A comparative study of old versus novel psychoactive substances on craving, perceived stigma and suicidal risk among rural-dwelling patients with substance abuse

WHAT IS KNOWN ON THE SUBJECT?: According to recent estimates, 10.4% of adults are patients with substance abuse, which is almost double the global rate. Rural areas are typically marginalized, compounded by a lack of access to mental health care, creating a startling disparity in suffering from drug use issues among rural cohorts. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Drawing on data from a descriptive comparative design would provide a distinctive picture related to the similarities and/or differences in relation to craving and how it affects perceived stigma and suicidal risk among patients using old versus novel psychoactive substances. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Substance abuse is a leading public health concern that forces nurses to encompass it into their agendas to tackle this looming problem. Addiction rehabilitation services are frequently run by nurses. They are well-versed in supporting patients during their journey to recovery and enabling them to adjust to a new lifestyle.

ABSTRACT

INTRODUCTION: Substance use disorder is a leading public health concern that currently, nations regulatory agencies are grappled with. The noticeable difference in the chemical structures between old and novel psychoactive substances can result in significant clinical complications among patients with substance abuse.

AIM

The study aims to compare substance craving, perceived stigma and suicidal risk among patients addicted to old and novel psychoactive substances (NPS).

METHOD

A descriptive comparative design was adopted on a sample of 105 patients with substance use who completed The Penn Alcohol Craving Scale (PACS), The Perceived Stigma of Addiction Scale (PSAS) and Suicide Probability Scale (SPS).

DISCUSSION

Most participants were male, with 89.5% in the old addictive substance group and 93.8% in the new addictive substance group. A statistically significant difference in the NPS groups' perceptions of stigma (23.4 ± 5.3) compared to the old addictive substance group (20.6 ± 4.2), (t = 3.037, p = .003).

IMPLICATION FOR PRACTICE

Participants in the new substance group report more suicidal ideation, negative self-evaluation and hostility than those in the old substance group. Policies and practices should be tailored to the type of drug used and potential risk factors to avoid suicide among patients with substance abuse.

The feasibility of motivational interviewing on adherence to care practices, emotional intelligence, and dispositional optimism among patients with permanent pacemakers

AIMS

Motivational interviewing (MI) has been recognized as highly effective for treating chronic diseases and various conditions, with encouraging results demonstrating its effectiveness in promoting health behaviour change. The current study was proposed to evaluate the feasibility of MI on adherence to care practices, emotional intelligence (EI), and dispositional optimism among patients with permanent pacemakers.

METHODS AND RESULTS

This study was a parallel arm randomized controlled trial. Seventy clients with permanent pacemakers were randomly allocated to a six-session MI intervention (n = 35) or a waiting list control group (n = 35). A statistically significant improvement in the mean scores of adherence to care practices, EI, and dispositional optimism, along with a significant reduction in pessimism, was registered among the study group compared with the control group.

CONCLUSION

Following the intervention for 1- and 2-month follow-up measurements, there were statistically significant improvements in self-care practice adherence. After 1 month of intervention, there were statistically significant gains in EI and dispositional optimism, but at the 2-month follow-up measurement, this improvement had somewhat lessened. The findings suggest that MI may be a feasible and practical approach for improving adherence to care practices, EI, and dispositional optimism in patients with permanent pacemakers.

REGISTRATION

ClinicalTrials.gov: NCT05883514.

Impact of resilience-based intervention on emotional regulation, grit and life satisfaction among female Egyptian and Saudi nursing students: A randomized controlled trial

AIM

Evaluate and compare the impact of a resilience-based intervention on emotional regulation, grit and life satisfaction among female Egyptian and Saudi nursing students.

BACKGROUND

Nursing students should experience a comprehensive learning environment since they are mind-body-spirit creatures. Therefore, nursing education should emphasize growing students' physical, social, emotional and spiritual well-being in addition to their knowledge, skills and attitudes.

DESIGN

This study followed a parallel arm randomized controlled trial design. Study participants were randomly assigned to the intervention or control groups in a (1:1) ratio. It was conducted between January 2023 and the end of April 2023.

METHOD

Students were randomly allocated to the eight-week resilience intervention (n= 60) or a control (n= 60) group (half of the students in each group were from each country). The intervention group received a pamphlet and attended eight weekly 15-person sessions on resilience, grit (perseverance), emotional regulation and self-care. The Emotion Regulation Questionnaire, the Short Grit Scale and the Satisfaction with Life Scales were administered pre- and immediately post-intervention.

