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\"This book presents recent advancements in positive psychology, specifically its application across broad areas of current interest. Chapters include submissions from various international authors in the field and cover discussion and presentation of relevant research, theories, and applications. The volume covers topics such as CBT, Psychotherapy, Coaching, Workplaces, Aging, Education, Leadership, Emotion, Interventions, Measurement, Technology, Design, Health, Relationships, Experiences, Communities. With the growing interest in the applications of positive psychology across diverse fields within psychology and beyond, this book will make a worthwhile contribution to the field. It will also fill the current need for a volume that highlights specifically the various recent advancements in positive psychology into diverse fields and as such will be of benefit to a wide range of professionals, including psychologists, educators, clinicians, therapists, and many others.\" -- Publisher's website.

Three Australian populations of Portulaca oleracea—Common Purslane, Omega Gold and Omega Red—were grown under identical conditions, separated into portions—leaf, bud, stem and root—and their extracts tested for total phenolic content (TPC), Trolox equivalent antioxidant capacity (TEAC), ferric-reducing antioxidant potential (FRAP), and for antioxidant activity against hydroperoxides and thiobarbituric acid reactive substances (TBARS) in a linoleic acid emulsion. Highest TPC was found in Omega Gold and Omega Red roots, with 31.1 and 36.5 mg gallic acid equivalents per gram dry weight (mg GAE/g DW), respectively, being ten times higher than for Common Purslane roots (3.1 mg GAE/g DW). Other plant portions were generally higher for Omega Gold and Omega Red, though with much less difference, i.e., <2-fold variation. Results from other antioxidant tests paralleled those of TPC. Online monitoring of antioxidant activity via post-column reaction with [2,2′-azino-bis-(3-ethyl-benzothiazoline-6-sulfonic acid)] (ABTS●+), revealed a peak with significant activity. Purification of the compound responsible yielded oleracein australis 1, and 1D and 2D NMR data are presented for the first time. The results of this study show that Australian populations of P. oleracea are high in bioactivity and may be superior to the internationally recognised medicinal plant, Common Purslane.

In the original publication [...]

Acacia implexa, Eucalyptus rossii and Exocarpos cupressiformis are native plants of Australia, which were used by the First Peoples for medicinal purposes. In this study, 70% aqueous ethanol crude extracts were prepared from A. implexa bark and leaves, E. rossii leaves and E. cupressiformis leaves, and partitioned via sequential extraction with n-hexane, dichloromethane (DCM), ethyl acetate and ethanol. The crude extracts and fractions were screened for antioxidant activity using a novel, high-throughput lipid-based antioxidant assay, as well as the aqueous ABTS (2,2′-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid)) assay and the Folin–Ciocalteu test for total phenols. In the lipid-based assay, non-polar n-hexane and DCM fractions showed higher antioxidant activity against the formation of peroxides and thiobarbituric acid reactive substances (TBARS) than the other fractions, whereas the non-polar fractions were not effective in aqueous assays. This illustrates that the high potential of the lipid-soluble n-hexane and DCM fractions as antioxidants would have been missed if only aqueous-based assays were used. In addition, the potent antioxidant compounds were putatively annotated using liquid chromatography quadrupole time-of-flight mass spectrometry (LC-qTOF-MS). Gallic acid, (+)-catechin, (−)-epicatechin and tannins were found in most crude extracts.

Aim Substance Use Disorder (SUD) increases HIV risk and is often a barrier to advancement along the PrEP Care Continuum. In the United States ~ 40,000 new HIV diagnoses occur annually, the majority among sexual and gender minorities who use substances. Insufficiently treated HIV and SUD results in substantial costs to society. Effective strategies that focus on SUD as part of a client-centered approach to improve PrEP engagement and address social determinants of health (SDoH), are critical. Understanding resources/cost requirements is important to know for prospective sites. Methods The parent R01 was a single-site, randomized stepped-care and cost-effectiveness trial of Assisted Service Knowledge (A.S.K)-PrEP vs. standard of care (SOC), where “non-responders” in the A.S.K-PrEP arm were stepped to additional attention for SUD via contingency management (CM), resulting in three strategies against SOC (A.S.K-PrEP; A.S.K-PrEP + CM; A.S.K-PrEPàCM alone). Resources needed to implement and sustain each strategy were captured as part of a detailed microcosting analysis. Resources were categorized as fixed start-up, time-dependent, or variable, and organized within the implementation or sustainment phase. Costs were assigned using nationally representative prices. Results Start-up costs (first year costs) were $25,958 and time-dependent costs (annually based) were $68,442 across strategies. Variable costs (annually based) differed across strategies resulting in $31,716 for A.S.K-PrEP alone, $31,994 for A.S.K-PrEP + CM and $30,271 for CM alone. The per-participant intervention cost was $55 for Standard of Care, $104 for A.S.K-PrEP alone, $73 for A.S.K-PrEP + CM, and $16 for CM alone. Conclusion This study provides key insights into the “real-world” resource/cost requirements for implementing and sustaining each A.S.K.-PrEP strategy. Our results and publicly available budget impact tool provide support for potential stakeholders to ensure both feasibility and long-term sustainability for PrEP uptake and adherence for sexual and gender minority individuals with a SUD. Trial registration number NCT05934877 and was registered on 05/23/23 as a clinical trial.

