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Objective: To examine undergraduate college students' attitudes toward 12-step support group utilization for opioid use disorder (OUD) and associations with previous experience with medications for OUD (MOUD). Participants: A convenience sample of undergraduate students at two major U.S. universities during Fall 2018 and Spring 2019. Method: A cross-sectional online survey of agreement with three 12-step orientation measures, MOUD experience, and demographic variables. Results: 1,281 students responded. Among 12-step orientation measures, respondents were most likely to agree that people with OUD should reach out to others in recovery. MOUD experience was significantly and negatively associated with agreement on each 12-step orientation measure. Religiosity/spirituality was positively associated with agreement that people with OUD should accept lack of control over OUD while placing trust in a higher power. Conclusion: Students with MOUD experience may be aware of anti-MOUD stigma in peer support groups and thus less likely to agree with 12-step orientation measures.

One of the more contentious policy changes in the past decade in the United States involves the decisions by several state legislatures and the Food and Drug Administration (FDA) to permit sales of emergency contraception on a nonprescription basis. We took advantage of a set of natural experiments to estimate the impact of changes in state and federal level nonprescription emergency contraception access on the probability of high-school students ' sexual and contraceptive behaviors. We extracted data from the Youth Risk Behavioral Survey for New England states that had data about contraceptive use (Maine, New Hampshire, Rhode Island, and Vermont) from 2003 to 2009. We combined this student-level data with information on when states and the FDA began allowing nonprescription sales of emergency contraceptives. We estimated a series of difference-in-difference models on the impact of these policies on the probability that students were sexually active and on the probability of condom or hormonal birth control use conditional on sexual activity. We found that switching emergency contraception to a nonprescription status had no systematic effect on the probability of sexual activity or the conditional probability of hormonal birth control use, but that it significantly reduced the probability that public school students used condoms by between 5.2% and 7.2%. (JEL I18, I12, I29), I. INTRODUCTION Data from the U.S. Centers for Disease Control and Prevention (CDC) indicate that in 2006 approximately 48% of all pregnancies in the United States were unintended (CDC 2012). [...]

Objective: To examine undergraduate college students' attitudes toward 12-step support group utilization for opioid use disorder (OUD) and associations with previous experience with medications for OUD (MOUD). Participants: A convenience sample of undergraduate students at two major U.S. universities during Fall 2018 and Spring 2019. Method: A cross-sectional online survey of agreement with three 12-step orientation measures, MOUD experience, and demographic variables. Results: 1,281 students responded. Among 12-step orientation measures, respondents were most likely to agree that people with OUD should reach out to others in recovery. MOUD experience was significantly and negatively associated with agreement on each 12-step orientation measure. Religiosity/spirituality was positively associated with agreement that people with OUD should accept lack of control over OUD while placing trust in a higher power. Conclusion: Students with MOUD experience may be aware of anti-MOUD stigma in peer support groups and thus less likely to agree with 12-step orientation measures. [ABSTRACT FROM AUTHOR]

Photographic identification (photo ID) is an established method that is used to count animals and track individuals' movements. This method performs well with some species of elasmobranchs (i.e., sharks, skates, and rays) where individuals have distinctive skin patterns. However, the unique skin patterns used for ID must be stable through time to allow re‐identification of individuals in future sampling events. More recently, artificial intelligence (AI) models have substantially decreased the labor‐intensive process of matching photos in extensive photo ID libraries and increased the reliability of photo ID. Here, photo ID and AI are used for the first time to identify epaulette sharks (Hemiscyllium ocellatum) at different life stages for approximately 2 years. An AI model was developed to assess and compare the reliability of human‐classified ID patterns in juvenile and neonate sharks. The model also tested the persistence of unique patterns in adult sharks. Results indicate that immature life stages are unreliable for pattern identification, using both human and AI approaches, due to the plasticity of these subadult growth forms. Mature sharks maintain their patterns through time and can be identified by AI models with approximately 86% accuracy. The approach outlined in this study has the potential of validating the stability of ID patterns through time; however, testing on wild populations and long‐term datasets is needed. This study's novel deep neural network development strategy offers a streamlined and accessible framework for generating a reliable model from a small data set, without requiring high‐performance computing. Since many photo ID studies commence with limited datasets and resources, this AI model presents practical solutions to such constraints. Overall, this approach has the potential to address challenges associated with long‐term photo ID data sets and the application of AI for shark identification. [ABSTRACT FROM AUTHOR]

The application of mathematics is an essential skillset for students in undergraduate health administration degree programs. Health administration majors are required to take courses that utilize mathematical concepts. Math anxiety, however, can be a barrier for many students within the field. Math anxiety is a feeling of apprehension regarding math-related assignments, assessments, and tests. Prior research has shown that math anxiety is prevalent among college students and is often associated with diminished academic performance on math-related assessments. The sample for this study consisted of 244 health administration undergraduate majors from a large public university. The tool used to measure math anxiety and math self-efficacy is the Mathematics Self-Efficacy and Anxiety Questionnaire (MSEAQ), which has been validated for use in the post-secondary student population. Descriptive statistics were computed to describe the characteristics of students who participated in the survey. Multivariate linear regression models were estimated to determine associations between student characteristics and the outcome variables of MSEAQ total score, math-anxiety score, and math self-efficacy score. Students who chose to take fully online math-related health administration courses were more likely to report lower levels of math anxiety and higher levels of math self-efficacy than those who chose to take in-person math-related health administration courses. No differences were found between gender, race, or other student demographic characteristics. Additionally, students who switched into the health administration major tended to be from math and science intensive majors. Implications for faculty and advisors in health administration programs are discussed. [ABSTRACT FROM AUTHOR]

Background: Criminal problem-solving courts and civil dependency courts often have participants with substance use disorder (SUD), including opioid use disorder (OUD). These courts refer participants to treatment and set treatment-related requirements for court participants to avoid incarceration or to regain custody of children. Medications for opioid use disorder (MOUD) are the most effective treatment for OUD but are underutilized by court system participants. Little is known about variation in court policies for different MOUDs. Also, more information is needed about types of policies for each MOUD, including whether participants may begin MOUD, continue previously begun MOUD, or complete the court program with MOUD. Methods: An online survey was distributed to criminal problem-solving and civil dependency judges in Florida in 2019 and 2020, yielding data from 58 judges (a 24% response rate). We used nonparametric statistics to test hypotheses with ordinal data. A Friedman's test for related samples or Cochran's Q was used to make within-group comparisons between policies and MOUDs. Results: We found considerable policy variation, with more permissive policies for naltrexone than buprenorphine or methadone, and more permissive policies for continuing MOUD than for initiating MOUD or completing a court program with MOUD. For each medication, less than one quarter of judges indicated their court always permits MOUD, with most indicating that MOUD is permitted sometimes or usually. Conclusion: Because respondents rarely chose "never" or "always" for any MOUD policy, most courts appear to be making MOUD decisions on a case-by-case basis. A clearer understanding of this decision-making process is needed. Some court participants may be required to discontinue MOUD before completing a court program, even if they were permitted to start or continue MOUD treatment. Discontinuation of MOUD without medical justification is contrary to the standard of care for individuals with OUD and increases their risk of overdose.

Background: Criminal problem-solving and dependency courts set treatment standards for opioid use disorder (OUD) but sometimes prohibit or limit utilization of medications for OUD (MOUD). Court staff beliefs about MOUD inform court treatment policies. Court staff MOUD policies may also be influenced by social norms, meaning perceptions of opinions of other individuals/entities about MOUD, including opinions of fellow staff in their court, staff in other courts, the state supreme court, other state agencies, the National Association of Drug Court Professionals (NADCP), federal agencies, and local peer support groups. To date no study has examined social norms among court staff with respect to MOUD. Methods: We distributed an online cross-sectional survey in 2019 to all criminal problem-solving and dependency court staff in Florida. Respondents were asked to identify the extent to which they cared about different entities'/individuals' opinions about MOUD and the extent to which they perceived each of those entities/individuals as encouraging MOUD. We hypothesized that court role and court type would be associated with responses. We used descriptive statistics, logistic regressions, and difference of proportions tests to analyze data. Results: 20% of the population ( n  = 119) completed the survey. Respondents cared most about the opinions of external treatment providers with whom they collaborate, fellow staff in their court, and the NADCP regarding MOUD. Fewer than half felt that any of these entities/individuals encourage methadone or oral buprenorphine. Additionally, fewer than 11% of respondents felt that local twelve-step peer support groups encourage the use of any form of MOUD. Conclusions: MOUD education should target all members of court teams, including collaborating treatment providers. Since court staff care relatively little about the MOUD opinions of staff in other courts, changes in opinions in one court may not affect changes in opinions in a neighboring court. The NADCP should more explicitly state its support for MOUD, and specifically oral buprenorphine and methadone treatment.