RESULTS

Between pre- and post-intervention, there were significant improvements in grit (from 41.374.27 to 51.235.22 among Egyptian students with an effect size of 0.663 and from 42.974.30 to 54.103.87 among Saudi students with an effect size of 0.800), as well as mean emotional regulation (from 36.635.11 to 55.707.51 among Egyptian students with an effect size of 0.818 and from 44.606.87 to 61. With a substantial effect size of 0.850 (p0.001), Egyptian nursing students experienced a more significant rise in mean life satisfaction than Saudi nursing students (18.336.54 to 29.305.14).

CONCLUSION

Resilience-based interventions enhanced emotional regulation, grit and life satisfaction in Egyptian and Saudi female nursing students. Grit, resilience and emotional regulation should be incorporated into nurse training to equip female students with the necessary values and protective factors to succeed in their studies. Given the unique challenges and stressors that female nursing students may face, nursing programs and institutions must provide resources and support services to help students manage stress and build resilience.

Association of Vitamins D, B6, and B12 Deficiencies with Hyperlipidemia Among Jordanian Adults

Background

Obesity is an abnormal fat accumulation that adversely affects human health. Studies reported several vitamin deficiencies in obese patients. The current study investigates the deficiencies of vitamins D, B6, and B12 among Jordanian adults with hyperlipidemia and demonstrates the association between serum vitamin levels and metabolic and lipid profile parameters.

Methods

Sixty male subjects were divided into 40 hyperlipidemic patients (age: 45.9 yr. ±10.2) and 20 controls (age: 41.2 yr. ±10.7). The blood levels of triglycerides, total cholesterol, high density lipoprotein (HDL)-cholesterol, hemoglobin A1c, and vitamins D, B6, and B12 were measured.

Results

The hyperlipidemic patients showed significantly increased triglycerides, total cholesterol, non-HDL, cholesterol/HDL ratio, low-density lipoprotein (LDL)- cholesterol levels, and decreased HDL-cholesterol levels compared to the controls. No significant differences were found in the blood levels of vitamin D, vitamin B6, or vitamin B12 between groups. However, 50% of the hyperlipidemic patients and 54.5% of the controls exhibited vitamin D deficiency. Only the hyperlipidemic patients exhibited deficiencies of vitamins B6 and B12 in 5.4% and 3.3% of cases, respectively. In the controls, vitamin B12 level was inversely associated with total cholesterol, whereas in the hyperlipidemic patients, vitamin B6 level was inversely correlated with total cholesterol and non-HDL levels.

Conclusions

The hyperlipidemic patients exhibited vitamins D, B6, and B12 deficiencies. Additionally, vitamins B6 and B12 levels were inversely correlated with total cholesterol and non-HDL levels. Our findings highlight the importance of routine evaluation of vitamin levels in patients with hyperlipidemia.

The Pro-Oxidant, Apoptotic and Anti-Angiogenic Effects of Selenium Supplementation on Colorectal Tumors Induced by 1,2-Dimethylhydrazine in BALB/C Mice

BACKGROUND

Selenium is a mineral that showed both pro- and anti-oxidant activities in various disease models. In this study, we evaluated the anti-tumor effect of selenium against 1,2-dimethylhydrazine (DMH)-induced colorectal cancer in BALB/C mice and its effect on apoptosis and angiogenesis.

METHODS

Colorectal cancer was induced by subcutaneous injection of DMH (20 mg/kg body weight) in BALB/C mice once weekly for 20 weeks. Selenium (200 mg/L) was given to DMH plus selenium-treated group in the drinking water for the next 3 months.

RESULTS

The DMH plus selenium-treated group exhibited significantly lower expression of cloned caudal-type homebox gene -2 (CDX-2) and vascular endothelial growth factor (VEGF) but higher caspase-3 expression level at p < 0.001 compared to the DMH-treated group. Moreover, a decrease in the reduced glutathione content and glutathione peroxidase activity but an increase in the malondialdehyde content were observed at p < 0.001. Both macroscopic and microscopic examination of the colorectal tissues confirmed the results.

CONCLUSION

The anti-tumor effect of selenium against an induced colorectal cancer in mice is attributed to its pro-oxidant, anti-angiogenic and apoptotic effects.

Polymorphisms of α1-antitrypsin and Interleukin-6 genes and the progression of hepatic cirrhosis in patients with a hepatitis C virus infection

Hepatitis C virus (HCV) infection represents a serious health problem. The –174 G/C mutation in the pro inflammatory cytokine interleukin-6 (IL-6) is associated with developing liver diseases. Likewise, the S and Z mutations in the serine protease inhibitor α1-antitrypsin (A1AT) are associated with pulmonary emphysema and/or liver cirrhosis. We explored the distribution of the single nucleotide polymorphisms (SNPs) of IL-6 and A1AT genes in chronic HCV-infected patients and evaluated their impact on the progression of liver cirrhosis.

