Medicated-Assisted Treatment and 12-Step Programs: Evaluating the Referral Process

Purpose/Background Overdose deaths in the U.S. from opioids have dramatically increased since the COVID-19 pandemic. Although medicated-assisted treatment (MAT) programs are widely available for sufferers of opiate addiction, many drop out of treatment prematurely. Twelve-step programs are considered a valuable part of treatment, but few studies have examined the effect of combining these approaches. We aimed to compare abstinence rates among patients receiving MAT who were referred to 12-step programs to those only receiving MAT. Methods In this prospective study, a cohort of participants from a MAT clinic agreeing to attend a 12-step program was compared to 15 controls selected from a database before project implementation. Eligible participants were diagnosed with OUD, receiving buprenorphine (opiate agonist), and at least 18. Participants were provided with temporary sponsors to attend Narcotics Anonymous, Alcoholics Anonymous, and Medication-Assisted Recovery meetings together. The primary endpoint was the change in positive opiate urine drug screens over 6 months between participants and controls. Results Between March 29, 2021, and April 16, 2021, 166 patients were scheduled at the clinic. Of those scheduled, 146 were established patients, and 123 were scheduled for face-to-face visits. Of these, 64 appeared for the appointment, 6 were screened, and 3 were enrolled. None of the participants attended a 12-step meeting. Enrollment barriers included excluding new patients and those attending virtual visits, the high percentage of patients who missed appointments, and lack of staff referrals. The low incidence of referrals was due to time constraints by both staff and patients. Implications for Nursing Practice Low enrollment limited our ability to determine whether combining medication management with a 12-step program improves abstinence. Failure to keep appointments is common among patients with OUD, and virtual meetings are becoming more prevalent post-COVID. Although these factors are unlikely to be controllable, developing strategies to expedite the enrollment process for staff and patients could hasten recruitment.

Use of GPS at research of roads & a vehicle

The purpose of this work are consideration of use of GPS for a research of roads and modeling of the vehicle/wheel machines (WM).Implementation for this problem of the measuring registering complex on a basis the Raspberry Pi 3/4 minicomputer, the GN-803G sensor and creation of the software in the language C/C ++ is considered.The obtained information about GPS and approaches of selection of necessary data from the messages on the basis of the NMEA 0183 standard submitted in the text ASCII form with the fields divided by a comma is analyzed. An assessment of opportunities of use of the obtained information is given.The scheme of connection of the GN-803N module to Raspberry 3/4 through the GPIO protocol is developed and proved.Reduction of the obtained data to a constant step with use of a polynom of Lagrange of the 2-nd order on three points of a variable step is considered.It is recommended at further use of this corrected data array in process modeling of the car application of a method of interpolation CatMull-Rom on the 4-th points at the fixed step. Program fragments are given in C/C ++.It is offered in the territory of RB during the determining of relative distances and a binding to cards at conversion it is possible to use the simplified linear formula lat_m= 112297,6196∙ Ddec lat , lon_m= 63215,444 ∙ Ddec lon .The offered technique of application of GPS, software, received data are planned to be used for a research of influence of the driver and road conditions on the movement of the vehicle and the subsequent their application when modeling in Matlab/ Simulink, and also in problems of preliminary debugging of management systems by self-driving vehicles.

Older Adults’ Experiences of Behavior Change Support in a Digital Fall Prevention Exercise Program: Qualitative Study Framed by the Self-determination Theory

Background Exercise is an effective intervention to prevent falls in older adults; however, long-term adherence is often poor. To increase adherence, additional support for behavior change has been advocated. However, consistency in the reporting of interventions using behavior change techniques is lacking. Recently, a classification system has been developed to increase consistency in studies using behavior change techniques within the self-determination theory. Objective This study aimed to explore expressions of self-determination among community-dwelling older adults using a self-managed digital fall prevention exercise program comprising behavior change support (the Safe Step program), which was developed in co-creation with intended users. Methods The qualitative study design was based on open-ended responses to questionnaires, and individual and focus group interviews. A deductive qualitative content analysis was applied using the classification system of motivation and behavior change techniques as an analytical matrix, followed by an inductive analysis. Twenty-five participants took part in a feasibility study and exercised in their homes with the Safe Step program for 4 months. The exercise program was available on computers, smartphones, and tablets, and was fully self-managed. Results In the deductive analysis, expressions of support were demonstrated for all three basic human psychological needs, namely, autonomy, competence, and relatedness. These expressions were related to 11 of the 21 motivation and behavior change techniques in the classification system. The inductive analysis indicated that autonomy (to be in control) was valued and enabled individual adaptations according to different rationales for realizing exercise goals. However, the experience of autonomy was also two-sided and depended on the participants’ competence in exercise and the use of technology. The clarity of the program and exercise videos was seen as key for support in performance and competent choices. Although augmented techniques for social support were requested, support through relatedness was found within the program. Conclusions In this study, the Safe Step program supported the establishment of new exercise routines, as well as the three basic human psychological needs, with autonomy and competence being expressed as central in this context. Based on the participants’ experiences, a proposed addition to the classification system used as an analytical matrix has been presented. Trial Registration ClinicalTrials.gov NCT02916849; https://clinicaltrials.gov/ct2/show/NCT02916849

