Notes

The creation of multi-kinase inhibitors since pancreatic most cancers therapeutics.
Using maps and spatial analysis are technologies to evaluate the magnitude and spatial distribution of disease in epidemiology investigations. We aimed to conduct a Bayesian spatial analysis on epidemiologic data of transfusion-dependent β-thalassemia (TDT) patients.

In this cross-sectional study, data of all TDT patients diagnosed during 1955-2018 in all counties of Fars Province were obtained from data registry of the Organization of Special Diseases of Shiraz University of Medical Sciences in Shiraz, Fars Province, Iran. Besag, York, and Mollie's (BYM) model was used for mapping.

The estimated relative risk ranged from 0.23 to 1.66 for TDT patients. The highest and lowest relative risks of TDT were observed in Larestan located in Southern and Abadeh in Northern Fars Province respectively.

Determining the accurate geographical distribution of a chronic disease such as β-thalassemia can be an essential prerequisite in allocation of regional health system resources.
Determining the accurate geographical distribution of a chronic disease such as β-thalassemia can be an essential prerequisite in allocation of regional health system resources.Recovery coaches, trained peers with a history of substance use disorder (SUD) who are formally embedded in the health care team, may be a cost-effective approach to support outpatient management of SUD treatment. Although recovery coach programs are scaling nationwide, limited data exist to support their impact on costs or clinical outcomes. This study aimed to evaluate the integration of peer recovery coaches in general medical settings. Staff hired and trained nine recovery coaches as a part of a health system-wide effort to redesign SUD care. We examined reductions in acute care utilization and increases in outpatient treatment utilization among patients connected to a recovery coach. Additionally, we examined buprenorphine treatment engagement and opioid abstinence among a subset of patients who initiated buprenorphine prior to or within 30 days of their first recovery coach contact. We hypothesized recovery coach contact would strengthen outpatient SUD treatment and be associated with reductions in SUD .02-1.70; p less then 0.001). Recovery coaches may be an impactful and potentially cost-effective addition to an SUD care team, but future research is needed that uses a matched comparison condition.
Evidence-based web and mobile interventions are available for a range of mental health concerns. Little is known about how self-administered web interventions are used outside of controlled research trials, and there is a critical need to empirically examine real-world public implementation of such programs. To this end, the aim of the current study was to evaluate and describe outcomes of a nationwide public implementation of VetChange, a self-administered web intervention for veterans with problematic alcohol use and symptoms of PTSD.

The study used the RE-AIM framework to organize outcomes along five key dimensions reach, effectiveness, adoption, implementation, and maintenance. This naturalistic observation study included program use information for all who registered an account with VetChange during the 2-year study period and who self-identified as a returning veteran. We collected program use data automatically via normal website operation; a subset of program users provided additional self-report rden associated with chronic alcohol use disorder and PTSD, this study demonstrates how web-based interventions can provide public health benefits and reduce long-term health care costs.
In Lithuania, injecting heroin and other illicit opioids has dominated high-risk drug use since about 2000. More recently, patients have reported a high-risk use of amphetamines. Newly diagnosed HIV cases among people who inject drugs peaked in 2002 and 2009 and drug-related deaths have been on the increase. Yet research has reported a limited number of available harm-reduction programs. This study aimed to estimate the size of high-risk drug using populations in Lithuania and to apply these estimates in assessing the coverage of opioid substitution treatment (OST) and needle and syringe programs (NSP).

We used indirect prevalence estimation methods (HIV and Mortality Multiplier, Capture-Recapture, Truncated Poisson and the Multivariate Indicator Method) to obtain annual prevalence estimates of the population of high-risk opioid users (HROU) and of people who inject drugs (PWID) in Lithuania in 2015/2016. We computed the coverage of OST (the annual percentage of HROU in these programs) and NSP (the numberon is markedly lower than in most countries of the European Union and warrants further investment.
A public health concern stemming from recreational marijuana legalization (RML) is the idea that marijuana may act as a "gateway" drug among youth and young adults, where growing marijuana use will lead to increasing substance use disorder (SUD) for "harder" illicit drugs. This study investigates whether SUD treatment admissions for cocaine, opioids, and methamphetamines increased following RML enactment in Colorado and Washington for adolescents and emerging adults.

We entered annual 2008-2017 treatment admissions data from the SAMHSA Treatment Episode Dataset - Admissions (TEDS-A) into difference-in-differences models to investigate whether the difference in treatment admissions for cocaine, opioids, and methamphetamines among adolescents (12-17), early emerging adults (18-20), and late emerging adults (21-24) before versus after RML enactment differed between Colorado and Washington and states without RML.

