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Objective: The present study aimed to examine the effect of group assertive training on self‐esteem and quality of life among spouses of drug‐abusing patients. Methods: This randomized clinical trial assignment study with a control group. The statistical population included all spouses of drug users referring to private addiction treatment centers in Tehran‐Iran in 2020 and the sample included 50 spouses of drug users who were selected by simple random sampling from among the volunteers. They were randomly divided into two groups control and experimental, each group consisting of 25 people. Results: The results of data analysis showed that group assertive training increased self‐esteem and quality of life in spouses of drug‐abusing patients in the experimental group compared to the witness group (p <.001). Conclusion: As a result, group assertive training is effective in increasing the self‐esteem and quality of life among the spouses of drug‐abusing patients. [ABSTRACT FROM AUTHOR]

Background Guidelines support the use of toxin tests after C. difficile antigen detection or nucleic acid amplification tests (e.g. PCR) to help clinicians distinguish colonization from infection and reduce overdiagnosis but the safety of toxin-based diagnostic approaches remains controversial. Methods Five California hospitals monitored hospitalized adults with C. difficile testing before and after operational changes to reduce test-related overdiagnosis (2016–2018). Four added a toxin test to an existing GDH antigen/PCR-based approach and/or changed reporting to encourage the use of toxin results for clinical decision-making (i.e."toxin-dominant reporting"). One used the same test (toxin only) and reporting strategy throughout. All used a standardized tool to document clinical outcomes and treatment four days after testing (i.e. Day 5). Results In total, 1,034 patients had a Day 5 assessment with PCR-dominant reporting (pre-operational changes); 2,511 patients had a Day 5 assessment with toxin-dominant reporting (post-operational changes and single facility with no test change). Fewer Toxin-negative/PCR-positive (Toxin−/PCR+) patients received treatment with toxin-dominant reporting (median change: −52.1% [interquartile range (IQR): −35.1%, −69.1%]; aggregate P < 0.001). Day 5 outcomes were similar or better with toxin-dominant reporting despite less treatment. Patient discharge rates and in hospital diarrheal recovery was greater in the subset of Toxin−/PCR+ patients during the toxin-dominant reporting period: median discharge rate change = 8.8% [IQR: 1.5%, 11.9%] (aggregate P = 0.04); median diarrheal recovery rate change = 11.8% [IQR: 8.8%, 18.2%] (aggregate P = 0.018). Conclusion In a 5-center study, toxin-dominant test result reporting decreased anti- C. difficile treatment and improved discharge rates and diarrheal recovery in Toxin−/PCR+ patients. More work is needed to determine the rate of C. difficile -related adverse events in Toxin−/PCR+ patients. Disclosures All Authors: No reported Disclosures. [ABSTRACT FROM AUTHOR]