Spiritual Therapies and Autolytic Behavior

"Can the Minnesota model and the 12-step program be an effective intervention model based on the religious and spiritual approach to reduce substance and alcohol consumption but also suicidal ideation? Can these programs also lead to increased quality of life and unconditional self-acceptance by study participants? In this study, we aimed to highlight the role of the Minnesota Model and the 12-Step Program used in reducing stress, anxiety, depression, suicidal ideation, increasing quality of life, and unconditional acceptance of oneself by participants in Alcoholics Anonymous groups in Constanta County. Another goal we set out was to compare the results obtained by the participants at the end of these programs, but also by comparing their results with the results obtained by the participants who make up a control group. Through this study, we aim to identify the most important predictors and include them in effective models for increasing the quality of life of alcohol addicts, as well as highlighting a relationship between alcohol dependence and suicidal ideation, before and after these two programs."

PROGRAM FOR THE DEVELOPMENT OF A FRANCHISE BUSINESS NETWORK ON THE MARKET

The franchise model is currently the most profitable, fast-growing business format that ensures the economic growth of the regional and Russian economy. The subject of the study was the program for the development of a franchise business network in the market. The purpose of this study is to develop effective management measures to expand the use of franchise relations in business networks. The use of the author's approach allowed to build a step-by-step program for scaling a ready-made partner business and increase the level of transparency of franchise relations. The practical significance lies in the development of a set of practical steps within the framework of the implementation of the action program to enhance the use of franchising in the Russian economy, which will increase the number of new participants in franchise systems.

Mentoring in Pediatric Thoracoscopy: From Theory to Practice

Introduction: Thoracoscopy represents the most challenging area of pediatric minimally invasive surgery due to its technical difficulty. A standardized training program would be advisable. The aim of this study is to evaluate the results of our surgical training.Materials and Methods: A retrospective, single-center, cohort study was performed. The following four-step program was tested: (1) theoretical part; (2) experimental training; (3) training in centers of reference; (4) personal operative experience. Particular attention was focused on the choice of mentor. Times and modality of adherence to the program were evaluated. The effectiveness and safety of the training were evaluated according to the surgical results of esophageal atresia (EA/TEF) repair and resection of congenital lung malformations (CLM). The study was conducted from January 2014 to May 2020. Attending surgeons with previous experience in neonatal and pediatric laparoscopy were selected for the training program after being evaluated by the head of Department.Results: The training program was fully completed in 2 years. Twenty-four lobectomies, 9 sequestrectomies, 2 bronchogenic cyst resections and 20 EA/TEF repair were performed. Thoracoscopy was always feasible and effective, with no conversion. The operative times progressively decreased. Only three minor complications were recorded, all treated conservatively.Conclusions: A standardized training program is highly desirable to learn how to safely perform advanced pediatric thoracoscopy. The 4-steps design seems a valid educational option. The choice of the mentor is crucial. An experience-based profile for pediatric surgeons who may teach thoracoscopy is advisable.

A Pilot Study of a Future Planning Program for Siblings of People With Intellectual and Developmental Disabilities

Given the increased longevity of people with intellectual and developmental disabilities (IDD), future planning programs are becoming increasingly common. However, although siblings are likely to fulfill caregiving roles for people with IDD, siblings have not been included in future planning interventions. The purpose of this study was to evaluate the outcomes and feasibility of the Sibling Training for Early future Planning (STEP) program. Using quantitative and qualitative data, 18 siblings of individuals with IDD participated in the study. After completing the STEP program, participants demonstrated significantly improved feelings of empowerment, disability connectedness, family communication, and knowledge of adult disability services. The STEP program was also feasible given high attendance, low attrition rates, and high participant satisfaction. Implications for research and practice are discussed.