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Education without Debt
Almost 50 million Americans have cumulatively borrowed more than
$1.5 trillion to attend college. Roughly one-third of all adults
aged 25 to 34 have a student loan. In Education without
Debt businessman and philanthropist Scott MacDonald examines
the real-life impact of crushing levels of student debt on
borrowers and what can be done to fix this crisis.
Weaving together stories of debt-impaired lives with stories of
personal success achieved with the essential help of financial aid,
MacDonald reveals the devastating personal and societal impact of
the debt problem and offers possible solutions. He explores the
efforts of colleges and private philanthropists to make education
affordable and relates his own experience of funding financial aid
for need-eligible students at five universities.
Education without Debt is a must-read book for anyone
concerned about the rising cost of education and what to do about
this critical policy and societal issue.
eBook
American ethnographic film and personal documentary : the Cambridge turn
\"American Ethnographic Film and Personal Documentary is a critical history of American filmmakers crucial to the development of ethnographic film and personal documentary. The Boston and Cambridge area is notable for nurturing these approaches to documentary film via institutions such as the MIT Film Section and the Film Study Center, the Carpenter Center and the Visual and Environmental Studies Department at Harvard. Scott MacDonald uses pragmatism's focus on empirical experience as a basis for measuring the groundbreaking achievements of such influential filmmakers as John Marshall, Robert Gardner, Timothy Asch, Ed Pincus, Miriam Weinstein, Alfred Guzzetti, Ross McElwee, Robb Moss, Nina Davenport, Steve Ascher and Jeanne Jordan, Michel Negroponte, John Gianvito, Alexander Olch, Amie Siegel, Ilisa Barbash, and Lucien Castaing-Taylor. By exploring the cinematic, personal, and professional relationships between these accomplished filmmakers, MacDonald shows how a pioneering, engaged, and uniquely cosmopolitan approach to documentary developed over the past half century. \"-- Provided by publisher.
Book
Incorporating prescription psychostimulants into the continuum of care for people with stimulant use disorder in Canada
Palis and MacDonald discusses the use of prescription psychostimulants in the continuum of care for people with stimulant use disorder in Canada. Illegal stimulant use methamphetamine use in particular) is rising in Canada and is associated with substantial morbidity and mortality. Accumulating evidence supports treatment of stimulant use disorder with prescribed psychostimulants, but no pharmacologic treatments for stimulant use disorder are currently approved in Canada. Off-label prescribing of psychostimulants for stimulant use disorder has been implemented on a small scale in certain jurisdictions in Canada. In the context of an unregulated supply of stimulants, implementation of psychostimulant prescribing can be considered by clinicians who provide care to patients with stimulant use disorder to reduce the use of and harms from illegal stimulant use.
Journal Article
American ethnographic film and personal documentary
American Ethnographic Film and Personal Documentary is a critical history of American filmmakers crucial to the development of ethnographic film and personal documentary. The Boston and Cambridge area is notable for nurturing these approaches to documentary film via institutions such as the MIT Film Section and the Film Study Center, the Carpenter Center and the Visual and Environmental Studies Department at Harvard. Scott MacDonald uses pragmatism's focus on empirical experience as a basis for measuring the groundbreaking achievements of such influential filmmakers as John Marshall, Robert Gardner, Timothy Asch, Ed Pincus, Miriam Weinstein, Alfred Guzzetti, Ross McElwee, Robb Moss, Nina Davenport, Steve Ascher and Jeanne Jordan, Michel Negroponte, John Gianvito, Alexander Olch, Amie Siegel, Ilisa Barbash, and Lucien Castaing-Taylor. By exploring the cinematic, personal, and professional relationships between these accomplished filmmakers, MacDonald shows how a pioneering, engaged, and uniquely cosmopolitan approach to documentary developed over the past half century.
eBook
The authors respond to letters on using prescribed psychostimulants to treat stimulant use disorder
Palis and MacDonald respond to letters discussing the use of prescribed psychostimulants to treat stimulant use disorder. They address comments made by various colleagues regarding the evidence supporting the use of prescription psychostimulants. They acknowledge that while the evidence is not as strong as that for medications used to treat other substance use disorders, such as opioid use disorder, this should not be a barrier to implementing prescription psychostimulants. They argue that the level of evidence available for opioid agonist treatment (OAT) should not be the benchmark for action on implementing prescription psychostimulants. They agree with the need for broader psychiatric supports, medical care, housing, and psychosocial treatments for people with stimulant use disorder. However, they argue that direct patient care is within the scope of practice for prescribers and can have immediate impacts on patients' lives. They call for the development of evidence and clinical protocols to guide the use of prescription psychostimulants and advance care for this population.
Journal Article
Building healthcare provider relationships for patient-centered care: A qualitative study of the experiences of people receiving injectable opioid agonist treatment
Background
Injectable opioid agonist treatment (iOAT) was designed as a pragmatic and compassionate approach for people who have not benefitted from medication assisted treatment with oral opioids (e.g., methadone). While, a substantial body of clinical trial evidence has demonstrated the safety and effectiveness of iOAT, considerably less is known about the patient-centered aspects of this treatment and their role in self-reported treatment goals and outcomes. The aim of this study was to explore participants’ experiences in iOAT as they broadly relate to the domains of patient-centered care. A secondary goal was to explore how these experiences affected participants’ self-reported treatment outcomes.
Methods
A qualitative methodology, and constructivist grounded theory approach, was used to guide sampling, data collection and analysis. A total of 30 in-depth interviews were conducted with people receiving iOAT in North America’s first clinic. Audio-recordings for each semi-structured interview were transcribed and read repeatedly. The strategy of constant comparison was used through iterative stages of line-by-line, focused and theoretical coding until theoretical saturation was achieved.
Results
“Building healthcare provider relationships for patient-centered care in iOAT”
was the emergent core concept. Healthcare provider relationships were established through two interrelated processes: ‘Opening up’ was attributed to the positive environment, and to feeling understood and supported by healthcare providers. ‘Being a part of care’ emerged as participants felt safe to ask for what was needed and had opportunities to collaborate in treatment decisions. These processes established a foundation in which participants experienced care that was responsive to their individual dose, health and psychosocial needs.
Conclusions
The core concept suggested that therapeutic relationships were fundamental to experiences of patient-centered care in iOAT. When relationships were respectful and understanding, participants received individualized and holistic care in iOAT. These findings offer a valuable example of how therapeutic relationships can be strengthened in other substance use treatment settings, particularly when responding to the diverse treatment needs of clients.
Journal Article
Injectable opioid agonist treatment for opioid use disorder: a national clinical guideline
In 2018, at least 4460 Canadians died from an opioid overdose, of which 94% were determined to be unintentional (accidental) overdoses. This represents a 9% increase in overdose deaths from 2017 and a 48% increase from 2016. The recent emergence of street fentanyl, carfentanil and other highly potent synthetic opioids increasingly cut into heroin and other street drugs is a pressing public health concern that has contributed substantially to the overdose emergency. Fentanyl and other synthetic analogs were implicated in 73% of opioid-related deaths in Canada in 2018, compared with 67% in 2017 and 50% in 2016. Individuals with severe opioid use disorder who inject opioids may not adequately benefit from oral opioid agonist treatment medications, for a variety of reasons. This guideline provides a framework for how to build a clinical practice of injectable opioid agonist treatment and recommends that this treatment should be considered for individuals with severe, treatment-refractory opioid use disorder and ongoing illicit injection opioid use.
Journal Article