American Indian/Alaska Native (AI/AN) communities are disproportionally impacted by the opioid overdose epidemic. There remains a dearth of research evaluating methods for effectively implementing ...treatments for opioid use disorder (OUD) within these communities. We describe proceedings from a 2‐day Collaborative Board (CB) meeting tasked with developing an implementation intervention for AI/AN clinical programs to improve the delivery of medications to treat OUD (MOUD). The CB was comprised of Elders, cultural leaders, providers, individuals with lived experience with OUD, and researchers from over 25 communities, organizations, and academic institutions. Conversations were audio‐recorded, transcribed, and coded by two academic researchers with interpretation oversight provided by the CB. These proceedings provided a foundation for ongoing CB work and a frame for developing the program‐level implementation intervention using a strength‐based and holistic model of OUD recovery and wellbeing. Topics of discussion posed to the CB included engagement and recovery strategies, integration of extended family traditions, and addressing stigma and building trust with providers and clients. Integration of traditional healing practices, ceremonies, and other cultural practices was recommended. The importance of centering AI/AN culture and involving family were highlighted as priorities for the intervention.
Highlights
Findings inform the future integration of a holistic approach to opioid treatment for Indigenous people.
Integration of traditional healing practices, ceremonies, and other practices was recommended.
Guidance was provided for implementation studies conducted in partnership with Indigenous communities.
Introduction: Preliminary findings have shown that integrated inter-professional supportive care approaches improve patientu2019s quality of life and might even impact overall survival. The ...University Hospital of Lausanne is the first Swiss comprehensive cancer center to develop and implement an inter-professional board called u201cCare-boardu201d (CB) during early treatment phase that is organized in parallel to the Tumor-board. The aim of the CB is to facilitate a standardised inter-professional consensus process that results in the agreement on supportive care recommendations for patients.Objective: To assess the feasibility of the CB model during a pilot phase.Methods: The pilot phase was conducted between October and December 2017 and included seven CB meetings. We analyzed participation rate and the related reasons for the absence, the number of patients presented to the CB, the meeting duration and the devoted time on supportive care for each patient.Results: CB members were two clinical nurse specialists, two oncologists, a palliative care physician, a psycho-oncologist, a social worker, and a complementary medicine nurse. The average participation rate of the team members was 70%. The most common reason for absence was u201cholidaysu201d (30%), u201cclinical activitiesu201d (35%), u201ccongress/continuing educationu201d (11%). The meeting duration was 50 (SD 8) minutes with an average time of 20 (SD 5) minutes per patient. Conclusions: Feasibility results of this new inter-professional supportive care board showed promising results. Future directions may include adapting and testing this new approach for other cancer populations.
After Collapse Schwartz, Glenn M; Nichols, John J
08/2010
eBook
From the Euphrates Valley to the southern Peruvian Andes, early complex societies have risen and fallen, but in some cases they have also been reborn. Prior archaeological investigation of these ...societies has focused primarily on emergence and collapse. This is the first book-length work to examine the question of how and why early complex urban societies have reappeared after periods of decentralization and collapse.Ranging widely across the Near East, the Aegean, East Asia, Mesoamerica, and the Andes, these cross-cultural studies expand our understanding of social evolution by examining how societies were transformed during the period of radical change now termed "collapse." They seek to discover how societal complexity reemerged, how second-generation states formed, and how these re-emergent states resembled or differed from the complex societies that preceded them.The contributors draw on material culture as well as textual and ethnohistoric data to consider such factors as preexistent institutions, structures, and ideologies that are influential in regeneration; economic and political resilience; the role of social mobility, marginal groups, and peripheries; and ethnic change. In addition to presenting a number of theoretical viewpoints, the contributors also propose reasons why regeneration sometimes does not occur after collapse. A concluding contribution by Norman Yoffee provides a critical exegesis of "collapse" and highlights important patterns found in the case histories related to peripheral regions and secondary elites, and to the ideology of statecraft.After Collapseblazes new research trails in both archaeology and the study of social change, demonstrating that the archaeological record often offers more clues to the "dark ages" that precede regeneration than do text-based studies. It opens up a new window on the past by shifting the focus away from the rise and fall of ancient civilizations to their often more telling fall and rise.CONTRIBUTORSBennet Bronson, Arlen F. Chase, Diane Z. Chase, Christina A. Conlee, Lisa Cooper, Timothy S. Hare, Alan L. Kolata, Marilyn A. Masson, Gordon F. McEwan, Ellen Morris, Ian Morris, Carlos Peraza Lope, Kenny Sims, Miriam T. Stark, Jill A. Weber, Norman Yoffee
PDF
