Effects of live-online, group mindfulness training on opioid use and anxiety during buprenorphine treatment: A comparative effectiveness RCT.

BACKGROUND: Office-based opioid treatment with buprenorphine has emerged as a popular evidence-based treatment for opioid use disorder. Unfortunately, psychosocial stress, anxiety, pain, and co-morbid substance use increase patients' risk for relapse. We designed this study to compare the effects of complementing buprenorphine treatment with 24 weeks of a live-online Mindful Recovery Opioid Care Continuum (M-ROCC) group to a time and attention-matched, live-online Recovery Support Group (RSG) active control condition. METHODS: We plan to enroll a maximum of N = 280 and randomize at least N = 192 patients prescribed buprenorphine through referrals from office-based and telemedicine buprenorphine treatment providers and social media advertisements. Participants will be randomly assigned to M-ROCC or RSG and will be blinded to their treatment condition. The primary outcome for this study will be biochemically confirmed periods of abstinence from illicit opioids, as measured by self-reported use and randomly collected, video-observed oral fluid toxicology testing during the final 12 weeks of study participation. Secondary outcomes include changes in Patient-Reported Outcomes Measurement Information System (PROMIS) anxiety and pain interference scores between baseline and week 24. RESULTS: The trial was funded by the National Institutes of Health, HEAL Initiative through NCCIH (R33AT010125). Data collection is projected to end by September 2023, and we expect publication of results in 2024. CONCLUSION: If the M-ROCC intervention is found to be effective in this format, it will demonstrate that live-online mindfulness groups can improve outcomes and address common co-morbidities like anxiety and pain during buprenorphine treatment.

National Psoriasis Foundation Telemedicine Task Force guidance for management of psoriatic disease via telemedicine.

Telemedicine emerged as an alternative care delivery system used to offer effective long-term management to patients with chronic, inflammatory conditions such as psoriatic disease. Teledermatology can provide reliable clinical information through thorough history-taking and virtual evaluations that include patient-provided images and disease activity assessment tools that may help accurately diagnose and manage patients with psoriasis. The integration of validated screening tools for psoriatic arthritis and effective teledermatology practices may improve access to specialists, thus avoiding preventable delays in the diagnosis and treatment of patients with psoriatic arthritis. Although the provision of telehealthcare should not completely replace high quality, in-person dermatologic or rheumatologic visits, the convenience and collaborative nature of teledermatology may lead to expanded access and expedited care in the appropriate setting, whether it be in a virtual or in-person visit.

Hearing Their Voices: Engaging Certified Peer Specialists in Dialogues About Racism and Recovery.

Certified peer specialists (CPSs) may be uniquely situated to help address inequities within the behavioral health system. However, CPSs and other mental health care providers often do not have opportunities to discuss their experiences with racism in the workplace. The Southeast Mental Health Technology Transfer Center and Georgia Mental Health Consumer Network offered the six-part Racism and Recovery event series as a space for such discussions (N=356 participants). Participant responses on the Government Performance and Results Act survey (N=239) and supplemental Qualtrics survey (N=213) identified potential actions at the individual and organizational levels for disrupting racism. The responses indicated that the series was a feasible and well-received model for engaging diverse participants.

Qualitative Study of Certified Peer Specialists' Experiences Delivering Peer Support Services During the COVID-19 Pandemic.

OBJECTIVE: The purpose of this qualitative study was to examine the experiences of certified peer specialists (CPSs) in delivering telehealth services during the COVID-19 pandemic. METHODS: Fourteen semistructured interviews with CPSs were conducted from August to November 2020. Data were analyzed by using thematic analysis. RESULTS: Helpful support from employers during the transition to telehealth included clear communication and access to training on telehealth technologies. Main barriers and facilitators were related to interpersonal relationships and logistical factors. CPSs reported that telehealth allowed them to continue to support the peers they serve but that the quality of interactions was not as good as with in-person services. Logistical challenges included inadequate equipment and Internet access. CONCLUSIONS: To support CPSs in delivering telehealth, employers can engage them in open and transparent communication about guidelines for service delivery, provide training and equipment, and allow them the flexibility to tailor service delivery modalities to the peers they serve.