One hundred and fifty Egyptian HCV-infected patients together with 100 healthy controls were enrolled in this study. The patient groups were subdivided into chronic hepatitis patients (n = 85) and cirrhotic patients (n = 65). The SNP of IL-6 (–174 G/C, rs1800795), A1AT Z mutation (342 Glu/Lys, rs28929474) and A1AT S mutation (264 Glu/Val, rs17580) were determined using a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method.

Cirrhotic patients exhibited significantly increased frequency of the A1AT S allele compared with the controls (34.6 vs. 5.0%), while the chronic hepatitis patients showed a higher frequency of the A1AT Z allele compared with the controls (14.7 vs. 2.5%). Remarkably, IL-6 (CC genotype) was detected only in the chronic hepatitis patients. Multivariate regression analysis showed that aspartate transaminase (AST) and the S alleles of A1AT, represented as SS+MS genotypes, were significantly independent predictors for development of liver cirrhosis. We concluded that inheritance of deficient S and Z alleles of the A1AT gene but not IL-6 (–174 G/C), were associated with progressive liver diseases.

RAPD assessment of in vivo induced genotoxicity of raw and treated wastewater to albino rat

Randomly amplified polymorphic DNA (RAPD) was applied to assess the potential genotoxicity of wastewater to albino rats. Cluster analysis using the Euclidean distance resulted in two clusters; one includes the control rats and the treated wastewater-injected rats (join at a distance of 0.57). The other one includes the rats injected with the raw wastewater (joins the first cluster at a distance of 0.6). Results confirm the ability of both raw and treated wastewater to in vivo induce genotoxic effects to rats. This demonstrates that the treatment process does not remove all mutagens found in raw wastewater completely. Consequently, the reuse of treated wastewater for irrigation poses health and environmental hazard. Therefore, we recommend genotoxicity testing be used to monitor the quality of wastewater effluents, in addition to the traditional tests used. Besides, hazardous chemicals from laboratories should be separated and treated differently. Finally, RAPD test is a reliable one that can be applied to evaluate in vivo genotoxic effects of chemicals.

Quality assessment of roof-harvested rainwater in the West Bank, Palestinian Authority

Rain harvesting is becoming more common in the Palestinian Territories as a result of drinking water scarcity. Although it might pose serious human health risk, this water is being consumed without treatment in many areas of the West Bank. The present study evaluates the physicochemical and microbial quality of harvested rainwater that is used as potable water in the West Bank. Samples from roof-harvested rainwater storage tanks (n = 42) were collected in summer (SS) 2006/winter (WS) 2007. Physicochemical parameters measured were: temperature, pH, electrical conductivity, salinity, total dissolved solids, turbidity, nitrate, copper and lead. With few exceptions, all these parameters were within WHO guideline values. All samples (100%) were found to contain coliforms and to be heavily contaminated with heterotrophic bacteria. About 67% of all samples were contaminated with fecal coliforms. Specific PCR technique confirmed the presence of five pathogenic microorganisms that can be ordered according to their prevalence as: Citrobacter (83%) > Acinetobacter (78%) > Aeromonas (52%) > Pseudomonas and Campylobacter (7%). Prevalence of microorganisms in SS was higher than in WS. Although the physicochemical quality of most harvested rainwater samples was in accordance with WHO guidelines for drinking water, stored rainwater was significantly contaminated with bacteria resulting in significant human health risk from infectious diseases.

Distribution of toxic metals in organs of local cattle, sheep, goat and poultry from the West Bank, Palestinian Authority

Graphite furnace atomic absorption spectrophotometry was used to measure the concentrations of Cu, Cd, Pb, and Zn in muscles and internal organs (liver, kidneys, heart, and lungs) of cattle, sheep goat and poultry sampled from local markets in the West Bank, Palestinian Authority. Mean levels of metals (dry weight basis) during this study were as follows: Cd: 0.34-0.57 microg/g, Pb: 0.2-4.7 microg/g, Cr: 0.44-3.62 microg/g and Cu: 1.03-217.9 microg/g. Muscles and internal organs of each species were found to have statistically different metal levels. Generally, livers and kidneys were found to have the highest levels of metals and muscles the lowest levels. When compared to each other, the four animal groups either did not show any significant differences or no clear trends. Compared to results reported in the literature, our results were comparable to or less than most of the studies reported from clean sites in different countries.

Assessment of heavy metal contamination in roadside surface soil and vegetation from the West Bank

Concentrations of heavy metals (Pb, Cd, Cu, Zn, Fe, Mn, Ni, and Cr) were investigated in roadside surface soil and the common perennial herb inula (Inula viscosa L., Compositae). Samples were collected at different distances (0-200 m) perpendicular to a main road that connects two main cities in the West Bank. Average concentrations of metals in soil samples were: Pb, 87.4; Cd, 0.27; