با سلام خدمت کاربران در صورتی که با خطای سیستم پرداخت بانکی مواجه شدید از طریق کارت به کارت (6037997535328901 بانک ملی ناصر خنجری ) مقاله خود را دریافت کنید (تا مشکل رفع گردد).
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“You are not clean until youre not on anything”: Perceptions of medicationassisted treatment in rural Appalachia
"شما تمیز نیستید تا وقتی که در هر چیزی هستید": برداشت از درمان با کمک دارو در دهستان آپالاچیا-2020 Background: Medication-assisted treatment (MAT) is an evidence-based strategy to treat opioid use disorder
(OUD). However, MAT-related stigma reduces MAT uptake, which is particularly low in rural areas. To date,
perceptions and attitudes towards MAT in rural settings have not been described.
Objective: This qualitative study aims to characterize perceptions and attitudes towards MAT and the environmental
factors contributing to these views in Appalachian Ohio.
Methods: From February to July 2018, semi-structured interviews were conducted with 34 stakeholders (12
healthcare professionals, 12 substance use treatment providers, 7 law enforcement agents and judicial officials,
and 3 members of relevant organizations) in three rural counties in Appalachian Ohio. Interviews were transcribed,
coded, and analyzed to characterize the risk environment and participants’ perceptions and attitudes
towards MAT.
Results: Participants expressed or described pervasive MAT-related stigma in the region. Participants consistently
described three elements of the environment affecting stigma: (1) a “conservative” culture in which
abstinence is necessary to be in recovery successfully, (2) fear of medication diversion and abuse, and (3) drug
court policies that keep MAT out of the criminal justice system.
Conclusion: MAT-related stigma will need to be addressed to tackle the opioid epidemic through evidence-based
treatment effectively. Keywords: Medication-assisted treatment | Opioid use disorder | Stigma | Appalachia | Rural | Risk environment |
مقاله انگلیسی |
2 |
A novel approach for occupational health and safety and environment risk assessment for nuclear power plant construction project
یک رویکرد جدید برای بهداشت و ایمنی شغلی و ارزیابی خطر محیط زیست برای پروژه ساخت نیروگاه هسته ای-2020 Nuclear Power Plant (NPP) construction project is a mega one with high level of occupational health and
safety and environment (OHSE) risks, and it is necessary to propose an approach for the OHSE risk
assessment so as to prevent the OHSE accidents or reduce their outcomes. However, there has not been
such an approach due to the high uncertainty and complexity of NPP construction project. Therefore, this
paper proposed a novel approach for the OHSE risk assessment which includes systematically identifying
the OHSE risks by using brainstorming method, establishing an OHSE risk assessment index system by
using Delphi method, and formulating a mathematical model by combining set pair analysis (SPA),
trapezoidal fuzzy number (TPFN), and set-valued statistics (SVS) methods for determining the overall
OHSE risk level for NPP construction project. The approach was used to assess the OHSE risks for the NPP
construction project in East China, and its overall OHSE risk level was assessed at level 2 (low OHSE risk
level). In addition, the problems in the OHSE risk management were found, and the corresponding OHSE
risk treatments for these problems were implemented. The results showed that the approach helped
reduce the OHSE risk level and protect the workers occupational health and safety and the environment
while the NPP construction project was under construction Keywords: Nuclear power plant construction project | Occupational health and safety and | environment | Risk assessment | Mathematical model |
مقاله انگلیسی |