17 results on '"E. Pivovarova"'
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2. Factors affecting problem-solving court team decisions about medications for opioid use disorder.
- Author
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Andraka-Christou B, Viglione J, Ahmed F, Del Pozo B, Atkins DN, Clark MH, Totaram R, and Pivovarova E
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- Humans, Methadone therapeutic use, Male, Female, Decision Making, Problem Solving, Adult, United States, Focus Groups, Analgesics, Opioid therapeutic use, Opioid-Related Disorders psychology, Opiate Substitution Treatment, Buprenorphine therapeutic use
- Abstract
Background: Problem-solving courts (PSCs) provide alternatives to prosecution and incarceration for drug-related crimes and offer integrated support for people who have lost custody of children due to drug use. Methadone and buprenorphine are lifesaving medications for opioid use disorder (MOUD) but are underused by PSC clients. Even when PSCs lack a court-level prohibition against MOUD, court staff still make individualized decisions about whether a court client can use MOUD. Therefore, we sought to identify factors involved in such individualized PSC court decisions about clients' use of MOUD., Methods: We conducted semi-structured interviews and focus groups between Summer and Fall 2022 with a convenience sample of 54 PSC staff members from 33 courts across four states. Data were analyzed using iterative categorization., Results: Interviewees indicated that their courts had eliminated blanket prohibitions against MOUD due to federal and state policy funding requirements, widespread dissemination of voluntary best practice standards, fear of lawsuits, and MOUD education targeting courts. Courts allowed MOUD if the court client accessed it through a treatment provider with whom the court collaborates. Some courts only allowed court clients to access MOUD from non-partnering treatment providers after a court-led "vetting" process of the proposed MOUD provider. MOUD provider characteristics considered during the vetting process included the provider's willingness to communicate with the court, frequent drug testing, adjustments of medication or dosage in response to aberrant results, offering of counseling, and acceptance of Medicaid or sliding scale payments. PSC staff were least comfortable with court clients using methadone treatment., Conclusions: The presence (or lack of) a PSC-MOUD partnership is a key factor involved in court staff decisions when a court client desires MOUD. Therefore, increasing the number of partnerships between PSCs and MOUD providers could lead to higher rates of MOUD utilization. It is unclear whether court-led vetting processes for non-partnering MOUD treatment providers are necessary or appropriate, and such vetting processes could reduce treatment choice or access in communities with few MOUD providers., Competing Interests: Declaration of competing interest Authors have no conflicts of interest to declare., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
- Published
- 2025
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3. Medication for Opioid Use Disorders (MOUD) Providers' Experiences with Recovery Courts: Qualitative Study of Individual and Systemic Factors Impacting Interagency Collaboration.
- Author
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Pivovarova E, Taxman FS, Boland AK, Andraka-Christou B, De La Cruz BA, Smelson D, Lemon SC, and Friedmann PD
- Abstract
Background: Recovery courts mandate substance use disorder treatment as an alternative to prosecution or incarceration but lack internal resources to offer treatment. Hence, recovery courts must rely on community-based providers to ensure access to care. Interagency collaborations between recovery courts and providers of medications for opioid use disorders (MOUD) are often challenging. This qualitative study aimed to understand community-based MOUD providers' perspectives on collaboration with recovery courts., Methods: Semi-structured, hourlong interviews were conducted with 24 providers from 11 community agencies about their experiences and perceptions of working with recovery courts. Consolidated Framework for Implementation Research informed study design, coding, and analysis., Results: At the individual-level domain, lack of knowledge about recovery courts and overall negative impressions of the criminal legal system were impediments to collaboration. Inner setting factors such as staffing shortages and provider roles in establishing therapeutic relationships limited active engagement in interagency collaboration. Outer setting domains such as communication barriers (eg, requirement of multiple release forms, lack of knowledge about who needed what information and when) and nonresponse from the courts were frequently referenced. Providers, however, also noted that direct experience with recovery court staff, especially in person, and recognition of mutual agency goals to ensure individuals receive proper care and remain in the community served as facilitators., Discussion: While interagency collaboration is essential to ensuring that individuals in recovery courts can access MOUD, providers identify individual- and system-level barriers that impact collaboration with recovery courts. Results from providers mirror findings from recovery court staff that note communication barriers, distrust toward external agencies, and limited resources for active collaboration. Findings highlight areas where implementation strategies to improve collaboration can be targeted to ensure that individuals in recovery courts can access and remain in MOUD treatment., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
- Published
- 2024
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4. Collaborating With Jails to Provide Community-Based Medication for Opioid Use Disorder: Qualitative Perspectives from MOUD Treatment Providers.