Surface modification of polyurethane with a hydrophilic, antibacterial polymer for improved antifouling and antibacterial function.

Antimicrobial surface is important for the inhibition of bacteria or biofilm formation on biomaterials. The objective of this study was to immobilize a novel hydrophilic polymer containing the antibacterial moiety onto polyurethane surface via a simple surface coating technology to make the surface not only antibacterial but also antifouling. The compound 3,4-dichloro-5-hydroxy-2(5H)-furanone was derivatized, characterized and incorporated onto polyvinylpyrrolidone containing succinimidyl functional groups, followed by coating onto the polyurethane surface. Contact angle, antibacterial function and protein adsorption of the modified surface were evaluated. The result shows that the modified surface exhibited significantly enhanced hydrophilicity with a 54-65% decrease in contact angle, increased antibacterial activity to Staphylococcus aureus, Staphylococcus epidermidis, and Pseudomonas aeruginosa with a 24-57% decrease in viability, and reduced human serum albumin adsorption with a 64-70% decrease in adsorption, as compared to the original polyurethane.

National Psoriasis Foundation: a patient-centric approach to improve access to psoriatic disease treatment.

Psoriasis and psoriatic arthritis are serious autoimmune diseases requiring lifelong management and support. Uncontrolled psoriatic disease wields a significant impact on the lives of those affected, resulting in lowered quality of life, disability, depression, increased risk of related illnesses (eg, heart disease, diabetes), and early mortality. In National Psoriasis Foundation (NPF) surveys, roughly two-thirds of patients with psoriasis and/or psoriatic arthritis said their disease made them feel angry, frustrated, and/or helpless, and more than half said psoriasis interfered with their ability to enjoy life. The economic burden of psoriasis is equally daunting, and NPF surveys consistently report cost to be a significant barrier to treatment. This challenge is one of many reasons the NPF launched an aggressive strategic plan in 2014 intended to: 1) cut in half the number of patients who report that their condition is a problem in everyday life, 2) increase by 50% the number of patients receiving the right treatment, and 3) double the number of healthcare providers effectively managing patients with psoriasis and psoriatic arthritis. The NPF has launched several large-scale projects-including the development and implementation of solutions that reduce high out-of-pocket costs-intended to significantly increase the number of people with psoriatic disease who are effectively managing their condition.

The Psoriatic Disease Payer Advisory Panel.

A collaborative exchange of ideas occurred at The Psoriatic Disease Payer Advisory Panel sponsored by International Dermatology Outcomes Measures (IDEOM) and The National Psoriasis Foundation (NPF) in January, 2016. Patient, provider, payer, pharmaceutical industry, IDEOM board member, and NPF leader representatives shared perspectives to address the unmet needs in the treatment of psoriatic patients. The payers who play a crucial role in controlling treatment access and improving patient outcomes played a pivotal role in the discussion. Progress made during the Payer Advisory Panel will ultimately advance psoriatic initiatives and help to address the persistent challenges of all vested stakeholders.

J Drugs Dermatol. 2016;15(5):641-644.

Preparation and evaluation of a novel star-shaped polyacid-constructed dental glass-ionomer system.

OBJECTIVE: The objective of this study was to synthesize and characterize novel star-shaped poly(acrylic acid-co-itaconic acid)s via chain-transfer radical polymerization technique, use these polyacids to formulate the resin-modified glass-ionomer cements, and evaluate the mechanical strengths of the formed cements MATERIALS AND METHODS: The star-shaped poly(acrylic acid-co-itaconic acid)s were synthesized via a chain-transfer radical polymerization reaction using a newly synthesized star-shaped chain-transfer agent. The effects of MW, GM-tethering ratio, P/L ratio and aging on the compressive properties of the formed experimental cements were studied. Compressive, diametral tensile as well as flexural strengths were evaluated and compared to those of Fuji II and Fuji II LC cements. RESULTS: The star-shaped polyacids showed significantly lower viscosities in water as compared to their linear counterparts. The cements formulated with these novel polyacids showed significantly improved mechanical strengths i.e., 49% in yield strength, 41% in modulus, 25% in CS, 20% in DTS and 36% in FS, higher than commercial Fuji II LC. After aging in water for 30 days, the compressive strengths of the experimental cements were significantly changed with an increase of 29% in YS, 19% in modulus as well as 23% in CS and a decrease of 5% in toughness, indicating that aging in water enhances the salt-bridge formation and increases brittleness. CONCLUSIONS: A novel light-cured glass-ionomer cement system composed of the star-shaped poly(carboxylic acid)s has been developed via a cost-effective and time-efficient chain-transfer radical polymerization.

