U of A College of Nursing receives $1.6M grant to support Indigenous students

An Indian Health Service grant will help Indigenous nursing students pursue higher education while also building new tribal-academic-practice collaborations to improve the care of Native populations.

University of Arizona Health Sciences

 

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Angela Acuna (center), flanked by nursing faculty members Sharon Hom, PhD, RN, (left) and Timian Godfrey, DNP, (right), graduated from the University of Arizona College of Nursing with a bachelor’s degree in 2022 and benefitted from the INCATS program, which provides Indigenous students with financial support to pursue a nursing degree.

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Credit: Photo Credit: Photo by Kris Hanning, U of A Health Sciences Office of Communications

Indigenous students pursuing nursing careers at the University of Arizona College of Nursing will benefit from additional financial support thanks to a $1.6 million grant from the U.S. Department of Health and Human Services’ Indian Health Service.

The grant will fund the successful Indians in Nursing: Career Advancement and Transition Scholars, or INCATS, program for another five years. The program provides Indigenous students at the U of A College of Nursing with financial support for tuition, fees and a living stipend.

Additionally, the grant provides resources for dedicated time and personnel to partner with tribal communities in Arizona, fostering outreach and engagement efforts to inspire Indigenous youths to pursue nursing careers.

“This grant provides critical resources that not only support our Indigenous nursing scholars but also help us connect with tribal communities in Arizona to strengthen the tribal nursing workforce,” said Timian Godfrey, DNP, an associate clinical professor at the College of Nursing and director of the INCATS program. 

Indigenous students pursuing nursing careers stand to gain significantly from INCATS funding, with an overall goal to ultimately improve health care in Native American communities. The program was developed to increase the number of highly trained and skilled Native American nurses in tribal health care facilities and create new pathways for nurses with two-year associate degrees to advance their careers.

Godfrey, who is Diné (Navajo), said the program has supported 13 Native American students, 10 of whom have graduated, in advancing their nursing education and careers.

“This grant provides a valuable opportunity to educate, train, mentor and graduate more Indigenous nurses from the University of Arizona who will then go on to work with Indigenous peoples and support the health of those respective communities,” Godfrey said. “The goal of this work is to advance health equity for Indigenous peoples, and education is a key component of health for a community.”

“This additional funding from the Indian Health Service is a vote of confidence in our program and, more importantly, our Native American students,” said Brian Ahn, PhD, dean of the College of Nursing. “The INCATS program has a successful record of increasing the number of Indigenous nurses in Arizona, and we look forward to expanding that impact over the next five years.”

Godfrey said the grant should fully support four to six Indigenous students during each of the next five years, providing them with the tools and education they need to succeed in the nursing profession. 

“The INCATS program is a model for the nation about how to diversify the nursing workforce and educate the next generation of Indigenous nurses,” said Terry Badger, PhD, RN, a professor, the director of research initiatives and the Eleanor Bauwens Endowed Chair at the College of Nursing.

Cold math, hot topic: Sea ice thermal conductivity

Mathematicians crack a sea ice puzzle that could reshape climate models

Macquarie University

 

image: 

An upside-down sea ice slab showcasing brine channels that facilitate the drainage of liquid brine and support convection along the interface. Photo credit: Ken Golden, 2007, Antarctica.

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Credit: Professor Ken Golden

A new applied mathematical theory could enhance our understanding of how sea ice affects global climate, potentially improving the accuracy of climate predictions.

The authors of a new paper published in the Proceedings of the Royal Society A on 28 August, offer new insights into how heat travels through sea ice, a crucial factor in regulating Earth's polar climate.

Dr Noa Kraitzman, Senior Lecturer in Applied Mathematics at Macquarie University and lead author of the study, says the research addresses a key gap in current climate modelling.

“Sea ice covers about 15 per cent of the ocean’s surface during the coldest season when it's at its vast majority,” Dr Kraitzman says. “It’s a thin layer that separates the atmosphere and the ocean and is responsible for heat transfer between the two.”

