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Contingency management is especially effective in supporting medication adherence and drug abstinence among people with opioid use disorder. However, the incorporation of contingency management into clinical practice has been slow. The present study was designed to evaluate the feasibility, acceptability, and usability of incentives for providers as a means of accelerating collaborative care with contingency management. Thirteen buprenorphine prescribers served as participants in a nonexperimental study. The prescribers who referred patients to a contingency‐management service received monetary incentives for reviewing patient performance data and describing their use of these data in treatment decisions. The results show that this approach is feasible, acceptable, and easy to use for everyone involved. Self‐reports indicate improved prescriber–patient relationships and more informed care. However, prescriber‐focused incentives did not appear to greatly enhance access to contingency‐management services for patients. Thus, provider incentives may be beneficial but further research is needed to advance adoption of contingency management. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic provided an opportunity to investigate factors related to public response to public health measures, which could help better prepare implementation of similar measures for inevitable future pandemics. To understand individual and environmental factors that influence likelihood in engaging in personal and public health measures, three crowdsourced convenience samples from Amazon Mechanical Turk (MTurk) completed likelihood‐discounting tasks of engaging in health behaviors given a variety of hypothetical viral outbreak scenarios. Experiment 1 assessed likelihood of mask wearing for a novel virus. Experiment 2 assessed vaccination likelihood based on efficacy and cost. Experiment 3 assessed likelihood of seeking health care based on number of symptoms and cost of treatment. Volume‐based measures and three‐dimensional modeling were used to analyze hypothetical decision making. Hypothetical public and personal health participation increased as viral fatality increased and generally followed a hyperbolic function. Public health participation was moderated by political orientation and trust in science, whereas treatment‐seeking was only moderated by income. Analytic methods used in this cross‐sectional study predicted population‐level outcomes that occurred later in the pandemic and can be extended to various health behaviors. [ABSTRACT FROM AUTHOR]

The article discusses a study which aimed at improving the treatment for elderly patients with primary central nervous system lymphoma (PCNSL). It focuses on 174 patients between the ages of 65 and 89 where 148 were treated with chemotherapy at the time of diagnosis, 31 of whom received additional whole-brain radiotherapy (WBRT). It shows that PCNSL among the elderly remains responsive to methotrexate-based chemotherapy, warranting aggressive treatment both at the time of diagnosis and recurrence.

Background Posttraumatic Stress Disorder (PTSD) is a debilitating psychological condition, never studied in relation to falls in older people. This study determines the prevalence and correlates of PTSD in older people post-fall. Method A prospective survey study, with baseline data collected by interview in hospital post-fall and by postal self-completion at 12 and 24 weeks post-baseline. A convenience sample of 196 people (≥ 65 years) were serially recruited, 87.9% of those eligible. Information collected at baseline included falls-related data, activity problems, fear of falling, PTSD symptoms, anxiety and depression, and at follow-up PTSD symptoms, anxiety and depression, the receipt of rehabilitation and further falls. Results In hospital, of 40 participants whose fall had occurred over 1 month previously 35% had full acute PTSD and 17.5% had partial acute PTSD. At follow-up full or partial chronic PTSD was found in 26.1% of participants at first follow-up, and in 27.4% of participants at second follow-up. Older age, pre-fall activity problems, fear of falling, and anxiety assessed at baseline were associated (p < 0.05) with follow-up PTSD diagnosis, as were anxiety and depression assessed concurrently. Conclusion PTSD occurs in a substantial minority of older people post-fall. No pattern emerged of factors predictive of PTSD, although the association between fear of falling and PTSD suggests some patients thought to have fear of falling may be manifesting PTSD, and require identification to enable therapeutic intervention. Copyright © 2009 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Aims Success of the quantitative prediction of drug–drug interactions via inhibition of CYP-mediated metabolism from the inhibitor concentration at the enzyme active site ([ I]) and the in vitro inhibition constant ( K i) is variable. The aim of this study was to examine the impact of the fraction of victim drug metabolized by a particular CYP ( f mCYP) and the inhibitor absorption rate constant ( k a) on prediction accuracy. Methods Drug–drug interaction studies involving inhibition of CYP2C9, CYP2D6 and CYP3A4 ( n = 115) were investigated. Data on f mCYP for the probe substrates of each enzyme and k a values for the inhibitors were incorporated into in vivo predictions, alone or in combination, using either the maximum hepatic input or the average systemic plasma concentration as a surrogate for [ I]. The success of prediction (AUC ratio predicted within twofold of in vivo value) was compared using nominal values of f mCY P = 1 and k a = 0.1 min−1. Results The incorporation of f mCYP values into in vivo predictions using the hepatic input plasma concentration resulted in 84% of studies within twofold of in vivo value. The effect of k a values alone significantly reduced the number of over-predictions for CYP2D6 and CYP3A4; however, less precision was observed compared with the f mCYP. The incorporation of both f mCYP and k a values resulted in 81% of studies within twofold of in vivo value. Conclusions The incorporation of substrate and inhibitor-related information, namely f mCYP and k a, markedly improved prediction of 115 interaction studies with CYP2C9, CYP2D6 and CYP3A4 in comparison with [ I]/ K i ratio alone. [ABSTRACT FROM AUTHOR]

In theory, the magnitude of an in vivo drug–drug interaction arising from the inhibition of metabolic clearance can be predicted using the ratio of inhibitor concentration ([I]) to inhibition constant ( Ki). The aim of this study was to construct a database for the prediction of drug–drug interactions from in vitro data and to evaluate the use of the various estimates for the inhibitor concentrations in the term [I]/ Ki. One hundred and ninety-three in vivo drug–drug interaction studies involving inhibition of CYP3A4, CYP2D6 or CYP2C9 were collated from the literature together with in vitro Ki values and pharmacokinetic parameters for inhibitors, to allow calculation of average/maximum systemic plasma concentration during the dosing interval and maximum hepatic input plasma concentration (both total and unbound concentration). The observed increase in AUC (decreased clearance) was plotted against the estimated [I]/ Ki ratio for qualitative zoning of the predictions. The incidence of false negative predictions (AUC ratio > 2, [I]/ Ki < 1) was largest using the average unbound plasma concentration and smallest using the hepatic input total plasma concentration of inhibitor for each of the CYP enzymes. Excluding mechanism-based inhibition, the use of total hepatic input concentration resulted in essentially no false negative predictions, though several false positive predictions (AUC ratio < 2, [I]/ Ki > 1) were found. The incidence of true positive predictions (AUC ratio > 2, [I]/ Ki > 1) was also highest using the total hepatic input concentration. The use of the total hepatic input concentration of inhibitor together with in vitro Ki values was the most successful method for the categorization of putative CYP inhibitors and for identifying negative drug–drug interactions. However this approach should be considered as an initial discriminating screen, as it is empirical and requires subsequent mechanistic studies to provide a comprehensive evaluation of a positive result. [ABSTRACT FROM AUTHOR]

Describes an initial investigation of a derivatization process utilizing alkylchloroformates that converts ammonium nitrate and methylammonium nitrate to a form suitable for recovery by solid phase microextraction (SMPE) and analysis by gas chromatography-mass spectrometry (GC-MS). Benefits offered by SPME-based analyses; Influences of high-molecular weight alkylchloroformates on recovery, chromatography and mass spectrometry of amine salt explosives; Modes in performing the derivatization-SPME.

Describes a vapor-phase procedure for the conversion of solid amphetamine salt samples into free bases by the use of triethylene. Use of solid-phase microextraction; Potential applications of the methodology; Amphetamine-type drugs.