Adoption of ED-initiated buprenorphine for opioid use disorder has been slow despite evidence of its effectiveness. Implementation facilitation (IF) is an evidence-based implementation strategy to promote adoption of new practices within clinical settings. The Clinical Trials Network (CTN)-0069 Project ED Health” study evaluated whether provision of ED-initiated buprenorphine with referral for community-based medication for opioid use disorder (MOUD) increased after IF. We identified the health system resources required to conduct IF and sustain ED-initiated buprenorphine with referral for community-based MOUD and then calculated the financial costs associated with using those resources. We estimated costs using nationally representative employee values of the formative evaluation and other IF-related resources (e.g., focus groups, clinician education, and academic detailing), using microcosting analysis to capture quantitative data and assign nationally-representative costs based on Drug Abuse Treatment Cost Analysis Program (DATCAP). The study data was collected from 2017 to 2020 from four sites. We calculated costs per site for three distinct phases: pre-implementation, IF, and sustainment. The mean, per-site, costs were: pre-implementation = $27,753 (range: $25,859$27,821), IF = $53,558 (range: $48,417–$59,468) and annual sustainment = $226,822(range: $104,871–$339,100), which resulted in a mean per-patient cost of $115 assuming an average of 195 patients identified with untreated OUD, per-month, across sites. The microcosting analysis revealed the resources and costs involved in implementing ED-initiated buprenorphine programs at various sites. Understanding the different ways each site customized the IF strategy can improve adoption to this initiative. Interpreting the costs during the intervention and what it takes to sustain it will help decision makers address uncertainty and promote increased acceptance of implementing these practices in the context of potential benefits that this approach can provide.

Background In the United States, most (~ 70%) annual newly diagnosed HIV infections are among substance-using sexual minority men (SMM) and gender minority transgender women (trans women). Trans women and SMM are more likely to report or be diagnosed with a substance use disorder (SUD) than their cisgender or heterosexual counterparts and the presence of an SUD substantially increases the risk of HIV infection in both groups. Although Pre-Exposure Prophylaxis (PrEP) is highly effective, initiation, adherence, and persistence are exclusively behavioral outcomes; thus, the biomedical benefits of PrEP are abrogated by substance use. SUD is also associated with reduced quality-of-life, and increased overdose deaths, utilization of high-cost healthcare services, engagement in a street economy, and cycles of incarceration. Objective To determine the optimal (considering efficacy and cost-effectiveness) strategy for advancement along the PrEP Care Continuum among trans women and SMM with an SUD. Methods This study will implement a randomized controlled trial, evaluating two Stepped Care approaches involving A.S.K.-PrEP vs. standard of care (SOC) to determine optimal intervention strategies for trans women and SMM with an SUD ( N  = 250; n  = 83 trans women; n  = 167 SMM) for advancement along the PrEP Care Continuum. Participants will be randomized (3:1) to Stepped Care ( n  = 187) or SOC ( n  = 63). Participants in the Stepped Care arm will be assessed at 3-months for intervention response; responders will be maintained in A.S.K.-PrEP , while non-responders will receive added attention to their SUD via Contingency Management (CM). Non-responders will be re-randomized (1:1) to either (a) receive A.S.K.-PrEP  + CM, or (b) shift the primary focus to their SUD (CM alone). Results Recruitment and enrollment began in May 2023. Recruitment will span approximately 36 months. Data collection, including all follow-up assessments, is expected to be completed in April 2027. Discussion Trans women and SMM with an SUD have the two highest HIV prevalence rates in the United States, which underscores the urgent need for effective measures to develop scalable behavioral interventions that can encourage advancement along the PrEP Care Continuum. To improve public health, researchers must identify scalable and cost-effective behavioral interventions to promote PrEP initiation, adherence, and persistence among trans women and SMM who use substances. Trial registration This trial has been registered at ClinicalTrials.gov under the number NCT05934877.

