TOPIC. Despite substantive advances in understanding of genetic and biochemical basis of substance abuse and addiction in the last decade, little information has been translated into alternative treatment models for the addicted patient. Rapid detox, an alternative form of detox treatment, is gaining in both acceptance and popularity. PURPOSE. To increase readers' understanding of the neurobiology of addiction and the mode of action of new detox approaches for patients addicted to opiate drugs. SOURCES. A review of the current literature pertaining to rapid detox. CONCLUSIONS. Rapid detox is a viable alternative for selected patients attempting to detox from opiate agents of abuse. Increasing knowledge of new treatment approaches allows nurses working to assist addicted patients in planning and receiving treatment based on new awareness of the neurobiology of addiction.

Many people seek out supports for addiction treatment and recovery. Communities are committed to providing addictions facility beds to individuals struggling with substance use. However, there is limited understanding of the experiences of people who move through these beds. The purpose of this research is to explore the experiences of individuals accessing addictions facility beds, including the process of coming to a facility, being in the facility, windows and doors to recovery, discharge, and follow up care. Interpretive descriptive methodology was used to guide this study. Eight qualitative interviews were completed with people who self-identified as having problematic substance use and were admitted to any addictions facility in the past six months. The interviews were analyzed using the grounded theory method of constant comparative methods of analysis. The five themes generated in this research were understanding individuals as the experts of their care; challenges in gaining access to supports; systemic issues, including knowing what to expect and flexibility; gaining insight into personal challenges and successes; and present experiences and expectations affecting future encounters. Understanding individual experiences of the process of accessing supports can be of great value in future planning and development, and making the available resources as effective as possible. The findings of this research may be useful in five ways. First, this research is directly useful to those working with individuals who have problematic substance use through helping them understand the experiences of their clients. Second, this research is useful for planning the delivery of services to individuals who have problematic substance use. Third, this research is indirectly useful to anyone negatively affected by problematic substance use, through the potential to improve supports. Fourth, this research contributes to the profession of nursing by building on and strengthening nursing care offered to individuals. Fifth, and last, this research contributes to the wider base of literature regarding what is known about caring for individuals with substance use. / Graduate

Försäljare av detoxpreparat hävdar att kroppens reningsmekanismer i vårt moderna samhälle inte längre räcker till och behöver hjälp på vägen, företrädesvis i form av påstått utrensande örtblandningar. Vissa förespråkar även tarmsköljningar och joniserande fotbad. Syftet med den här studien är att kartlägga floran av detoxprodukter i form av kosttillskott: vilka typer det finns, vilka ingredienser som ingår och vilka påståenden som görs. Påståendena har klassificerats efter testbarhet och trovärdigheten har bedömts genom sökningar i PubMed och Web of Science. Några av de testbara påståendena verkar helt sakna evidens, något påstående lutar sig mot studier behäftade med problematiska brister medan vissa påståenden förtjänar vidare studier, då de bygger på studier med preliminärt lovande resultat. Det går inte att utesluta en framtid för evidensbaserade detoxdieter, lika lite som det går att säga att detoxdieter av idag håller vad de lovar. Det krävs fler kliniska, placebokontrollerade studier och en tydligare skiljelinje mellan det som är ren bluff och det som är seriös forskning. Konsumenter bör vara medvetna om bristen på evidens och riskerna som finns, exempelvis i form av kontaminerade produkter och risk för interaktioner med läkemedel. / Sellers of detox preparations argue that in our modern society, the body's purification mechanisms are no longer sufficient and need a little help, preferably in the form of alleged cleansing herbal formulas. Some also advocate colonic irrigation and ionizing foot baths. The purpose of this study is to survey the flora of detox products in the form of nutritional supplements: what types there are, what ingredients are included and which claims are made. The claims have been classified for testability and reliability was assessed through searches in PubMed and Web of Science. Some of the testable assertions seem to completely lack evidence, other claims lean on studies that suffer from problematic deficiencies, while some claims deserve further study since they find support from studies with promising preliminary results. You cannot rule out a future for evidence-based detox diets, no more than you can to say that detox diets today keep their promises. More clinical, placebo-controlled studies are required and a clearer dividing line between what is pure bluff and what is serious research. Consumers should be aware of the lack of evidence and the risks that exist, for example in the form of contaminated products and the potential risk of interactions with medicines.

