Discover and read the best of Twitter Threads about #od

Most recents (14)

This is an example of “echo chamber” #distortion that is pervasive in #OD and #leadership

quick 🧵👇🏼
1/ “on 100 senior leaders are telling us”

I’m sure these 100 senior leaders believe what they say about team effectiveness and their own personality
2/ research reports on what it actually measures

which might be nothing, or pure bullshit

So the best research about executives, that executives will want to purchase, is research that gives them validation like “leadership is a team sport”
Read 4 tweets
#ODKDJ #OD #KDJ #plotja #joongdok #orv

(OD and KDJ get along really well after the epilogue!AU but things turn an unexpected turn, when OD gets to experience the precious love that KDJ has for KimCo,and gets addicted to it. Minor romance, mostly OD POV)
Kim Dokja (Also known as "The demon king of salvation") finally woke up from his coma. Once the news was received by OD, SP, and the 999 gang, OD asked if he could visit KDJ. They were reluctant at first, but eventually gave in to his insistence.
OD and KDJ had a heart to hear talk. Turns out, KDJ didn't even want to hurt OD when he first saw him, but was driven by the promise he made with SP. OD figured that out a long time ago, SP apologized to him after all, but he wanted to hear it from KDJ himself
Read 19 tweets
Este final de curso estamos trabajando varias sesiones de #GO4O dentro de la UD de Orientación Deportiva.
Lo hacemos con varios niveles ⭐️ y formatos, pero ahora en la recta final, tenemos que buscar aplicación a ese trabajo acotado de #OD dentro de un contexto + amplio (sigo⬇️)
Para ello, desde el depart. de EF, hemos querido contextualizar esta progresión de #OD dentro del entorno vinícola de la comarca.
Utiel, junto a Requena, forman parte de una de las comarcas vinícolas 🍇 por excelencia de la C. Valenciana
Hemos adaptado el #GO4O para crear #VID4O Image
Con el objetivo principal de hacer la actividad + atractiva aproximando al alumnado a la cultura vinícola de su zona, a su vocabulario y, a la puesta en valor de su variedad + famosa, el BOBAL.
Hemos utilizado un entorno cercano y hemos graduado las tarjetas en 3 niveles/sigo ⬇️
Read 8 tweets
I’m really proud to share a just-published article in @TheLancetPH about our #ChequeDayStudy. It is the culmination of years of work and input from community. I hope it informs policy to improve the lives of PWUD in BC & beyond 1/13 thelancet.com/journals/lanpu…
Monthly synchronized income assistance payments have long been linked in past research to considerable and costly increases in drug use and drug-related harm, including overdose, hospital admission, treatment interruption, and emergency service calls. 2/13
This research suggests an individual signal for increased use from payments themselves and social signals from everyone being paid at the same time, producing calls to vary payment timing and frequency. 3/13 doi.org/10.1111/add.15…
Read 13 tweets
2,887 #vets died of #overdose or #suicide after they were taken off #opioids meds by the VA to adhere to guidelines. @StefanKertesz & colleagues found stopping meds increases the risk of death up to 6.8x (study in linked tweet). @headsUPmigraine thanks him for his work.
2,887 #vets died of #OD/suicide after their rx #opioid was stopped in FY2013, only 90 fewer deaths than on 9/11.
Stopping treatment was associated with increased risk of fatal OD/#suicide regardless of the length of treatment (Oliva et al BMJ 2020). 1/3
#Vets whose #opioid med was stopped were 1.67 to 6.77 times more likely to die than those who continued to be treated. Deaths were highest in 1st 3 months after treatment was stopped. 2/3

Oliva, Bowe, Manhapra, Kertesz et al. BMJ 2020. bmj.com/content/368/bm…
Read 4 tweets
Risk of OD to prescribed #opioids is 0.13% (Kaiser, Jnl of Pain 2019), while risk of death by OD increases more than 300% with dose variability of ≥30% (JAMA 2019).

VHA study: discontinuation increases the risk of death by #OD or #suicide up to 6.8 times (BMJ 2020). / thread
0.13% = risk of OD to prescribed #opioids (Kaiser 2019). Dose reduction is "inconsistent" in lowering OD risk. Research found "no support for RSM [risk stratification & monitoring] as a means of decreasing overdose.”

Jnl of Pain 2019;20(1) jpain.org/article/S1526-…
0.1% to 0.23% = risk of OD to prescribed #opioids, per Canada's 2017 Guideline.

0.1% for <20 MED, 0.14% for 20–49, 0.18% for 50–99 MED, 0.23% for ≥100 MED.

Discontinuation carries a significantly higher risk of death.
#PCP #MedicalTwitter
ncbi.nlm.nih.gov/pmc/articles/P…
Read 10 tweets
0.1% = rate of fatal #OD in the medical use of #opioids acc'g to 2019 research from Kaiser Permanente (link below).

Bwn 2006-2014, 41 of 31,142 died of OD, a rate of 5 per year. Risk stratification did not lower OD rates. Dose reductions were "inconsistent" (VonKorff). /thread
2,887 #vets died by #overdose or #suicide after their #opioid medicine was stopped by the VHA in FY2013 (90 fewer than on 9/11) (Oliva et al 2020).

Patients whose rx opioid was stopped were 3 times MORE likely to die by OD than those whose medicine continued (James 2019).
4.9% of discontinued patients died of OD.
1.7% of continued patients died of OD.

Discontinuation of rx #opioids was associated with 1.35 times the risk of death & 2.94 times the risk of fatal OD compared to patients whose rx continued (James et al 2019).
Read 12 tweets
#Opioid tapering is "extremely difficult" for people w/ #ChronicPain, "not only in those w/ problematic opioid use."

