in the six states and has been accessed by thousands of consumers.

This study developed valid, reliable, and useful addiction treatment quality measures. Dissemination of these measures may help consumers select among providers and help providers, policy makers, and payers improve quality.
This study developed valid, reliable, and useful addiction treatment quality measures. Dissemination of these measures may help consumers select among providers and help providers, policy makers, and payers improve quality.Myocarditis has been recognized as a rare complication of coronavirus disease 2019 (COVID-19) mRNA vaccinations, especially in young adult and adolescent males. According to the US Centers for Disease Control and Prevention, myocarditis/pericarditis rates are ≈12.6 cases per million doses of second-dose mRNA vaccine among individuals 12 to 39 years of age. In reported cases, patients with myocarditis invariably presented with chest pain, usually 2 to 3 days after a second dose of mRNA vaccination, and had elevated cardiac troponin levels. ECG was abnormal with ST elevations in most, and cardiac MRI was suggestive of myocarditis in all tested patients. There was no evidence of acute COVID-19 or other viral infections. In 1 case, a cardiomyopathy gene panel was negative, but autoantibody levels against certain self-antigens and frequency of natural killer cells were increased. Although the mechanisms for development of myocarditis are not clear, molecular mimicry between the spike protein of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and self-antigens, trigger of preexisting dysregulated immune pathways in certain individuals, immune response to mRNA, and activation of immunologic pathways, and dysregulated cytokine expression have been proposed. The reasons for male predominance in myocarditis cases are unknown, but possible explanations relate to sex hormone differences in immune response and myocarditis, and also underdiagnosis of cardiac disease in women. Olaparib Almost all patients had resolution of symptoms and signs and improvement in diagnostic markers and imaging with or without treatment. Despite rare cases of myocarditis, the benefit-risk assessment for COVID-19 vaccination shows a favorable balance for all age and sex groups; therefore, COVID-19 vaccination is recommended for everyone ≥12 years of age.
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