Acetabular cup stiffness and implant orientation change acetabular loading patterns.

Acetabular cup orientation has been shown to influence dislocation, impingement, edge loading, contact stress, and polyethylene wear in total hip arthroplasty. Acetabular implant stiffness has been suggested as a factor in pelvic stress shielding and osseous integration. This study was designed to examine the combined effects of acetabular cup orientation and stiffness and on pelvic osseous loading. Four implant designs of varying stiffness were implanted into a composite hemipelvis in 35° or 50° of abduction. Specimens were dynamically loaded to simulate gait and pelvic strains were quantified with a grid of rosette strain gages and digital image correlation techniques. Changes in the joint reaction force orientation significantly altered mean acetabular bone strain values up to 67%. Increased cup abduction resulted in a 12% increase along the medial acetabular wall and an 18% decrease in strain in inferior lateral regions. Imbalanced loading distributions were observed with the stiffer components, resulting in higher, more variable, and localized surface strains. This study illustrates the effects of cup stiffness, gait, and implant orientation on loading distributions across the implanted pelvis.

High initial stability in porous titanium acetabular cups: a biomechanical study.

Initial stability with limited micromotion in uncemented total hip arthroplasty acetabular components is essential for bony attachment and long-term biomechanical fixation. This study compared porous titanium fixation surfaces to clinically established, plasma-sprayed designs in terms of interface stability and required seating force. Porous plasma-sprayed modular and metal-on-metal (MOM) cups were compared to a modular, porous titanium designs. Cups were implanted into polyurethane blocks with1-mm interference fit and subsequently edge loaded to failure. Porous titanium cups exhibited 23% to 65% improvement in initial stability when compared to plasma-sprayed cup designs (P=.01): a clinically significant increase, based on experience and prior literature. The results of this study indicate increased interface stability in porous titanium-coated cups without significantly increasing the necessary force and energy required for full seating.

A novel furanone-modified antibacterial dental glass ionomer cement.

A novel furanone derivative and a polyacid constructed from it were synthesized, characterized and formulated into experimental high strength cements. The compressive strength (CS) and Streptococcus mutans viability were used to evaluate the mechanical strength and antibacterial activity of the cements. The effect of human saliva and aging were investigated. The antibacterial activity against Lactobacillus sp. and cytotoxicity to human pulp cells were also evaluated. The results show that all the formulated furanone-containing cements showed antibacterial activity, with an initial reduction in CS. The effect of the furanone derivative loading was significant. Increasing loading enhanced the antibacterial activity but reduced the initial CS of the formed cements. The derivative showed antibacterial activity against both S. mutans and Lactobacillus sp. Human saliva did not affect the antibacterial activity of the cement. The cytotoxicity study with human dental pulp cells shows that the furanone-modified cement was biocompatible. A 30 day aging study indicated that the cements may have long-lasting antibacterial activity. Within the limitations of this study it appears that the experimental cement could be a clinically attractive dental restorative due to its high mechanical strength and antibacterial function.

A novel antibacterial resin composite for improved dental restoratives.

A novel furanone-containing antibacterial resin composite has been prepared and evaluated. compressive strength (CS) and Streptococcus mutans viability were used to evaluate the mechanical strength and antibacterial activity of the composites. The modified resin composites showed a significant antibacterial activity without substantially decreasing the mechanical strengths. With 5-30 % addition of the furanone derivative, the composite kept its original CS unchanged but showed a significant antibacterial activity with a 16-68 % reduction in the S. mutans viability. Further, the antibacterial function of the new composite was not affected by human saliva. The aging study indicates that the composite may have a long-lasting antibacterial function. Within the limitations of this study, it appears that the experimental antibacterial resin composite may potentially be developed into a clinically attractive dental restorative due to its high mechanical strength and antibacterial function.