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This preliminary study explored a person-group dissimilarity hypothesis in the context of adolescent sexual harassment. Theory suggests that victimized youth are expected to experience worse outcomes if they perceive victimization to be a rare experience among their peers. This study comprised 435 middle school students who reported on their experiences of sexual harassment (victimization and witnessing), shame, and depressive symptoms. We tested a cross-sectional conditional indirect-effects model, with shame mediating the relationship between victimization and depressive symptoms (the indirect effect) and with witnessing as a moderator of the indirect effect. For all students, shame mediated the relationship between victimization and depressive symptoms. For female students, there was a buffering effect of witnessing, whereby the indirect effect was weaker at high levels of witnessing. These findings have potential implications for theory and intervention, suggesting the importance of examining young people's social contexts to better understand their responses to sexual harassment. [ABSTRACT FROM AUTHOR]

For emerging adults, high-quality friendships can be an important source of companionship and support. The most commonly studied negative interaction between friends is conflict, yet work with youth suggests more serious victimization also occurs in friendship. In the current study, we developed and obtained preliminary psychometric evidence for the Friendship Victimization Scale, a measure that assesses physical, sexual, relational, and verbal forms of victimization in the friendships of emerging adults, as well as coercive and controlling behaviors. Emerging adults (N = 316, M age = 21.27 years, SD = 1.47; 60.4% women, 37.0% men; 59.2% White) completed the Friendship Victimization Scale along with measures to examine construct validity. The majority of the sample reported experiencing at least one act of victimization by a friend, and men reported more victimization than did women. Results supported a 2-factor structure, with relational and verbal victimization loading on one factor and physical and sexual victimization and controlling behaviors loading on the other. Cronbach's alphas exceeded.90 for the total score and both subscales. Greater friendship victimization was predicted by negative features in each of a best and a challenging friendship, even after accounting for negative features in a dating relationship, and was unrelated to positive features in any of these relationships. Overall, results indicate that victimization is common in emerging adults' friendships. The findings provide preliminary evidence for the utility of the Friendship Victimization Scale as a measure of this understudied source of risk in the interpersonal lives of emerging adults. [ABSTRACT FROM AUTHOR]

Background: Transversus abdominis plane blocks are an established method of postoperative analgesia for abdominopelvic surgeries. Liposomal bupivacaine is an extended‐release formulation of bupivacaine providing up to 72 h of analgesia. This study aims to determine if transversus abdominis plane blocks performed with liposomal bupivacaine are associated with reduced opioid consumption and level of pain intensity compared to conventional bupivacaine in patients undergoing lower abdominal surgery. Methods: This retrospective cohort study was conducted at a single institution between December 2020 and December 2021. After institutional review board approval, we identified patients who underwent lower abdominopelvic surgery with transversus abdominis plane blocks done with liposomal or conventional bupivacaine and collected demographic, clinical, and procedural information for analysis. We compared total opioid consumption over 72‐h postoperatively in milligram morphine equivalents (MME), frequency of opioid utilization, and average level of pain intensity between groups. These outcomes were also evaluated after adjusting for covariates. Data were presented as mean ± SD, median [IQR] or frequency (%), as appropriate; p < 0.05 was accepted as significant. Results: A total of 178 patients met inclusion criteria, with 79 patients receiving an admixture of liposomal bupivacaine and conventional bupivacaine and 99 patients receiving conventional bupivacaine. The liposomal bupivacaine group had a median opioid consumption 72‐h postoperatively of 47.5 [18–91.8] MME compared to 88 [43.8–160] MME in the conventional bupivacaine group, p = 0.045. Differences in opioid consumption between the groups did not reach statistical significance after adjustment for demographic and clinical characteristics, p = 0.11. There was no significant difference in frequency of opioid use or average pain intensity. Conclusion: Transversus abdominis plane blocks using an admixture of liposomal bupivacaine conventional bupivacaine are not associated with decreased opioid consumption or reduced pain up to 72 h following elective abdominopelvic surgery. [ABSTRACT FROM AUTHOR]

Objectives: Universal screening for substance use during pregnancy, brief intervention, and referral to treatment (SBIRT) is recommended by ACOG and the USPSTF. Here we present the implementation of SBIRT into the electronic health record (EHR) to inform clinical intervention and collect data on the prevalence of substance use during pregnancy at three prenatal clinics. Methods: A literature-based SBIRT instrument was developed. The tool was integrated into the EHR of a resident Ob/Gyn clinic, an MFM practice, and an Ob/Gyn generalist practice at our institution, an academic, tertiary care medical center in an urban area, and automated reports of aggregate retrospective EHR data were used to monitor patient responses to SBIRT over time. Data reports included patient responses to screening for substance use, brief intervention, and referral to treatment from January to December 2018 Results: An interprofessional team of health care providers and systems analysts guided the SBIRT implementation process. As of December 2018, overall SBIRT performance during prenatal care encounters was 1797/2619 (69%), 432/1350 (32%), and 1290/1518 (85%) in the resident clinic, MFM practice, and generalist practice, respectively. Eighty (5.1%) women in the resident clinic, 2 (0.5%) in the MFM practice and 14 (1%) in the generalist practice reported past or present substance use. Conclusions for Practice: Integrating universal SBIRT into prenatal care using the EHR requires a multi-disciplinary approach. The SBIRT tool facilitates reportable substance use screening, brief intervention, and referral to treatment during prenatal care. Future reports will further characterize substance use in our prenatal practices and inform intervention strategies in this population. [ABSTRACT FROM AUTHOR]