Background In 2018 Massachusetts mandated that county jails offer all FDA-approved medications for opioid use disorder (MOUD) to incarcerated individuals with OUD. Estimating costs needed to implement and sustain an MOUD program are not clearly known in jail facilities. The objective of this study was to identify the type of MOUD model deployed by the jails serving as research sites for the Massachusetts JCOIN hub, determine which resources were utilized at each stage of development, and estimate the associated costs. Methods Resources required to implement and sustain the MOUD programs were identified through detailed, site-specific microcosting analyses at six participating jails in Massachusetts. Quantitative resource utilization data were captured primarily through in-person site-visits and semi-structured interviews with key personnel. Unit costs were derived from the Federal Supply Schedule and Bureau Labor of Statistics from a site-specific level perspective. Our customizable budget impact tool, designed to assist jails/prisons with assessing the viability of alternative MOUD models, was used to organize each site’s resources and estimate their associated costs. Resources/costs were summarized by site, according to type and phase, and cross-site comparisons were made to identify common program elements and unique models. Results Three MOUD models were identified. Model 1 consisted of a vendor hired to deliver and administer methadone daily, while clinical jail staff administered buprenorphine and extended-release naltrexone. Model 2 included facilities that hired a certified vendor to operate an in-house opioid treatment program (OTP) to oversee the administration of all MOUD. Jails in Model 3 became certified OTPs, thereby allowing jail staff to manage all aspects of the MOUD program. There was considerable variability in implementation costs, both within and across models, driven by model-specific factors, but also with switching models, expanding infrastructure, etc. Entering the sustainment phase, the per-person costs of care were quite similar across models but differed according to the proportion of costs considered time-dependent vs. variable. Conclusion Our findings represent the most detailed and comprehensive estimates of resource/cost requirements for jail-based MOUD programs. Given the budget constraints faced by jails, the investment required to implement/sustain an MOUD program will likely result in the need to obtain additional funding or reallocate existing resources away from other initiatives.

Abstract INTRODUCTION: Chiari I decompression (C1D) is a common pediatric neurosurgical procedure. Inpatient C1D postoperative care is often notable for pain and poor activity. Initiation of rehabilitation therapies, including physical, occupational, massage, and recreational, may impact recovery, but published evidence is scant. METHODS: An electronic medical record query by Current Procedural Terminology code identified all patients who underwent C1D at our pediatric tertiary-care hospital from January 1, 2012 through February 20, 2016. Chiari II, redo C1D, and unrelated foramen magnum decompression operations were excluded. Demographic, financial, surgical, therapy, and outcome data were analyzed. RESULTS: The study population included 59 patients with a mean age of 11 years (range 1-18) and sex distribution of 56% male. Sixty-one percent (36/59) had private insurance and 39% (23/59) had public insurance. C1D was intradural in 75% (44/59) and extradural in 25% (15/59). Seventy-three percent of patients (43/59) received at least 1 form of rehabilitation therapy. Public insurance was associated with a higher reoperation and readmission rate than private insurance. Intradural surgery was associated with a greater LOS, reoperation rate, and readmission rate than extradural surgery. Having received any rehabilitation therapy was associated with an increased LOS compared with no therapy, even when stratified for intradural vs extradural surgery, but a lower readmission rate. An association of therapy with reoperation rate was less distinct. CONCLUSION: In our population, rehabilitation therapy was associated with an increased inpatient LOS but a lower readmission rate. It is possible that the initiation of therapy was a marker for a more symptomatic child who would require more time to recover. It is also possible that the lower readmission rate related to an increased discharge readiness among the therapy group. Further investigation is ongoing.

Many transgender women with HIV achieve suboptimal advancement through the HIV Care Continuum, including poor HIV health care usage, retention in HIV medical care, and rates of viral suppression. These issues are exacerbated by comorbid conditions, such as substance use disorder, which is also associated with reduced quality of life, increased overdose deaths, usage of high-cost health care services, engagement in a street economy, and cycles of incarceration. Thus, it is critical that efforts to End the HIV Epidemic include effective interventions to link and retain transgender women in HIV care through full viral suppression. This study builds on the promising findings from our two Health Resources and Services Administration-funded demonstration projects, The Alexis Project and Text Me, Girl!, which used peer health navigation (PHN) and SMS text messaging, respectively, for advancing transgender women with HIV to full viral suppression. Though the effectiveness of both interventions has been established, their comparative effectiveness, required resources or costs, cost-effectiveness, and heterogeneous effects on subgroups, including those with substance use disorder, have not been evaluated. Given the many negative personal and public health consequences of untreated or undertreated HIV, and that HIV services for transgender women are frequently delivered in resource-limited, community-based settings, a comprehensive economic evaluation is critical to inform decisions of stakeholders, such as providers, insurers, and policy makers. Text Me, Alexis! is a 3-arm randomized controlled trial. Participants (N=195) will be randomized (1:1:1) into: PHN alone (n=65), SMS text messaging alone (n=65), or PHN+SMS text messaging (n=65). Using the same time points as the Health Resources and Services Administration demonstration projects, the repeated-measures design will assess participants at baseline, 3, 6, 12, and 18 months post randomization. Over the course of the 90 days, participants in the PHN arm will receive unlimited navigation sessions; participants in the SMS text messaging arm will receive 270 theory-based SMS text messages (3 messages daily) that are targeted, tailored, and personalized specifically for transgender women with HIV; and participants in the PHN+SMS text messaging arm will receive a combined PHN and SMS text message intervention. The desired outcome of Text Me, Alexis! is viral suppression and cost-effectiveness. Recruitment began on April 10, 2024, and the first participant was enrolled on April 11, 2024. Data collection is expected to be completed in July 2027. Primary outcome analyses will begin immediately following the conclusion of the follow-up evaluations. Transgender women are a high-priority population for reaching End the HIV Epidemic goals. Findings have the potential to improve individual and population health outcomes by generating significant improvements in viral suppression among transgender women and guiding service provision and public policy. DERR1-10.2196/65313.