There was no significant difference (p<0.05) between Colorado and Washington and other stateor opioids, cocaine, or methamphetamines. Future studies should extend this research to other states, other substances, for older adults, and over longer time periods; and consider how the effects of drug policies may differ across different jurisdictions.Incentive salience, or the attribution of motivational value to stimuli, is a biopsychological process that is disrupted in alcohol use disorder (AUD). The Addictions Neuroclinical Assessment (ANA) is a framework to characterize heterogeneity in addiction and establish a common assessment battery for research and clinical use. The ANA framework hypothesizes three constructs that correspond to processes in the etiology, course, and treatment of addiction incentive salience, negative emotionality, and executive function. The current study extends prior findings on the ANA by validating the incentive salience construct among participants (n = 563) in a multisite prospective study of individuals entering treatment for AUD. We used confirmatory factor analysis to test a one-factor model of incentive salience. Indicators included items assessing perception of urges to drink from the Alcohol Dependence Scale, Impaired Control Scale, and Marlatt Relapse Interview. compound library chemical Results indicated the one-factor model fit the data well (χ2 (12) = 19.42, p = .08; RMSEA = 0.034 [90% CI 0.000, 0.060], CFI = 0.992) and was measurement invariant across sex. Incentive salience was associated with drinking patterns (e.g., drinks per day, r = 0.447 [95% CI 0.379, 0.514]); reasons for drinking (urges/temptation r = 0.529 [95% CI 0.460, 0.599]); testing personal control, r = 0.384 (95% CI 0.308, 0.461); social pressure, r = 0.549 (95% CI 0.481, 0.617); and family history of AUD, r = 0.134. The incentive salience factor demonstrated greater predictive validity for drinking outcomes compared to alternative preexisting scales. Overall, this study provides support for the construct validity and measurement invariance of the ANA incentive salience construct in a sample of individuals seeking AUD treatment.
Many people drop out of substance use disorder (SUD) treatment within the first few sessions, which suggests the need for innovative strategies to address this. We examined the effectiveness of incentive-based contracting for Maine's publicly funded outpatient (OP) and intensive outpatient (IOP) SUD treatment, to determine its potential for improving treatment engagement and retention.

Maine's incentive-based contract with federally block grant-funded OP and IOP treatment agencies created a natural experiment, in which we could compare treatment engagement and retention with a group of state-licensed treatment agencies that were not part of the incentive-based contract. We used administrative data for OP (N=18,375) and IOP (N=5986) SUD treatment admissions from FY2005-FY2011 to capture trends prior to and after the FY2008 contract implementation date. We performed multivariable difference-in-difference logistic regression models following propensity score matching of clients.

Two-thirds (66%) of OP admimeasures, adding to the body of evidence that shows few or null results for value-based purchasing in SUD treatment programs. The limited success of such efforts is likely to reflect the bandwidth that providers and programs have to focus on new endeavors, the importance of the incentive funding to their bottom line, and forces beyond their immediate control.
We found little to no impact of the incentive-based contract on the treatment engagement, retention, and completion measures, adding to the body of evidence that shows few or null results for value-based purchasing in SUD treatment programs. The limited success of such efforts is likely to reflect the bandwidth that providers and programs have to focus on new endeavors, the importance of the incentive funding to their bottom line, and forces beyond their immediate control.
Co-occurrence of tobacco use and heavy episodic drinking (HED; 5+ drinks for men and 4+ drinks for women per occasion) is common among young adults; both warrant attention and intervention. In a two-group randomized pilot trial, we investigated whether a Facebook-based smoking cessation intervention addressing both alcohol and tobacco use would increase smoking abstinence and reduce HED compared to a similar intervention addressing only tobacco.

Participants were 179 young adults (age 18-25; 49.7% male; 80.4% non-Hispanic white) recruited from Facebook and Instagram who reported smoking 4+ days/week and past-month HED. The Smoking Tobacco and Drinking (STAND) intervention (N=84) and the Tobacco Status Project (TSP), a tobacco-only intervention (N=95), both included daily Facebook posts for 90days and weekly live counseling sessions in private "secret" groups. We verified self-reported 7-day smoking abstinence via remote salivary cotinine tests at 3, 6, and 12months (with retention at 83%, 66%, and 84%, re behavioral changes.
Adding an alcohol treatment component to a tobacco cessation social media intervention was acceptable and engaging but did not result in significant differences by treatment condition in smoking or alcohol use outcomes. Participants in both conditions reported smoking and drinking less over time, suggesting covariation in behavioral changes.Opioid-related overdoses and the coronavirus disease 2019 (COVID-19) represent two of the deadliest crises in United States' history and together constitute a syndemic. The intersecting risks of this syndemic underscore the urgent need to implement effective opioid use disorder (OUD) treatments that are sustainable amid COVID-19 mitigation strategies. In response to new federal guidance released during the pandemic, opioid treatment programs (OTPs) have quickly innovated to implement new systems of medication delivery. OTPs rapid implementation of new medication delivery models defies conventional wisdom about the pace of research transfer. As part of an ongoing cluster-randomized type 3 hybrid trial evaluating strategies to implement contingency management (CM), select staff of eight OTPs had been trained to deliver CM and were in the midst of receiving ongoing implementation support. As COVID-19 emerged, all eight OTPs mirrored trends in the addiction field and effectively adapted to federal/state demands to implement new methods of medication delivery.
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