Youth who experience peer victimization are at risk of developing mental health problems. However, little is known about the emotional causal mechanisms linking peer victimization with these negative outcomes. This study investigated whether shame mediated this relationship. At three time points (T1-T3), 396 10- to 13-year-olds completed measures of peer victimization, shame (characterological, bodily, and behavioral; shame proneness), and mental health (depression, social anxiety, and externalizing behavior). Three multiple mediation models tested the indirect effects of T1 victimization on T3 mental health through the four T2 shame-related variables. Analyses revealed indirect effects for the shame-related mediators on depression, social anxiety, and externalizing behaviors. Specifically, indirect positive effects for characterological and bodily shame on depression and social anxiety were found, with greater bodily shame linked to higher levels of social anxiety in girls but not boys. In addition, an indirect negative effect for behavioral shame on externalizing problems was found, with higher levels of externalizing problems in victimized boys but not in girls. Finally, an indirect positive effect for shame proneness and externalizing problems was found. To clarify the directionality, three additional mediation models were run with mental health symptoms as predictors of shame and subsequent victimization. Indirect effects for the shame-related mediators were found for all outcomes, specifically bodily shame and shame proneness as mediators between internalizing and externalizing symptoms and victimization. These three models were compared and contrasted with the hypothesized models. In sum, findings support the role of shame as an underlying emotional mechanism of peer victimization, and may guide intervention programs to address the mental health concerns of victimized youth. [ABSTRACT FROM AUTHOR]

Purpose Despite its availability for more than 70 years, many details concerning methadone remain contentious, such as the dosing equivalents for intravenous and enteral administration. A scoping review was performed to evaluate whether existing literature on methadone bioavailability in human subjects support the current recommendation that an equivalent enteral dose is twice the intravenous dose. Methods A librarian-assisted search of the PubMed and EMBASE databases identified all English-language articles with the terms methadone and bioavailability and/or conversion in the title or abstract published from inception though December 2019. A manual search of references was also performed to identify any additional articles. Studies were included in a scoping review if they were published in English and evaluated methadone bioavailability in human subjects. Results Among 65 publications initially identified, 6 studies involving a total of 50 patients were included in the review. Bioavailability data for healthy volunteers and patients with opioid use disorder, metastatic cancer, chronic pain from malignant or nonmalignant disease were available for analysis. The pooled mean (95% confidence interval) bioavailability (F) was 85.4% (75.2%-95.6%), with heterogeneity (I 2) of 0. In the 4 studies that provided individual patient–level data, F was >50% in 40 of 42 patient measurements (95.2%) and ≥75% in 33 of 42 patient measurements (78.6%). Conclusion Available evidence suggests the bioavailability of methadone is generally more than 75%, there is limited evidence for the currently recommended 1:2 ratio (intravenous:enteral), and a more appropriate dosing ratio may be 1:1.3. This scoping review underscores the need for further research to establish an effective and safe ratio when converting between intravenous and enteral dosing formulations of methadone. [ABSTRACT FROM AUTHOR]

Buprenorphine is highly effective for the treatment of opioid use disorder (OUD), and, in recent years, the rates of patients maintained on buprenorphine requiring critical care have been steadily increasing. Currently, no unified guidance exists for buprenorphine management during critical illness. Likewise, we do not know if patients maintained on buprenorphine for OUD are prescribed medications for OUD (MOUD) following hospital discharge or if buprenorphine management influences mu opioid agonist dispensing. In our cohort of adults over the age of 18 with OUD, receiving buprenorphine formulations in the 3 months preceding their ICU admission, we sought to investigate the relationship between receipt of MOUD and non-MOUD opioid prescribing up to 12 months following hospital discharge. This was a single-center, retrospective cohort study approved by the MaineHealth institutional review board. The study analyzed differences in prescription rates between discharge and subsequent time points using chi square or Fisher's exact test, as appropriate. We performed analyses using SPSS Statistical Software version 28 (IBM SPSS Inc., Armonk, NY) with significance set at p < 0.05. We identified a statistically significant increase in MOUD prescribing 3 months posthospital discharge in patients who received MOUD at time of discharge (87.9 % vs 40 % p = 0.002.) The study found a significant increase in nonbuprenorphine opioid prescribing in patients who did not receive an MOUD prescription at time of discharge (24.2 % vs 70 % p = 0.007). This trend persisted at the 6-month and 12-month time points; however, it did not reach statistical significance. Additionally, the study identified a significant reduction in the incidence of non-MOUD opioid dispensing in patients prescribed MOUD at each time point measured (p = 0.007, p < 0.001. p < 0.001 and p = 0.008 at discharge, 3, 6, and 12 months, respectively). These findings support continuing buprenorphine dispensing following hospital discharge. • MOUD prescribing at hospital discharge associated with increased MOUD dispensing • Outpatient opioid agonist prescribing more likely when MOUD not prescribed at discharge • Decreased opioid agonist dispensing 12 months post-discharge in patients given MOUD [ABSTRACT FROM AUTHOR]

Background: Bullying among children and adolescents is a public health concern; victimization is associated with psychological and physical health problems. The purpose of this study is to examine temporal trends in bullying victimization among school-aged children in Europe and North America. Methods: Data were obtained from crosssectional self-report surveys collected as part of the Health Behaviour in School-aged Children (HBSC) study from nationally representative samples of 11-, 13- and 15-year-olds, from 33 countries and regions which participated in the 2001-02, 2005-06 and 2009-10 surveys. Responses from 581 838 children were included in the analyses. Binary logistic regression was used for the data analyses. Results: The binary logistic regression models showed significant decreasing trends in occasional and chronic victimization between 2001-02 and 2009-10 across both genders in a third of participating countries. One country reported significant increasing trends for both occasional and chronic victimization. Gender differences in trends were evident across many countries. Conclusion: Overall, while still common in many countries, bullying victimization is decreasing. The differences between countries highlight the need to further investigate measures undertaken in countries demonstrating a downward trend. [ABSTRACT FROM AUTHOR]