Kurita: Worsened pain &/or function led more than half of those studied to stop scheduled dose reduction of 10% or 20% per week. /thread onlinelibrary.wiley.com/doi/full/10.10…
1b/ Kurita: Altho 40 of 75 didn't complete the taper, researchers found "improvements after opioid treatment stabilization was achieved," suggesting stabilization (whether at a dose or at 0 dose) is a preferable goal to forcing everyone off rx #opioids.

Stopping can be fatal.
2/ Glanz: "Attempts to adhere to prescribing guidelines may lead patients to be exposed to variability in #opioid dosing." Dose variability of 30% or more increases the risk of overdose more than 300%.

Glanz et al. JAMA Network Open. 2019;2(4):e192613.
jamanetwork.com/journals/jaman…
Read 16 tweets
2019 study in the AMA journal reports that reducing access to rx #opioids has "failed" to reduce overdoses.

OD crisis is projected to become "substantially worse" if public policy continues to wrongly target medical use. (thread) filtermag.org/rate-of-opioid…
Chen et al (JAMA 2019): Analyses of programs designed to reduce overdoses by reducing the medical use of #opioids "have failed to demonstrate a consistent benefit on fatal or nonfatal opioid overdoses." jamanetwork.com/journals/jaman… Image
JAMA> #OD rates are projected to soar 149% above 2015's crisis levels by 2025. Overdose deaths from 2016-25 could reach as high as 1.21 million if the crisis doesn't soon stabilize.

🟡 Continuing prescription restrictions will have a "modest effect, at best" on reducing ODs. Image
Read 13 tweets
Yearly since 2012, #opioid prescriptions have hit all-time lows as #overdoses hit all-time highs. Here's why:

1>#Addiction thru medical use is "very rare" (@AmericanCancer Society).

2>Multiple studies show stopping/tapering rx #opioids *increases* the risk of OD or #suicide. Image
#CDC had to get #squirrely w/ data in 2013 to make it seem as tho #opioid scripts were fueling overdoses. Note they compare kilograms per 10,000 to ODs per 100,000 & literally fail to connect the dots when scripts fell in 2012. Image
#Opioid prescribing peaked 8 years ago, & drug overdoses are the #1 cause of death for Americans under 50. Denying or discontinuing medicine *increased* rates of #OD & #suicide.

Doctors & policymakers are killing people to "save" them from the "very rare" risk of #addiction.
Read 6 tweets
What have false assumptions about rx #opioids cost people in #pain? Damn near everything.

@Brian_Goldstone's report ought to be required reading for every #PCP & every legislator who wants to play doctor. #MedicalTwitter harpers.org/archive/2018/0…
For 4 yrs, an rx #opioid let Austin Sell escape the cage of pain, care for his kids, study to become a physician asst to help others w/ #ChronicPain. Then lawmakers in DC imposed a limit on what his clinic could prescribe. "And that was it. The app'ment lasted about 10 minutes."
Dr @StefanKertesz told @Harpers: “In a time of incredible tragedy, there’s a desire for something simple to latch onto as a way of explaining it. A story that has a clear-cut villain, with doctors as dupes and patients as innocent victims, is about as easy to sell as any story.”
Read 25 tweets
.@NPR's response to the outcry that they wrongly blamed medical #opioid use as the cause of the OD epidemic? 4 days later they did it again. @BrianMannADK @carriefeibel @vicwj This is LAZY & HARMFUL reporting.

Evidence shows: #ODs & #suicides go UP as # of scripts goes DOWN.
.@NPR @BrianMannADK @carriefeibel @vicwj

🔴 2,887 #vets DIED from #OD or #suicide AFTER their #opioid pain med was stopped in FY 2013.

🔴 1 year of the VA's policy to take #vets off medicine produced just 90 fewer bodies than 9/11. (Link next tweet)
VA study showing people are 4 to 6.8 times MORE LIKELY to die of #overdose or #suicide after discontinuation of a prescription #opioid. THIS IS NOT AN OUTLIER. @NPR, PLEASE contact co-author @StefanKertesz. bmj.com/content/368/bm…
Read 9 tweets
.@AmerMedicalAssn STILL hasn't read a study they published in 2019 showing rx #opioid limits "have failed" to reduce #ODs.

@AmericanCancer Society explains: People "very rarely" become addicted from medical use. Thread: Research shows pushing patients off opioids can kill them.
"#Addiction is very rare" when #opioid pain meds are taken as prescribed (American Cancer Society). Large studies have put the rate of addiction in medical use at under 1%. #cpp

-Brat bmj.com/content/bmj/36…
-Ciesielski
amjmed.com/article/S0002-…
-AmCancer
pdffox.com/get-help-for-c…
Chen et al: Restrictions on rx #opioids "have failed" to reduce ODs. Complex mathematical modeling shows they'll likely have a "modest effect, at best" on expected rises in ODs, which are fueled by illegal drugs. jamanetwork.com/journals/jaman…
Read 10 tweets
Welcome to today's session of #HRwithEM, a weekly #TwitterSession #TweetChat to connect, learn and share career development tips, employee experience practices, as well as resolve burning #HR issues and/or questions.
Thank you for joining us this evening. Please identify yourself and the location you are joining from, so we can acknowledge you properly. #HRwithEM
Feel free to tweet your question(s) at me with the hashtag #HRwithEM as the session is going on, and I would respond to all at the end of the session.
Read 26 tweets

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