Abstract
Objective: To assess the attitudes and knowledge of behavioral health technicians (BHTs)
towards opioid overdose management and to assess the effect of online training on opioid
overdose response on BHTs’ attitudes and knowledge, and the confidence to identify and
respond to opioid overdose situations.

Design/Methods: Pre-intervention Opioid Overdose Knowledge Scale (OOKS) and Opioid
Overdose Attitude Scale (OOAS) surveys were administered electronically to five BHTs in
2020. Data obtained were de-identified. Comparisons between responses to pre-and post-surveys questions were carried out using the standardized Wilcoxon signed-rank statistical test(z). This study was conducted in a residential treatment center (RTC) with the institutional review board's approval from Arizona State University. BHTs aged 18 years and above, working at this RTC were included in the study.

Interventions: An online training was provided on opioid overdose response (OOR) and
naloxone administration and on when to refer patients with opioid use disorder (OUD) for
medication-assisted treatment.

Results: Compared to the pre-intervention surveys, the BHTs showed significant improvements
in attitudes on the overall score on the OOAS (mean= 26.4 ± 13.1; 95% CI = 10.1 - 42.7; z =
2.02; p = 0.043) and significant improvement in knowledge on the OOKS (mean= 10.6 ± 6.5;
95% CI = 2.5 – 18.7; z =2.02, p = 0.043).

Conclusions and Relevance: Training BHTs working in an RTC on opioid overdose response is
effective in increasing attitudes and knowledge related to opioid overdose management. opioid
overdose reversal in RTCs.

Keywords: Naloxone, opioid overdose, overdose education, overdose response program

Anatomical models have always been a mainstay of descriptive embryology. As the training of embryologists grew in the late 1800s, so too did the need for large-scale teaching models. Embryo wax models, such as those made by Adolf Ziegler and Gustav Born, were popular in the latter part of the nineteenth century and the early twentieth century as a way to visualize, in three dimensions, the fine detail of embryos without the aid of a microscope. While these models were found in many university laboratories, museums of science, and even expositions and world's fairs, they were anything but easy to make or obtain. Wax modeling required skill, patience, and specialized tools. Small laboratories with only one or two embryologists often found the prospect of wax modeling too laborious, too difficult, and too expensive to make the pursuit worthwhile. As an alternative, Susanna Phelps Gage, an embryologist at Cornell University, perfected a technique of using stacks of absorbent blotting paper rather than stacks of wax plates for constructing embryo models. She first demonstrated her blotting paper method to other embryologists at the annual meeting of the Association of American Anatomists in 1905 and later at the International Zoological Congress, held in Boston in August 1907.

As the third director of the Carnegie Institute of Washington s Department of Embryology, George Washington Corner made a number of contributions to the life sciences as well as to administration. Corner was born on 12 December 1889 in Baltimore, Maryland, near the newly established Johns Hopkins University. Although Corner was not exposed to science much in school at a young age, he developed an early appreciation for science through conversations with his father about geography and by looking through the family's National Geographic magazines.

Franklin Paine Mall was born into a farming family in Belle Plaine, Iowa, on 28 September 1862. While he attended a local academy, an influential teacher fueled Mall's interest in science. From 1880-1883, he studied medicine at the University of Michigan, attaining his MD degree in 1883. William J. Mayo, who later became a famous surgeon and co-founder of the Mayo Clinic in Rochester, Minnesota, was a classmate of Mall's. Throughout his studies at Michigan, he was influenced by Corydon L. Ford, a professor of anatomy, Victor C. Vaughn, a biochemist and bacteriologist, and Henry Sewall, a physiologist.

Seclusion and restraint are restrictive interventions that continue to be used in both physical care and mental health care settings as a means of controlling dangerous behavior such as aggression. Restrictive interventions place patients and healthcare staff in hostile situations that can lead to physical, mental, and emotional injuries that can last a lifetime. Unfortunately, restrictive interventions continue to be used in many healthcare organizations around the world and the number of patient and staff injuries continue to rise. Stakeholders at a Phoenix area psychiatric inpatient hospital conducted an internal audit on the number of seclusion and restraint episodes in 2019, which revealed an increase in the number of seclusion and restraints episodes on the adolescent unit.

The result of this audit led to the project question: For nurses on an acute adolescent inpatient unit, is a seclusion and restraint education program more effective than usual
practice in changing the knowledge and attitude regarding seclusion and restraint? The purpose of this practice change project was to provide staff education that focused on trauma informed care, de-escalation techniques, and therapeutic communication to improve staff confidence to ultimately lead to the reduction of seclusion and restraint use on an adolescent inpatient unit. A
pre and posttest questionnaire designed to better understand nurse attitude and knowledge regarding restrictive interventions prior to the education session was provided. A convenience sample of nurses (N=9) participated in the project. The findings from the pre and posttest questionnaire suggest that seclusion and restraint education for nurses may improve nurse knowledge and attitude regarding the use of restrictive interventions and reduce rates of use.

The goal of science education in the United States is promoting scientific literacy for all students. The goal necessitates understanding the nature of science-what science is as a body of knowledge, explanatory tool, and human enterprise. The history of science is one of the most long-standing pedagogical methods of getting at the nature of science. But scientific literacy also encompasses education in scientific inquiry, and in the relationships among science, technology, and society (STS), as well as fact and theory-based subject-matter content.

Biologist William Keith Brooks studied embryological development in invertebrates and used his results as evidence for theories of evolution and ancestral heredity. He founded a marine biological laboratory where his and others' embryological studies took place. Later in life, Brooks became head of the Biology Department at Johns Hopkins University where he helped shape the minds of leading embryologists.

Embryos in Wax: Models from the Ziegler Studio is a history of embryo wax modeling written by science historian Nick Hopwood. Published by the Whipple Museum of the History of Science University of Cambridge and the Institute of the History of Medicine University of Bern, 2002, the book, like the wax models, helps exemplify the visual and material culture of science. The first half of the book describes the modeling work of Germany's Adolf and son Friedrich Ziegler during the rise of developmental embryology from 1850 to 1920, a time when embryology's practitioners needed educational aids that could help teach students in laboratories and lay persons in public lectures. Three-dimensional wax models provided just this visual aid.

Florence Rena Sabin had successful careers as both a researcher and public health reformer. When Johns Hopkins University Medical School opened, accepting women and men on the same basis, Sabin was one of the first to enter. After the successful completion of her MD degree, Sabin went on to become the first female faculty member and later full-time professor at Johns Hopkins. From 1924-1925, she was the first woman elected president of the American Association of Anatomists, the first woman elected to the National Academy of Sciences in 1925, and the first woman to become a full member of the Rockefeller Institute. Her research on the brain, the lymphatic system, and immunology was revolutionary, and her vast scientific knowledge and convincing personality greatly contributed to the passage of much needed public health reform legislation during her retirement years in Colorado.

Making Visible Embryos is a 2008 online exhibition of embryos authored and designed by Tatjana Buklijaz and Nick Hopwood who work in the Department of History and Philosophy of Science at the University of Cambridge. Hopwood's research on the history of Ziegler wax models and the use of visual aids to promote the teaching and learning of science is well known.