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Pivovarova E, Planas Garcia BY, Friedmann PD, Stopka TJ, Santelices C, and Evans EA
- Abstract
Objectives: As carceral settings increasingly offer medications for opioid use disorders (MOUD), community-based providers will need to navigate relationships with correctional agencies to ensure continuity of MOUD upon release. Although collaboration has been identified as critical between agencies, limited research is available that details how providers can work with jails. We describe the perspectives of MOUD providers about their experiences collaborating with jails that had recently begun to offer MOUD., Methods: We conducted hour-long interviews with 36 MOUD providers from 18 community-based agencies. Exploration, Preparation, Implementation, and Sustainment (EPIS) concepts informed data collection and analysis., Results: MOUD providers described agency-specific (inner context) factors that facilitated collaboration, including staffing (employing staff with knowledge of co-occurring conditions) and agency culture (adaptability to change, recognition of gaps in services, being judgment-free). Providers also reported external factors as facilitators, such as broad community support of MOUD services and provision of training about MOUD to jail staff. Holding regular meetings, with a dedicated contact person, helped to overcome communication problems. However, the fragmentation of in-jail treatment services, exacerbated by jails' contracting with different healthcare providers, made it difficult to coordinate re-entry and establish agency relationships. Actively and intentionally building interagency partnerships and collaborating across interagency cultural and structural differences were bridging factors that developed and sustained collaborations., Conclusions: Our findings offer promising suggestions for establishing collaborations with carceral partners, including assessing internal agency conditions, seeking external community supports, committing to actively engaging and sustaining collaborations, and using interagency differences to develop mutually beneficial relationships., Competing Interests: Conflict of interest: None., (Copyright © 2024 American Society of Addiction Medicine.)
- Published
- 2024
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5. Perceptions of extended-release buprenorphine among people who received medication for opioid use disorder in jail: a qualitative study.
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Stopka TJ, Rottapel R, Friedmann PD, Pivovarova E, and Evans EA
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- Humans, Male, Female, Adult, Middle Aged, Massachusetts, Jails, Prisoners, Interviews as Topic, Narcotic Antagonists administration & dosage, Narcotic Antagonists therapeutic use, Buprenorphine administration & dosage, Buprenorphine therapeutic use, Opioid-Related Disorders drug therapy, Qualitative Research, Delayed-Action Preparations, Opiate Substitution Treatment methods
- Abstract
Background: Incarceration provides an opportunity for health interventions, including opioid use disorder (OUD) treatment and prevention of opioid-related overdoses post-release. All FDA-approved forms of medication for OUD (MOUD) treatment were mandated in several Massachusetts jails in 2019, with some jails offering extended-release buprenorphine (XR-Bup). Little is known about patient perspectives on and experiences with XR-Bup in carceral settings., Methods: We conducted semi-structured interviews in 2022 with community-dwelling people who received MOUD during a recent incarceration in a Massachusetts jail. We asked participants about their experiences with and perspectives on XR-Bup while in jail. Qualitative data were double-coded deductively and reviewed inductively to identify emergent themes, which were structured using the Theoretical Framework of Acceptability (TFA)., Results: Participants (n = 38) had a mean age of 41.5 years, were 86% male, 84% White, 24% Hispanic, and 95% continued to receive MOUD at the time of their interview, including 11% receiving XR-Bup. Participants who viewed XR-Bup favorably appreciated avoiding the taste of sublingual buprenorphine; avoiding procedural difficulties and indignities associated with daily dosing in carceral settings (e.g., mouth checks, stigmatizing treatment from correctional staff); avoiding daily reminders of their addiction; experiencing less withdrawal; having extra time for other activities, such as work; and reduction of diversion of MOUD within the jail setting. Participants who viewed XR-Bup less favorably preferred to maintain their daily dosing routine; liked daily time out of their housing unit; wanted to know what was "going into my body everyday"; and feared needles and adverse events. Participants also reported that jail clinicians used XR-Bup for patients who were previously caught diverting sublingual buprenorphine, suggesting limited patient participation in decision-making around XR-Bup initiation in some jails., Conclusion: People who received MOUD in Massachusetts jails had both favorable and unfavorable views and experiences with XR-Bup. Understanding these preferences can inform protocols in jails that are considering implementation of XR-Bup treatment., (© 2024. The Author(s).)
