Reporting on Diverse Current Practices
Notice bibliographique
Résumé
As our field grows in complexity, so does the range of submissions to the Canadian Journal of Addiction. The leading policy debate is possibly about the relative effectiveness of Safer Supply (SS) and Opioid Agonist Treatment (OAT) programs to address the country’s skyrocketing number of overdose deaths. These have been estimated to be an average of 23 people killed each day in Canada last year, for a total of 40,000 opioid-related deaths since 2016, the year when the Public Health Agency of Canada began collecting such data. Kahan M, in a leading review of retrospective studies, identified reduced rates of hospitalizations and visits to emergency departments in patients of SS programs. There is evidence, however, of common diversion of hydromorphone tablets. By comparison, OAT programs reduce overdose mortality as well as rates of injection-related infections in this context despite limited access and low treatment retention rates. Recommended strategies involve the observed dosing of oral hydromorphone, a combination of hydromorphone with OAT, and coordination of care between program providers. The role of pharmacists in our clinical practice teams has gained increased recognition over the last decade. Llewelyn-Williams and colleagues report on 50 consultations involving opioid use disorders and alcohol use disorders. The expanding pharmacology now available, including initiation of acamprosate, naltrexone, and extended-release buprenorphine, as well as the needed follow-up and monitoring of their interactions with other medications, are examples of the positive impact of pharmacist involvement in patient care. We look forward to further studies demonstrating outcomes from the interventions. The third article, by Roy and colleagues, is a retrospective cohort study of patients admitted to 2 Canadian hospitals that evaluated the use of opioids during inpatient hospitalization between 2017 and 2019. An overall rate of 65% of opioid prescribing is reported, comprised mostly of as-needed opioids. These prescriptions remain active on the day of discharge. The patterns identified could be targets for eventual strategies to reduce opioid exposure. Mercante and colleagues, in a submission from Sao Paolo, Brazil, investigate the sociodemographic profile of role-playing games (RPG) players (N=115), their game habits, and psychopathological symptoms. Personal characteristics, such as having no emotional support and parents who are not interested in RPGs, appear to be risk factors for a pathological relationship to tabletop RPG playing. An international cultural comparison of these findings would be welcome. In a limited literature review, Prada and de Moissac provide a snapshot of substance use, addictions, and related treatment services available to 2 Official Language Minority Communities (OLMC) in Canada. Gaps in knowledge and service provision are reported. Networking, collaborating, financial support, and active offer of services in both languages are recommended to improve mental health and addiction services through a continuum of care. The last article, by Cavacuiti and colleagues, describes a “simplified care model” implemented in True North Medical Centre in Ontario and its efficacy for people who achieved sustained virologic response 12 weeks after antiviral treatment. In a sample of 1408 people, a higher proportion of treatment-eligible people initiated direct-acting antiviral (DAA) treatment for hepatitis C virus compared with traditional care. Traditional care included HCV antibody screening, ribonucleic (RNA) testing, noninvasive assessment of fibrosis, and referral to DAA treatment. Simplified care included the above, along with telemedicine consults. This model increased retention of care and higher rates of treatment completion due to a decentralized and simplified approach to HCV diagnosis and linkage to care. We hope this panoply of practice insights will facilitate our daily tasks. Nady el-Guebaly, CM, MD, FRCPC Editor-in-Chief, CJA
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,011 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».