Texte remanié de: Proefschrift--Groningen--Rijksuniversiteit, 2000. / Bibliogr. p. 350-366. Résumé en anglais et en français.

No abstract available. / Thesis (DPhil)--University of Pretoria, 1949. / gm2014 / Historical and Heritage Studies / Unrestricted

Proefschrift--Utrecht. / "Stellingen": [2] p. laid in. Bibliographical foot-notes.

Originally presented as the author's thesis, Göttingen, 1974. / At head of title: Akademie der Wissenschaften der DDR. Zentralinstitut für Alte Geschichte und Archäologie. Romanized text, German translation and facsimile reproduction of Mss. CH/U7570 of Turfan-Sammlung of Akademie der Wissenschaften der DDR. "Das Thema des Insadi-Sūtra sind die Prāvaraṇā-Zeremonie (die Zeremonie des "Einander-Einladens") und insbesondere ihre Entstehungsgründe."--P. 10. Includes bibliographical references (p. [19]-22).

No description available.

Supervised Injection Facilities (SIFs) for the medical supervision of illicit drug use exist in Europe, Canada, and Australia to reduce infectious disease transmission, overdose deaths, and other harms of drug use. They have been shown to reduce rates of needle sharing by 69% and local overdose mortality by 35% without increasing rates of drug use or related crime. In light of increasing rates of illicit opioid use and overdose death in Massachusetts, the Massachusetts Medical Society recently endorsed opening a SIF in Boston. This thesis proposes a study of the Boston SIF with the hypothesis that higher SIF utilization will be associated with decreased incidence of fatal overdose, HIV seroconversion, and HCV seroconversion during the study period. I propose evaluating this hypothesis prospectively by following clients of the SIF at 6 month intervals and comparing the rates of overdose death and HIV or HCV seroconversion among frequent and infrequent clients of the SIF. Based on data reported from previous SIFs and projections of the population of people who inject drugs (PWID) in Boston, a study with this design should detect a significant difference in these three primary endpoints between people using the SIF frequently and those using it infrequently within five years. A positive finding would confirm the efficacy of SIFs in harm reduction and secondary prevention for Opioid Use Disorder (OUD), potentially leading to broader adoption in other hotspots of opioid use in the United States.

The United States is in the midst of an opioid crisis. Fortunately, effective treatments for opioid use disorder exist (OUD); however, they are underutilized. Medications for opioid use disorder (MOUDs) decrease death by 50 %. These MOUDs are particularly relevant in the criminal justice population given that this population has a higher OUD disease burden but is less likely than the general population to receive this life-saving treatment. Research has identified negative attitudes toward MOUDs among corrections staff as a barrier to utilizing MOUDs. This thesis examines the relationships between community correction staff familiarity with methadone, one type of MOUD, and their opinions toward methadone using extant data from the Criminal Justice Drug Abuse Treatment Studies 2 (CJ-DATS 2) series. These data were collected between 2010-2012. The study was guided by the Knowledge-Attitude Behavior (KAB) model. The data are described using descriptive statistics, and I estimate logistic regressions to examine the relationship between respondent familiarity with methadone and their attitude toward methadone while controlling for other covariates. With a sample of 167 corrections employees, I found that corrections staff who agreed or strongly agreed with the statement that they were familiar with methadone had more positive methadone attitudes. Future research should examine the relationship between familiarity/knowledge, attitudes, and behaviors in other criminal justice settings and for other MOUDs (i.e., buprenorphine and naltrexone).

No description available.

Introduction and background Opioid use disorder (OUD) is an epidemic in the U.S. OUD affects both the mother’s and infant’s health. Substance-exposed infants suffer from decreased health outcomes relative to non-exposed infants. Purpose The aim is to identify infant health outcomes when pregnant women are prescribed medication-assisted treatment (MAT) for OUD. Among pregnant women with OUD in the U.S., is medication-assisted therapy as compared to no therapy associated with decreased negative infant health outcomes? Literature review Five studies on OUD and infant outcomes in the U.S. were reviewed. CINAHL and PubMed were searched using terms opioid use disorder, pregnancy, and neonatal abstinence syndrome (NAS). The search was limited to the last five years and full text only. Of the 815 results, five articles were selected that focused on infant outcomes and prevention of NAS. Articles were excluded if the focus was solely on the maternal outcomes, cost, or unoriginal research. One meta-analysis was included that compared two types of MAT for pregnant women with OUD. Findings MAT is correlated with a shorter hospital stay and less severe NAS symptoms in infants. Conclusion and implications Rates of NAS and OUD have increased significantly in the US. Some of the increase may be attributed to the transition to ICD-10 codes. MAT for pregnant women with OUD is associated with better health outcomes for infants. Patient-centered care could help decrease negative health outcomes for both infants and women with OUD. Future study should focus on degrees of opioid exposure and related outcomes.

Background: The prevalence of opioid use disorder has increased across the United States, but the rural population of Appalachia has been disproportionately impacted. Concurrently, the slow, but steady progress in the legalization of marijuana may be affecting perception of marijuana use in pregnancy. However, marijuana use in pregnancy has been associated with adverse perinatal outcomes. Concomitant use of opioids and marijuana in pregnancy has not been evaluated. Objective: The primary aim of the study was to evaluate the association between confirmed marijuana use in late pregnancy and preterm birth in opioid-exposed pregnancies. Methodology: A retrospective chart review was conducted that included all births from July 2011 to June 2016 from 6 delivery hospitals in South-Central Appalachia. Out of 18,732 births, 2368 singleton pregnancies indicated opioid use and met remaining inclusion criteria, with 108 of these mothers testing positive for marijuana at delivery. Independent sample t-test and Chi-Square analyses compared marijuana and non-marijuana exposed groups on maternal and neonatal outcomes. Regression analyses controlled for confounding variables in predicting neonatal abstinence syndrome (NAS), NICU admission, preterm birth, small for gestational age, and low birth weight outcomes as shown in Table 1. Results: Neonates born to marijuana-positive women in opioid-exposed pregnancy were more likely to be born preterm, small for gestational age, have low birth weight, and be admitted to NICU. After statistically controlling for parity, marital status, tobacco and benzodiazepine use, preterm birth and low birth weight remained statistically significant with aOR of 2.35 (1.30–4.24) and 2.01 (1.18–3.44), respectively. Conclusions: Maternal use of marijuana in any opioid-exposed pregnancy may increase risk of preterm birth and low-birth weight infants. Prospective studies need to examine the dose and timing of marijuana and opioid use in pregnancy to better delineate perinatal effects. Nonetheless, pregnant women using opioids, including recommended medication assisted treatment for opioid use disorder, should be educated about the risks of concurrent marijuana use during pregnancy and may need to be counseled to abstain from marijuana use during pregnancy for an optimal outcome.