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- 2024
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6. Diversion of medications to treat opioid use disorder: Qualitative findings from formerly incarcerated adults in Massachusetts.
- Author
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Evans EA, Pivovarova E, Senthilkumar R, Rottapel RE, Stopka TJ, Santelices C, Ferguson WJ, and Friedmann PD
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- Adult, Humans, Massachusetts, Opiate Substitution Treatment, Prisons, Buprenorphine therapeutic use, Opioid-Related Disorders drug therapy, Prisoners
- Abstract
Background: Carceral officials often cite diversion of medication for opioid use disorder (MOUD) (e.g., buprenorphine) as a reason for not offering MOUD treatment in jails and prisons with little understanding of patient perspectives. We aimed to understand patient perceptions of medication diversion from jail-based MOUD programs and the factors that contribute to and reduce diversion., Methods: We conducted thematic analyses of semi-structured interviews held in 2021-22 with 38 adults who received MOUD treatment and were released from eight Massachusetts jails that had implemented a MOUD program on or after September 2019., Results: Consistent with prior reports from carceral staff, patients perceived MOUD diversion to happen less frequently than expected, which they attributed to dosing protocols that have effectively reduced it. Patients reported that MOUD availability reduced the contraband buprenorphine market, although other contraband substances have entered jails (fentanyl, oxycodone, K2). Patients perceived Subutex to have greater misuse potential and added diversion risks. Patients valued graduated consequences and other efforts to reduce MOUD diversion and contraband for making jails safer and for enabling patients to receive treatment. Nearly all participants reported having heard about, witnessed, or been involved in actual or attempted diversion, with variation in reports by jail. Patients suggested that dispensing MOUD to all who need it immediately upon intake would be the most effective way to reduce MOUD diversion and contraband., Conclusion: Formerly incarcerated patients perceived MOUD diversion within jail medication programs as occurring less often than expected and that it can be reduced with appropriate protocols. To help limit medication diversion, patients recommended provision of MOUD upon intake to all individuals with opioid use disorder who need it. Findings have implications for MOUD program adaptation, successful routinization, and diffusion in carceral settings., Competing Interests: Declaration of Competing Interest No financial interests/personal relationships are declared. All procedures were performed in compliance with relevant laws and institutional guidelines and the appropriate institutional committee(s) have approved them. Verbal consent was obtained and the privacy rights of human participants was always observed., (Copyright © 2023 Elsevier B.V. All rights reserved.)
- Published
- 2023
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7. Facilitators and barriers to collaboration between drug courts and community-based medication for opioid use disorder providers.
- Author
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Pivovarova E, Taxman FS, Boland AK, Smelson DA, Lemon SC, and Friedmann PD
- Subjects
- Humans, Methadone therapeutic use, Communication, Jails, Mental Processes, Opioid-Related Disorders drug therapy
- Abstract
Introduction: Access to medications for opioid use disorder (MOUD) is limited for individuals in drug courts - programs that leverage sanctions for mandatory substance use treatment. Drug courts rely on community agencies to provide MOUD. However, relationships with MOUD agencies, which impact access to treatment, are understudied. We examined barriers and facilitators from drug court staffs' perspectives to understand how to enhance collaborations with MOUD providers., Methods: Drug court staff (n = 21) from seven courts participated in semi-structured interviews about their experience in collaborating with MOUD providers. Interviews were informed by the Consolidated Framework for Implementation Research. Inductive (theory-based) and deductive (ground-up) approaches were used for analyses., Results: Facilitator and barrier themes centered around the needs and resources of drug court participants, external policies such MOUD access in jails, networking with external agencies, and beliefs about MOUD providers. Drug court staff preferred working with agencies that offered MOUD alongside comprehensive services. Drug courts benefited when jails offered MOUD in-house and facilitated community referrals. Existing relationships with providers and responsive communication eased referrals and served to educate the courts about MOUD. Barriers included logistical limitations (limited hours, few methadone providers) and inadequate communication patterns between providers and drug court staff. A lack of confidence in providers' prescribing practices and concerns around perceived overmedication of participants impacted referrals, interagency collaboration, and further burdened the participants., Conclusions: Collaboration between drug courts and MOUD providers was driven by patient needs, external policies, communication patterns, and perceptions. Interventions to increase access MOUD for drug court participants will need to incorporate collaboration strategies while considering the unique features of drug courts., Competing Interests: Declaration of competing interest None of the authors have any conflicts of interest to report. The views expressed in this article are those of these authors only and do not reflect the position or policies of any of the affiliated agencies., (Copyright © 2023. Published by Elsevier Inc.)
- Published
- 2023
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8. COVID-19 impact on opioid overdose after jail release in Massachusetts.
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Friedmann PD, Dunn D, Michener P, Bernson D, Stopka TJ, Pivovarova E, Ferguson WJ, Rottapel R, Hoskinson R Jr, Wilson D, and Evans EA
- Abstract
Introduction: Release from incarceration is a high-risk period for opioid overdose. Concern about COVID-19 spread in jails led to early releases; it is unknown whether pandemic era releases of persons with opioid use disorder (OUD) contributed to increases in community overdose rates., Methods: Observational data compared overdose rates three months after release among jailed persons with OUD released before (9/1/2019-3/9/2020) and during the pandemic (3/10/2020-8/10/2020) from seven jails in Massachusetts. Data on overdoses come from the Massachusetts Ambulance Trip Record Information System and Registry of Vital Records Death Certificate file. Other information came from jail administrative data. Logistic models regressed overdose on release period, controlling for MOUD received, county of release, race/ethnicity, sex, age, and prior overdose., Results: Pandemic releases with OUD had a higher risk of fatal overdose (adjusted odds ratio [aOR] 3.06; 95% CI, 1.49 to 6.26); 20 persons released with OUD (1.3%) experienced a fatal overdose within three months of release, versus 14 (0.5%) pre-pandemic. MOUD had no detectable relationship with overdose mortality. Pandemic release did not impact non-fatal overdose rates (aOR 0.84; 95% CI 0.60 to 1.18), though in-jail methadone treatment was protective (aOR 0.34; 95% CI 0.18 to 0.67)., Conclusions: Persons with OUD released from jail during the pandemic experienced higher overdose mortality compared to pre-pandemic, but the number of deaths was small. They did not experience significantly different rates of non-fatal overdose. Early jail releases during the pandemic were unlikely to explain much, if any, of the observed increase in community overdoses in Massachusetts., Competing Interests: No conflict declared., (© 2023 The Authors. Published by Elsevier B.V.)
- Published
- 2023
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9. Anticancer and antimicrobial activity of new copper (II) complexes.
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Climova A, Pivovarova E, Szczesio M, Gobis K, Ziembicka D, Korga-Plewko A, Kubik J, Iwan M, Antos-Bielska M, Krzyżowska M, and Czylkowska A
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- Humans, Ligands, Molecular Structure, Spectroscopy, Fourier Transform Infrared, Anti-Bacterial Agents pharmacology, Copper chemistry, Coordination Complexes chemistry
- Abstract
In this study, three new organic ligands N'-(benzylidene)-6-chloropyrazine-2-carbohydrazonamide (L
1 ), 6-chloro-N'-(4-nitrobenzylidene)picolinohydrazonamide(L2 ), and N'-(benzylidene)-4-chloropicolinohydrazonamide (L3 ) and three copper coordination compounds (Cu(L1 )Cl2 , Cu(L2 )Cl2 and Cu(L3 )Cl2 ) based on them were synthesized. All obtained compounds were characterized using appropriate analytical techniques: elemental analysis (EA), thermogravimetric analysis (TG-DTG), Fourier transform infrared spectroscopy (FTIR) and flame-atomic absorption spectrometry (F-AAS). These methods of physicochemical analyses helped to assume that the complexation in three cases proceeds in a bidentate manner. The X-ray investigation confirmed the synthesis pathway and molecular structures for L1 and L3 ligands. The antimicrobial activity of the obtained compounds was then comprehensively investigated, where Cu(L3 )Cl2 showed the strongest antibacterial properties against all tested bacteria (Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli). LN229 human glioma cells and BJ human normal fibroblasts cells were treated with tested compounds and their cytotoxicity was evaluated with MTT test. The effect of complexing on antitumor activity has been investigated. The ligand L1 and its complex showed similar activity against normal cells while complexation increases toxicity against cancer cells in concentrations of 50 and 100 μM. For the one pair of ligand/complex compounds the apoptosis detection, cell cycle analysis and gene expression analysis (qRT-PCR) were performed. Cu(L1 )Cl2 showed the stronger toxic effect in comparison with L1 due to the population of early apoptotic cells which revealed metabolic activity in MTT assay., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)- Published
- 2023
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10. Medication for opioid use disorder treatment continuity post-release from jail: A qualitative study with community-based treatment providers.
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Stopka TJ, Rottapel RE, Ferguson WJ, Pivovarova E, Toro-Mejias LD, Friedmann PD, and Evans EA
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- Humans, Qualitative Research, Grounded Theory, Opiate Substitution Treatment, Opiate Overdose, Drug Overdose drug therapy, Opioid-Related Disorders drug therapy, Buprenorphine
- Abstract
Background: People released from jail are at elevated opioid overdose risk. Medications for opioid use disorder (MOUD) are effective in reducing overdoses. MOUD treatment was recently mandated in seven Massachusetts jails, but little is known about barriers and facilitators to treatment continuity post-release. We aimed to assess MOUD provider perspectives on treatment continuity among people released from jail., Methods: We conducted qualitative interviews with 36 medical, supervisory, and administrative staff at MOUD programs that serve jail-referred patients. We used the Exploration, Preparation, Implementation, and Sustainment (EPIS) implementation science framework to guide development of instruments, codes, and analyses. We employed deductive and inductive coding, and a grounded theory analytical approach to identify salient themes., Results: Inner context findings highlighted necessary adjustments among jail staff to approve MOUD treatment, especially with agonist medications that were previously considered contraband. Participants perceived that some staff within jails favored abstinence-based recovery, viewing agonists as a crutch. Bridging results highlighted the importance of inter-agency communication and coordination to ensure information transfer for seamless treatment continuity in the community post-release. Pre-release planning, release on pre-scheduled dates, medication provision to cover gaps between jail release and intake at community MOUD sites, and exchange of treatment information across agencies were viewed as paramount to success. Unexpected early releases and releases from court were viewed as barriers to treatment coordination. Outer context domains were largely tied to social determinants of health. Substantial barriers to treatment continuity included shelter, food security, employment, transportation, and insurance reactivation., Conclusion: Through qualitative interviews with community-based MOUD staff, we identified salient barriers and facilitators to treatment continuity post-release from jails. Findings point to needed investments in care coordination, staffing, and funding to strengthen jail-to-community-based MOUD treatment, removing barriers to continuity, and decreasing opioid overdose deaths during this high-risk transition., Competing Interests: Declarations of Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022. Published by Elsevier B.V.)
- Published
- 2022
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11. Jail-based reentry programming to support continued treatment with medications for opioid use disorder: Qualitative perspectives and experiences among jail staff in Massachusetts.
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Matsumoto A, Santelices C, Evans EA, Pivovarova E, Stopka TJ, Ferguson WJ, and Friedmann PD
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- Humans, Jails, Opiate Substitution Treatment, Massachusetts, Opioid-Related Disorders drug therapy, Drug Overdose prevention & control, Drug Overdose drug therapy, Buprenorphine therapeutic use
- Abstract
Background: Individuals with opioid use disorder released to communities after incarceration experience an elevated risk for overdose death. Massachusetts is the first state to mandate county jails to deliver all FDA approved medications for opioid use disorder (MOUD). The present study considered perspectives around coordination of post-release care among jail staff engaged in MOUD programs focused on coordination of care to the community., Methods: Focus groups and semi-structured interviews were conducted with 61 jail staff involved in implementation of MOUD programs. Interview guide development, and coding and analysis of qualitative data were guided by the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework. Deductive and inductive approaches were used for coding and themes were organized using the EPIS., Results: Salient themes in the inner context focused on the elements of reentry planning that influence coordination of post-release care including timing of initiation, staff knowledge about availability of MOUD in community settings, and internal collaborations. Findings on bridging factors highlighted the importance of interagency communication to follow pre-scheduled release dates and use of bridge scripts to minimize the gap in treatment during the transition. Use of navigators was an additional factor that influenced MOUD initiation and engagement in community settings. Outer context findings indicated partnerships with community providers and timely reinstatement of health insurance coverage as critical factors that influence coordination of post-release care., Conclusions: Coordination of MOUD post-release continuity of care requires training supporting staff in reentry planning as well as resources to enhance internal collaborations and bridging partnerships between in-jail MOUD programs and community MOUD providers. In addition, efforts to reduce systemic barriers related to unanticipated timing of release and reinstatement of health insurance coverage are needed to optimize seamless post-release care., Competing Interests: Declarations of Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022. Published by Elsevier B.V.)
- Published
- 2022
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12. Synthesis and Biological Evaluation of Thiazole-Based Derivatives with Potential against Breast Cancer and Antimicrobial Agents.
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Pivovarova E, Climova A, Świątkowski M, Staszewski M, Walczyński K, Dzięgielewski M, Bauer M, Kamysz W, Krześlak A, Jóźwiak P, and Czylkowska A
- Subjects
- Anti-Bacterial Agents pharmacology, Antifungal Agents pharmacology, Female, Humans, Microbial Sensitivity Tests, Spectroscopy, Fourier Transform Infrared, Thiazoles chemistry, Anti-Infective Agents chemistry, Antineoplastic Agents pharmacology, Breast Neoplasms drug therapy
- Abstract
Investigating novel, biologically-active coordination compounds that may be useful in the design of breast anticancer, antifungal, and antimicrobial agents is still the main challenge for chemists. In order to get closer to solving this problem, three new copper coordination compounds containing thiazole-based derivatives were synthesized. The structures of the synthesized compounds and their physicochemical characterization were evaluated based on elemental analysis,
1 H andl3 C nuclear magnetic resonance (NMR), flame atomic absorption spectroscopy (F-AAS), single-crystal X-ray diffraction, thermogravimetric analysis (TGA), and Fourier-transform infrared spectroscopy (FTIR). The pharmacokinetics were studied using SwissADME. The results obtained from the computational studies supported the results obtained from the MTT analysis, and the antimicrobial activity was expressed as the minimum inhibitory concentration (MIC).- Published
- 2022
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13. Uncommon and preventable: Perceptions of diversion of medication for opioid use disorder in jail.
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Evans EA, Pivovarova E, Stopka TJ, Santelices C, Ferguson WJ, and Friedmann PD
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- Humans, Jails, Opiate Substitution Treatment, Prescription Drug Diversion prevention & control, Buprenorphine therapeutic use, Opioid-Related Disorders drug therapy
- Abstract
Introduction: Correctional officials often cite diversion of medication for opioid use disorder (MOUD) treatment (e.g., buprenorphine) as a reason for not offering MOUD treatment in jails and prisons, but it is poorly understood whether these fears are justified. We aimed to understand staff perceptions of medication diversion from jail-based MOUD programs and the factors that contribute to and prevent diversion., Methods: We conducted qualitative analyses of semi-structured in-depth interviews and focus groups performed in 2019-20 with 61 administrative, security, behavioral health, and clinical staff who implement MOUD programming in seven Massachusetts jails., Results: Contrary to staff expectations, buprenorphine diversion was perceived to occur infrequently during MOUD program implementation. The MOUD program changed staff views of buprenorphine, i.e., as legitimate treatment instead of as illicit contraband. Also, the program was perceived to have disrupted the illicit buprenorphine market in jail and reduced related coercion. Proactive strategies were essential to prevent and respond to buprenorphine diversion. Key components of diversion prevention strategies included: staff who distinguished among different reasons for diversion; comprehensive and routinized but flexible dosing protocols; communication, education, and monitoring; patient involvement in assessing reasons for diversion; and written policies to adjudicate diversion consequences., Conclusion: With appropriate protocols, buprenorphine diversion within correctional programs designed to provide MOUD treatment is perceived to be uncommon and preventable. Promising practices in program design help limit medication diversion and inform correctional officials and lawmakers as they consider whether and how to provide MOUD treatment in correctional settings., (Published by Elsevier Inc.)
- Published
- 2022
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14. New Coordination Compounds Based on a Pyrazine Derivative: Design, Characterization, and Biological Study.
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Climova A, Pivovarova E, Rogalewicz B, Raducka A, Szczesio M, Korona-Głowniak I, Korga-Plewko A, Iwan M, Gobis K, and Czylkowska A
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- Anti-Bacterial Agents chemistry, Anti-Bacterial Agents pharmacology, Cobalt chemistry, Copper chemistry, Ferric Compounds, Ligands, Manganese chemistry, Microbial Sensitivity Tests, Nickel chemistry, Pyrazines pharmacology, Coordination Complexes chemistry, Coordination Complexes pharmacology
- Abstract
New coordination compounds of Mn(II), Fe(III), Co(II), and Ni(II) and the biologically active ligand L ( N '-benzylidenepyrazine-2-carbohydrazonamide) were synthesized and characterized by appropriate analytical techniques: elemental analysis (EA), thermogravimetric analysis (TG-DTG), infrared spectroscopy (FTIR), and flame-atomic absorption spectrometry (F-AAS). The biological activity of the obtained compounds was then comprehensively investigated. Rational use of these compounds as potential drugs was proven by ADME analysis. All obtained compounds were screened in vitro for antibacterial, antifungal, and anticancer activities. Some of the studied complexes exhibited significantly higher activity than the ligand alone.
- Published
- 2022
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15. Legislatively mandated implementation of medications for opioid use disorders in jails: A qualitative study of clinical, correctional, and jail administrator perspectives.
- Author
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Pivovarova E, Evans EA, Stopka TJ, Santelices C, Ferguson WJ, and Friedmann PD
- Subjects
- Humans, Jails, Opiate Substitution Treatment, Qualitative Research, Buprenorphine therapeutic use, Drug Overdose drug therapy, Opioid-Related Disorders drug therapy
- Abstract
Background: Individuals with legal involvement and opioid use disorders (OUD) are at an increased risk of overdose and premature death. Yet, few correctional systems provide all FDA approved medications for OUD (MOUD) to all qualifying incarcerated individuals. We report on the implementation of MOUD in seven Massachusetts' jails following a state legislative mandate to provide access to all FDA-approved MOUD and to connect with treatment upon release., Methods/participants: Based on the Exploration, Preparation, Implementation, and Sustainment framework, 61 clinical, corrections, and senior jail administrators participated in semi-structured interviews and focus groups between December 2019 and January 2020. Qualitative analyses focused on external and internal contexts and bridging factors., Findings: Participants detailed how the outer context (i.e., legislative mandate) drove acceptance of MOUD and assisted with continuity of care. Salient inner context factors included decision-making around administration of agonist medications, staff perceptions and training, and changes to infrastructure and daily routines. Leadership was critical in flattening standard hierarchies and advocating for flexibility. System-based characteristics of incarcerated individuals, specifically those who were pre-sentenced, presented challenges with treatment initiation. Inter- and intra-agency bridging factors reduced duplication of effort and led to quick, innovative solutions., Conclusions: Implementation of MOUD in jails requires collaboration with and reliance on external agencies. Preparation for implementation should involve systematic reviews of available resources and connections. Implementation requires flexibility from institutional systems that are inherently rigid. Accordingly, leaders and policymakers must recognize the cultural shift inherent in such programs and allow for resources and education to assure program success., (Copyright © 2022 Elsevier B.V. All rights reserved.)
- Published
- 2022
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16. Assessing feigning with the Feigning Evaluation INtegrating Sources (FEINS) in a forensic psychiatric sample.
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Grossi LM, Green D, Cabeldue M, and Pivovarova E
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- Humans, Male, Pilot Projects, Reproducibility of Results, Cognitive Dysfunction, Malingering diagnosis, Malingering psychology
- Abstract
Evaluators of examinees in forensic contexts must consider the potential for falsified or exaggerated psychiatric symptoms and/or cognitive deficits. A number of validated assessment tools assist evaluators in identifying those examinees who feign impairment; however, no comprehensive method has been established for consolidating data from multiple tests, interviews, behavioral observations, and collateral sources. The current pilot study preliminarily examined the interrater reliability and validity of a new forensic assessment tool, the Feigning Evaluation INtegrating Sources (FEINS), developed to guide evaluators in the comprehensive assessment of feigning by adding structure to the collection of relevant data. Fifty-eight male pretrial defendants undergoing restoration of competency to stand trial at a state forensic psychiatric center participated in the study. Results provided preliminary support for reliability in scoring the FEINS, construct validity, and predictive validity. FEINS items that assessed clinical presentation, and those that guided the use of test data, were more useful than items capturing historical/demographic data. Structured professional judgments developed using the FEINS appeared to be more accurate in predicting competency evaluators' perceptions of feigning than both unstructured clinical judgment (i.e., referring psychologist's perception of feigning) alone and test data alone, using hierarchical multiple regressions. Findings suggest that the FEINS may have practical utility in guiding clinical opinions regarding feigning across psychiatric, cognitive, and psycholegal/functional domains. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
- Published
- 2022
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17. Antitumor Activity and Physicochemical Properties of New Thiosemicarbazide Derivative and Its Co(II), Ni(II), Cu(II), Zn(II) and Cd(II) Complexes.
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Rogalewicz B, Climova A, Pivovarova E, Sukiennik J, Czarnecka K, Szymański P, Szczesio M, Gas K, Sawicki M, Pitucha M, and Czylkowska A
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- Cadmium chemistry, Copper chemistry, Humans, Ligands, Semicarbazides pharmacology, Spectrophotometry, Infrared, Zinc chemistry, Coordination Complexes chemistry, Coordination Complexes pharmacology
- Abstract
A novel biologically active thiosemicarbazide derivative ligand L ( N-[(phenylcarbamothioyl)amino]pyridine-3-carboxamide ) and a series of its five metal(II) complexes, namely: [Co(L)Cl
2 ], [Ni(L)Cl2 (H2 O)], [Cu(L)Cl2 (H2 O)], [Zn(L)Cl2 ] and [Cd(L)Cl2 (H2 O)] have been synthesized and thoroughly investigated. The physicochemical characterization of the newly obtained compounds has been performed using appropriate analytical techniques, such as1 H andl3 C nuclear magnetic resonance (NMR), inductively coupled plasma (ICP), thermogravimetric analysis (TGA), Fourier-transform infrared spectroscopy (FTIR) and magnetic measurements. In order to study the pharmacokinetic profile of the compounds, ADMET analysis was performed. The in vitro studies revealed that the synthesized compounds exhibit potent biological activity against A549 human cancer cell line.- Published
- 2022
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