The purpose of this project was to determine the time between arrival, assessment, and treatment for patients presenting with alcohol withdrawal syndrome (AWS) to the emergency department (ED) as well as to identify patient and environmental factors that may prolong initiation of the implementation of the clinical institute withdrawal alcohol (CIWA-Ar) protocol for assessment and treatment of AWS. There is clear evidence that rapid assessment and treatment of AWS improves cost, quality, risk, safety and patient outcomes. This project found that patients in the emergency department at Banner University Medical Center South campus (BUMCS) in 2016 on average waited 2 hours and 20 minutes for initial CIWA-Ar assessment and 50 minutes for medication to be administered. When taking into account the physiological process of AWS and the highly variable nature of ethanol metabolism this timeline is suboptimal and significant reduction of these times are recommended. The only factor that was significantly associated with increased wait times was elevated blood alcohol content (BAC). With higher BAC resulting in longer wait times. This is a concerning finding since patients experiencing symptoms of withdrawal in the presence of elevated BAC are at significantly higher risk for the most severe AWS including delirium tremens and seizure.

The topic of this thesis is "Motivational work with a client in Child and adolescent detox center". The target of the theoretical part of this thesis is to describe motivational work with the client of the Child and adolescent detox center in the Hospital Sisters of Mercy of St. Charles Borromeo in Prague. The theoretical part is focused on general issue of drugs and addiction. Furthermore, there are described historical changes of the drug scene in our country in the 60s of the 20th century. Moreover, there are mentioned preventive measures against the emergence of the drug addiction. The detailed focus was given to the department of the Child and adoslescent detox center of the Hospital Sisters of Mercy of St. Charles Borromeo in Prague. In addtion, there are stated options of the treatment which can be used by the client during the stay in the Child and adolescent detox center in the Czech Republic. The aim of the practial part of the thesis is to analyse if and how the motivation for the change of the curent behaviour of the client varies during his or her visit in the Child and adolescent detox center. Furthermore, the analysis is focused on the casuistic description of personal and social background of the clients as well as the development of their drug issues during the treatment. The...

The “always on” culture of constant connectivity afforded by the ubiquity of smartphones and social media has profoundly influenced society, reorienting our sense of self and connection to others. This thesis particularly investigates the impact of these technologies on present-day college students, who are among the first to incorporate these tools into their ongoing identity development processes from adolescence into emerging adulthood. Specifically, it explores how the absence of everyday devices during a “digital detox” alters their experiences of self, socialization, and ways of being in the world. Phenomenological analysis through participant observation and interview methods reveals how the digital detox provides an opportunity for these emerging adults, who have grown up predominately using these technologies of virtual extension—values espoused in a culture of constant connection— to recognize the value of embodied experiences. The digital detox experience can encourage the cultivation of more digitally mindful media and technology use.

Uppsatsens syfte är att få en djupare förståelse för fenomenet digital detox och hur problem knutna till det alltmer digitalt uppkopplade samhället framställs samt hur dessa är tänkta att lösas inom detox-trenden. Följande frågeställningar är utformade för att besvara syftet: 1. Hur framställs problem knutna till det alltmer digitalt uppkopplade samhället inom digital detoxtrenden? 2. Hur är dessa problem tänkta att lösas? Det vill säga, vad innebär det egentligen att göra en digital detox? Uppsatsens teoretiska ramverk kretsar runt det accelererande samhället samt de effekter som de digitala medierna har inneburit för människan. Däribland redogörs det för upplevelsen av tid, tidspress, medierad interaktion och digital bundenhet. Studien genomfördes med en deltagande observation på digital detox-lägret Villa Insikt i norra Sverige den 17-19 november 2017. Materialet består bland annat av en intervju med kursledaren, informella samtal med densamme och övriga deltagare, fältanteckningar samt analys av broschyrer och lägrets hemsida. Resultatet visar att digitala medier, enligt detox-lägret, har inneburit en rad olika problem för människor. Trots detta ges inga konstruktiva förslag för hur dessa problem ska lösas. Uppsatsens huvudsakliga slutsats är således att detoxen enbart fungerar som ett konstaterande över att människors bundenhet och förhållningssätt till de digitala medierna är problematisk samt att detoxen inte innebär någon större förändring för deltagarna som istället individuellt måste försöka att lösa de problem som detoxen påvisar genom insikt och digital strategi.