Sea ice acts as an insulating blanket on the ocean, reflecting sunlight and moderating heat exchange. As global temperatures rise, understanding how sea ice behaves will become increasingly important for predicting climate change.

The study focuses on the thermal conductivity of sea ice, a critical parameter used in many global climate models. The movement of liquid brine within sea ice, which can potentially increase its heat transport, was not accounted for in previous models.

Dr Kraitzman says the unique structure of sea ice, along with its sensitive dependence on temperature and salinity, means it is challenging to measure and predict its properties, specifically its thermal conductivity.

“When you look at sea ice on a small scale, what makes it interesting is its complex structure because it’s made up of ice, air bubbles, and brine inclusions.

“As the atmosphere above the ocean becomes extremely cold, below minus 30 degrees Celsius, while the ocean water remains at about minus two degrees, this creates a large temperature difference, and the water freezes from the top down.

“As the water freezes rapidly, it pushes out the salt, creating an ice matrix of purely frozen water which captures air bubbles and pockets of very salty water, called brine inclusions, surrounded by nearly pure ice.”

These dense brine inclusions are heavier than the fresh ocean water which results in convective flow within the ice, creating big ‘chimneys’ where liquid salt flows out.

The research builds on earlier field work by Trodahl in 1999, which first suggested that fluid flow within sea ice might enhance its thermal conductivity. Dr Kraitzman’s team has now provided mathematical proof of this phenomenon.

“Our mathematics definitely shows that such an enhancement should be expected once convective flow within the sea ice begins,” Dr Kraitzman says.

The model also offers a way to relate the sea ice’s thermal properties to its temperature and salt content, allowing theoretical results to be compared with measurements.

Specifically, it provides a tool to be used in large-scale climate models, potentially leading to more accurate predictions of future conditions in the polar regions.

Sea ice in the Arctic has been declining rapidly in recent decades. This loss of ice can lead to a feedback loop: as more dark ocean water is exposed, it absorbs more sunlight, leading to further warming and ice loss.

The loss of sea ice can affect weather patterns, ocean circulation, and marine ecosystems far beyond the polar regions.

Dr Kraitzman says understanding the thermal conductivity of sea ice is important for predicting its future.

The researchers note that while their model provides a theoretical framework, more experimental work is needed to integrate these findings into large-scale climate models.

The study was conducted by mathematicians from Macquarie University in Australia, the University of Utah and Dartmouth College, New Hampshire in the USA.

It was supported by funding from the US National Science Foundation.

Dr Noa Kraitzman, Senior Lecturer in Applied Mathematics, School of Mathematical and Physical Sciences, Macquarie University

Credit

Noa Kraitzman

DOI

10.1098/rspa.2023.0747 

Method of Research

Computational simulation/modeling

Subject of Research

Not applicable

Article Title

Homogenisation for convection-enhanced thermal transport in sea ice

Article Publication Date

28-Aug-2024

 

Moths may use disco gene to regulate day/night cycles

Florida Museum of Natural History

 

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Yash Sondhi went looking for differences in color vision between two closely related moths, one of which is active at night and the other during the day. Instead, he found differences in the way they kept time.

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Credit: Jeremy Squire

How does one species become two? If you’re a biologist, that’s a loaded question. The consensus is that, in most cases, the process of speciation occurs when individuals from a single population become geographically isolated. If they remain separate long enough, they lose the ability to interbreed.

A new study published in the journal Proceedings of the Royal Society B: Biological Sciences demonstrates what happens when a less common form of speciation occurs. Rather than being separated by a physical barrier, such as a mountain range or an ocean, members of a species can become separated in time.

The researchers focused on two closely related moth species with overlapping ranges in the southeastern United States.

“These two are very similar,” said lead author Yash Sondhi, who conducted research for the study while working at Florida International University and later at the Florida Museum of Natural History. “They’ve differentiated along this one axis, which is when they fly.”

Rosy maple moths, in the genus Dryocampa, look like what you’d get if Roald Dahl painted something from a fever dream. They bear a thick lion’s mane above their head and abdomen, and their vibrant scales are the color of strawberry and banana taffy. Both male and female rosy moths fly exclusively at night.

Pink-striped oakworm moths, in the genus Anisota, are less flashy, with subtle grades of ochre, umber and marl. While females of this species are active at dusk and early evening, the males prefer to fly during the day.

Sondhi knew from previous research that these two groups, Dryocampa and Anisota, originated from a single species approximately 3.8 million years ago, which is relatively recent on evolutionary time scales. There’s a handful of species in the genus Anisota, all of which are active during the day. The nocturnal rosy maple moths are the only species in the genus Dryocampa.

Sondhi specializes in the biology of insect vision and saw the moth pair as the perfect opportunity to explore how vision evolves when a species switches up its pattern of activity.

But things didn’t go as planned.

“I went in looking for differences in color vision. Instead, we found differences in their clock genes, which in hindsight makes sense,” Sondhi said.

Clock genes control the circadian rhythm of plants and animals. The ebb and flow of the proteins they create causes cells to become either active or dormant over a period of roughly 24 hours. They affect everything from metabolism and cell growth to blood pressure and body temperature.

For any organism reversing its pattern of activity, clock genes are virtually guaranteed to be involved. “It’s a system that’s been retained in everything from fruit flies to mammals and plants. They all have some kind of time-keeping mechanism,” he said.

Sondhi compared the transcriptomes of the two moths. Unlike genomes, which contain the entirety of an organism’s DNA, transcriptomes contain only the subset of genetic material that is being actively used to make proteins. This makes them useful for exploring differences in protein levels throughout the day.

As expected, Sondhi found a number of genes that were expressed in different quantities in the two moth species. Nocturnal rosy maple moths invested more energy in their sense of smell, whereas the day-flying oakworm moth produced more genes associated with vision.

There were, however, no differences in the genes that confer the ability to see color. That doesn’t necessarily mean that their color vision is identical, but if differences do exist, they are likely at the level of tuning and sensitivity and not in the structure of the genes themselves.

There was an additional gene that stood out. Disconnected, or disco, was expressed at different levels during the day and night in both species. In fruit flies, disco is known to indirectly influence circadian rhythms through the production of neurons that transmit clock enzymes from the brain to the body.

The disco gene Sondhi found in his moth samples was twice the size of its fruit fly counterpart, and it had additional zinc fingers — active portions of a gene that directly interacts with DNA, RNA and proteins. It seemed likely that changes in the disco gene were at least partially responsible for the switch to night-flying in rosy maple moths.

When he compared the disco gene of rosy maple moths with the one in oakworms, he found 23 mutations that made each distinct from the other. The mutations were also located in active portions of the gene, meaning they likely contribute to observable physical differences between the moths. Sondhi was looking at evolution in action.

“If this is functionally confirmed, this is a really concrete example of the mechanism behind how they speciated at the molecular level, which is rare to come by,” he said.

The study is also an important push for a better understanding of the various ways in which life sustains and propagates itself. When genetics first became a field of study, researchers focused most their efforts on a few representative species, such as fruit flies or lab mice. This was done primarily for the sake of expediency, but it limits how much we know about broad biological patterns. Just as a human is not a lab mouse, a moth is not a fruit fly.

“As species continue to decline due to climate change and other anthropogenic changes, we’ll need to genetically engineer a greater number of the ones that remain to enable drought tolerance, for example, or to be active in light polluted regimes. To do that consistently, having a broader pool of functionally characterized genes across organisms is crucial. We can’t just use Drosophila,” Sondhi said.

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The Florida Museum of Natural History has been inspiring people to value and protect the biological richness and cultural heritage of our diverse world for more than a century. Located on the University of Florida campus, the Florida Museum is home to more than 40 million specimens and artifacts, one of the nation’s largest natural history collections. For more Florida Museum research and collections news, visit www.floridamuseum.ufl.edu/science/ or follow us on social media, @FloridaMuseum.

As their name implies, rosy maple moths often use maple trees as host plants. Their caterpillars can be so numerous and voracious that they sometimes strip away the leaves on a tree.

Credit

Jeremy Squire

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Journal

Proceedings of the Royal Society B Biological Sciences

DOI

10.1098/rspb.2024.0591 

Article Title

Day-night gene expression reveals circadian gene disco as a candidate for diel-niche evolution in moths

Article Publication Date

28-Aug-2024

 

Henna secures $30,000 from PSU’s University Venture Development Fund to enhance AI fairness & safety

Portland State University

UVDF Funding, Henna

Henna Secures $30,000 from PSU’s University Venture Development Fund to Enhance AI Fairness & Safety

Portland, OR – August 13, 2024 – Henna, a startup with deep ties to Portland State University (PSU), has successfully secured $30,000 in funding from the University Venture Development Fund (UVDF). This grant will support Henna's mission to make AI adoption fairer and safer.

Henna was founded earlier this year by Arsh Haque (they/them), Chair of the Diversity, Equity, & Inclusion (DEI) Committee for the Research & Graduate Studies (RGS) department at PSU. “PSU has been integral in building the foundation for our startup” said Haque. “Our AI methods are based on DEI innovations I developed at and that they we have licensed from PSU, our prototype was built in collaboration with capstone students in Computer Science, and we ran our first pilot programs with units in RGS.”

With UVDF funds, Henna has brought on Joel Porter (he/him) as a CTO and is on track to launch a no-code auditing platform later this fall. The platform is designed to provide teams assurances that the way they use AI tools minimizes risks to compliance, reputation, and fairness.

In collaboration with leading AI experts, Henna is actively working on multiple projects to close the gap between theoretical AI safety advancements and their practical application. One such project that UVDF also supports is a public leaderboard that evaluates the bias of publicly available language models (LLMs) based on landmark economic research and open source AI safety standards.

As Henna grows, it remains committed to creating tools that empower organizations to use AI responsibly and effectively, and looks forward to continuing to collaborate with PSU to make that happen.

For more information about Henna and its work in AI fairness and safety, please visit www.askhenna.com.

About Henna:

Henna is a spinout from Portland State University dedicated to providing a safe pathway for organizations to adopt AI technologies. By offering a no-code platform for AI audits, Henna helps ensure that AI tools are fair, inclusive, and safe, supporting organizations in their journey towards responsible AI integration.

About the University Venture Development Fund:

The University Venture Development Fund (UVDF) is an initiative by the Oregon state legislature that allows public universities to support the commercialization of promising technologies. Through UVDF, universities like Portland State University can invest in spinout companies, providing them with the resources needed to bring innovative solutions to market.

 

A world mired in conflict calls for international tribunals that play multiple roles

Radboud University Nijmegen

The International Court of Justice in The Hague has been busier than ever in recent years: it has been asked to render judgments and issue advisory opinions on conflicts in Gaza, Ukraine and Myanmar, among others, and it settles border disputes all over the world. What roles does this Court of Justice play in such cases, and how can its authority be explained? Rosa Möhrlein examined these questions and will defend her PhD thesis at Radboud University on 28 August.

In national legal systems such as that of the Netherlands, the roles and powers of a court, court of appeal or tribunal are fairly clear. It is different for international tribunals, which operate in the international legal system, partly due to the fact that regulations have not been drawn up by a central legislative body. The absence of any compulsory jurisdiction for international tribunals is also often cited as a complicating factor.

Delicate balance

Möhrlein: “An international court therefore constantly faces challenges relating to its roles and has to try to strike a delicate balance: offering a resolution to the dispute without antagonising the parties.” In her research, Möhrlein deconstructs various rulings and advisory opinions by a number of interstate tribunals: the International Court of Justice (not to be confused with the International Criminal Court), the International Tribunal for the Law of the Sea and the Appellate Body of the WTO. Based on i) the legal issues of the dispute, ii) the application and interpretation of the law in the relevant case and iii) the answer or conclusion given by these tribunals, she identifies five judicial roles: dispute resolution, legal clarification, judicial lawmaking, legitimation, and control and compliance.

“Dispute resolution is often cited as the cornerstone of international law,” explains Möhrlein. “Understandably so, as interstate tribunals have often been established with the notion that they provide an alternative to armed conflict. But it is usually unclear exactly what dispute resolution entails and where the boundaries lie for what a court actually does within this role. In addition, other important roles are performed that also matter greatly for the development of stable relations between states as well as the formation and interpretation of the law. It is important to have a clear picture of those roles because that also explains why a court has and maintains authority.” 

Crowbar

“Judicial lawmaking involves not just applying the law, but also providing interpretations relating to how the law should be understood in case of gaps and in new areas of law. This is a controversial role given that it could see the International Court of Justice encroach too much on territory where only states have competence: the creation of new obligations in international law. Legitimation is also an important role in international rulings and advisory opinions. One example is the advisory opinion in the Namibia case, where the situation was politically deadlocked and the request for an opinion was supposed to signal a breakthrough. If you do it wrong, it becomes a controversial crowbar; if you do it right, it delivers valuable guidance.

Möhrlein’s research offers explanations as to why international tribunals possess authority and why many states (continue to) knock on the Court’s door. “On the one hand, there is a perception that a court of this nature is limited in what it can achieve due to its focus on dispute resolution. On the other hand, rulings and advisory opinions are frequently used as arguments in other cases, including national ones. One explanation for this is that the International Court of Justice goes beyond simply performing a dispute resolution role. You can see this, for example, in the advisory case relating to the wall Israel built around the West Bank. The Court of Justice issued an advisory opinion on this in 2004 and again last July. While these opinions are not (so far) improving the situation on the ground, they are seen as a guide to what is permissible in international law in this area and what is not. Moreover, they can damage a country’s reputation and offer direction in terms of how the conflict is talked about.” This may be why states continue to turn to the International Court of Justice. 

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Article Title

The Multiplicity of Judicial Functions of International Courts and Tribunals. An Inquiry with a focus on the International Court of Justice

Article Publication Date

28-Aug-2024

 

Pregnancy after sterilization turns out to be surprisingly common

University of California - San Francisco

Study led by UCSF estimates 3 to 5% of women have unplanned pregnancies following “permanent” sterilization  

Tubal sterilization is thought to be a permanent form of birth control and is the most common method of contraception nationally. But a new study led by UC San Francisco reports that tubal surgery fails often enough that some other forms of birth control are usually more effective.  
 
The authors found that 3 to 5% of women in the United States who had their tubes tied later reported an unplanned pregnancy. This failure rate led the authors to suggest that patients who really want to avoid future pregnancy should instead use a contraceptive arm implant or intrauterine device (IUD).  
 
The paper appears August 27 in NEJM Evidence.  
 
Interest in permanent contraception has risen since the 2022 U.S. Supreme Court Dobbs decision removed federal protections for abortion services and limited access to abortion services in many states. As a result, the researchers say that information about contraceptive effectiveness is especially important. 
 
“Since the Dobbs decision, many more people are worried about how pregnancy may impact their health and family life,” said first author Eleanor Bimla Schwarz, MD, chief of the UCSF Division of General Internal Medicine at Zuckerberg San Francisco General. “This is especially true for patients with medical conditions like diabetes and high blood pressure that can complicate pregnancy. 
 
“This study shows that tubal surgery cannot be considered the best way to prevent pregnancy,” Schwarz said. “People using a contraceptive arm implant or an IUD are less likely to become pregnant than those who have their tubes tied.”  
 
Many U.S. women get tubal surgeries  
 
About 65 percent of women 15 to 49 in the U.S. use birth control, according to national statistics, and tubal sterilization – an abdominal surgery in which the fallopian tubes are clamped or cut and removed – is used by more than 21% of women ages 30 to 39, and 39% of women older than 40. These surgeries are especially common among low-income people and those with chronic medical conditions. 
 
Tubal sterilization aims to permanently end fertility, but as previously reported, women can nonetheless get pregnant. Based on older studies, the American College of Obstetricians and Gynecologists has advised that fewer than 1% of patients become pregnant after tubal sterilization.  
 
In the new study, the authors examined four independent rounds of the National Survey of Family Growth from 2002 to 2015. Data were collected from more than 31,000 women, including 4,184 who reported having undergone tubal sterilization and were the focus of the study.  
 
Within the first year after tubal surgery, the researchers estimated that 2.9% of those who reported having been sterilized in 2013 to 2015 became pregnant. The chance of pregnancy was highest among those who were younger at the time of their tubal surgery.  
 
Patients who had Medicaid-funded procedures were not more likely than those with private insurance to become pregnant. In recent years, the proportion of respondents who reported a tubal sterilization funded by Medicaid has increased from 18% in 2002 to about 36% from 2013 to 2015.  
 
“When choosing what birth control will work best for them, people consider many different things including safety, convenience and how fast they can start to use the method,” Schwarz said. “For people who have chosen a ‘permanent’ method, learning they got pregnant can be very distressing. It turns out this is unfortunately a fairly common experience.”  
 
Authors: Besides Schwarz, authors are Amy Yunyu Ciang, PhD, of UCSF; Carrie A. Lewis, MPH, of the Center for Healthcare Policy and Research at UC Davis; Aileen M. Gariepy, MD, of Weill Cornell Medicine at Cornell University; and Matt Reeves, MD, of the Bloomberg School of Public Health at Johns Hopkins University. 

Funding: The paper was funded in part by an AHRQ R18 grant. The authors disclose no conflicts of interest. 

 

About UCSF: The University of California, San Francisco (UCSF) is exclusively focused on the health sciences and is dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. UCSF Health, which serves as UCSF's primary academic medical center, includes top-ranked specialty hospitals and other clinical programs, and has affiliations throughout the Bay Area. UCSF School of Medicine also has a regional campus in Fresno. Learn more at ucsf.edu, or see our Fact Sheet.

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Journal

NEJM Evidence

 

Harm reduction education, tools access may help women prevent opioid overdose

Women with opioid use disorders face structural barriers and stigma that may keep them from engaging with traditional harm reduction practices that could reduce opioid overdoses, researchers find

Penn State

UNIVERSITY PARK, Pa. — Woman with opioid use disorder and who are also involved with the criminal legal system face unique challenges and stigmas that may keep them from seeking substance use treatment and harm reduction tools that could prevent overdose deaths, according to new research led by a team from Penn State. Harm reduction strategies are evidence-based practices to engage people who use drugs and provide them with tools and information to reduce the risk of overdose. These practices can play a critical role in addressing the overdose crisis in the United States, especially when tailored to address women’s needs.

Through in-depth interviews with women with opioid use disorder and professionals who work with them, the researchers identified recommendations for more effective drug treatment programs. Recommendations include increasing the accessibility of harm reduction tools, expanding harm reduction education and shifting away from “abstinence only” paradigms within substance use treatment programs.

They published their findings in the journal Psychology of Addictive Behavior.

“Improving engagement in overdose prevention and harm reduction practices is one challenge that must be addressed to mitigate the impacts of the U.S. overdose crisis,” said Eric Harrison, graduate student in the human development and family studies program at Penn State and lead author of the paper. “Finding ways to teach women with opioid use disorder about harm reduction, more effectively distribute harm reduction tools to them and reduce stigma among providers and professionals is essential to reduce overdose risk for women with opioid use disorder.”

According to the Centers for Disease Control and Prevention, nearly 108,000 people died from drug overdoses in 2022, 76% of which involved an opioid. However, there is limited research that examines the risk factors for overdose particularly among women who may face different challenges compared to men.

“Women who use drugs are heavily stigmatized because many are also mothers. This stigma may prohibit women from seeking harm reduction programs and substance use treatment,” said Abenaa Jones, the Ann Atherton Hertzler Early Career Professor in Health and Human Development, assistant professor of human development and family studies and senior author of the paper.

Women who use drugs and are involved in the criminal legal system are in a particularly vulnerable state, the researchers said. Not only do they face a high chance of overdose immediately following release but involvement in the criminal legal system also imposes longer-term challenges to recovery.

“These stigmas and barriers can make it hard to attain the forms of ‘recovery capital’ that are so needed to sustain recovery,” said Kristina Brant, assistant professor of rural sociology and co-author of the study. “Finding unique ways to support this group facing so many intersecting vulnerabilities is essential to promoting well-being.”

Researchers conducted in-depth interviews with 20 women with an opioid-use disorder and history of criminal justice involvement, 12 substance use disorder treatment professionals and 10 criminal justice professional who have worked with women with opioid use disorder, all of whom were based in Pennsylvania. 

The interviews explored the women’s personal experience with overdose, their use or knowledge of overdose prevention techniques and barriers faced when accessing or using those techniques or the professionals’ experience working with women with opioid use disorder. In these conversations, the researchers also parsed the challenges that pregnant people and mothers face when seeking treatment. They detailed those findings in a paper published earlier this year.

From these interviews, they also found that there’s a lack of knowledge about harm reduction practices. Women may not be aware of tools like naloxone — or Narcan, a medication that can reverse overdose from opioids — and fentanyl testing strips, where to access them and how to use them, which severely limits their usefulness in preventing overdose. In some cases, this could be attributed to low communication between substance use treatment professionals and clients or insufficient aftercare support following an overdose. Without proper tools or knowledge, women may turn to strategies that may be ineffective or even harmful.

“Harm reduction tools like Narcan are more common today, but we need to consider the implications of effectively getting Narcan into everyone's hands. Even with Narcan available over the counter, there are still people who may never purchase it,” Harrison said, explaining that stigma may prevent the purchase, especially for women who fear possible legal or child custody repercussions. “Increasing accessibility and expanding education around naloxone and other harm reduction tools, especially to individuals not directly connected to substance use, is an important consideration.”

The findings also highlight important differences in perspective between women with opioid use disorder and the professionals who work with them, the researchers said. While both groups noted a heightened vulnerability to overdose because of a drug supply increasingly contaminated with substances like fentanyl and xylazine, some of the professionals drew on a narrative that people put themselves at risk by seeking out more potent substances and weren’t concerned about overdosing.

“The women never put this blame on themselves or others who use drugs, instead telling us about the dangers of a toxic drug supply and lack of access to tolls that can help assess drug type, like fentanyl testing strips, and help people make decisions about how to reduce risk,” Brant said.

In order to prevent opioid overdose, the researchers said there needs to be increased access to naloxone and other harm reduction tools, expanded harm reduction education and a shift away from “abstinence only” paradigms within substance use treatment programs.

“Some people may not seek help because they don’t want to pursue total abstinence,” Harrison said. “We need more open discussions about overdose prevention and harm reduction and more socially accepted options to help save lives by meeting people where they are without bias or judgment.”

The study’s findings will inform the design of a comprehensive intervention for women with opioid-use disorder and involved in the criminal legal system. The program integrates substance use treatment with peer support, overdose response training, access to overdose reversal drugs, and assistance with transportation, childcare and housing. Half of the women will be randomly selected to participate in a trauma support group.

“These components are rarely offered in tandem with substance use treatment. This research is assessing if having this comprehensive program is linked with better substance use and social outcomes,” Jones said.

Other Penn State authors on the paper include Emma Skogseth and Sienna Strong-Jones, graduate students in human development and family studies. Carl Latkin, vice chair, department of health, behavior and society at Johns Hopkins University also contributed to the paper.

Funding from the National Institute on Drug Abuse and the Social Science Research Institute at Penn State supported this work.

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Journal

Psychology of Addictive Behaviors

DOI

10.1037/adb0001021 

Method of Research

Survey

Subject of Research

People

Article Title

Challenges and Recommendations for Overdose Prevention and Harm Reduction in an Era of Fentanyl and Xylazine: Perspectives of Women With Opioid Use Disorder and Professionals

Article Publication Date

27-Aug-2024