Objective: This study was completed as a follow up to research regarding buprenorphine Medication Assisted Therapy (MAT) in Johnson City Tennessee for-profit clinics. We wished to determine the practice patterns over the last three years. Methods: Johnson City for-profit Medical Assisted Therapy clinics were called with a telephone survey. When the clinic representative answered the phone, they were asked questions regarding patient costs for therapy, insurance coverage, counseling offered on site, and opportunities for tapering while 20 weeks pregnant. Results: At all the MAT clinics contacted, the representative informed us that tapering in pregnancy could be considered contrary to current national guidelines. 43% of the clinics are now accepting insurance as compared to 0% in the 2016 study. The average weekly cost per visit remained consistent. Conclusion: The concept of tapering buprenorphine during pregnancy appears to have become a standard of care for this community and it is offered at all of the clinics that were contacted, some even require it, even though national organizations such as American College of Obstetricians and Gynecologists and American Society of Addiction Medicine; do not recommend this approach. Patients who have insurance including government funded insurance, are now able to obtain buprenorphine with no out of pocket expense at numerous clinics. The high cost for the uninsured patient continues to create an environment conducive to buprenorphine diversion.

Background: Even though the use of social media is one of the most popular activities of our time a decline in the number of active users can be observed at present. Users discontinue using social media platforms temporarily or stop the usage permanently. Thereby, the trend to do a social media detox has emerged, meaning users consciously take a break from social media platforms like Instagram, often for a set period of time. Instagram is one of the most widely used social media platforms of the younger generation, especially Generation Y, and is also noted for its addictive potential. Purpose: Previous studies and scholars have primarily concentrated on the permanent discontinuance of social media, whereby users permanently stop using social media platforms without actively planning to return. Thereby, the focus of the research was often on the social media network Facebook. By studying the journey of intermittent discontinuance of Instagram, the purpose of this research study is to explore Generation Y’s motivation before, experiences and feelings during and post-behavior after a 14-day detox by holistically representing the Instagram Detox Journey. Method: To fulfil the purpose of this thesis being of exploratory nature, a qualitative research design was applied. Empirical data were collected over 4 weeks, beginning with a focus group discussion before, followed by diary research during and 15 in-depth semi- structured interviews after the detox, and concluding with another focus group discussion at a later time. Using an inductive approach, the data was decoded, analysed, and interpreted using thematic analysis. Conclusion: The findings of the study show two main motivations before starting the detox: gaining back control and self-reformation. During the detox, five final themes were identified: mood & satisfaction, technological craving, mental well-being, physical well- being, and social relationships. Lastly, three different post-behaviors after completion were noted: the boomerang effect, conscious consumption, and an attitude change. The findings led to the development of the conceptual framework “Instagram Detox Journey”.

The oversaturation of our current way of interpreting news has become my point of interest. I believe we have become globalized yet isolated by our social media and news feeds, which has led to an inability to understand the graveness of what we learn. This is a consequence of the algorithmic attention grabbing focus that companies have been driven to. The almost infinite choice of outlet has led to escapism, radicalization and polarization rather than learning opportunity. In order to shine a light at this issue I am proposing a building that exhibits news and stories in a critical way. With the use of different interactive mediums in separate micro spaces they would give a different feel and bring different perspectives. The user would have the opportunity of smaller action to be part of the entirety. Panels that are cladded on the building with movable modules create a pattern as an interactive evolving art piece. Throughout the experience two other elements are present, a sharing democratic platform in the form of a table and the river of Umeå. The building is placed on the river, with the use of old industrial cement "dolphins", in order to use and emphasize the metaphor of the constant flow of the river to our constant flow of information. The current of the water is presented in different views and perspectives throughout. The building is designed to feel as a monolithic experience as well as a collective art piece in order to be as memorable as possible, in contrast to how forgetful our current way of interpreting news is.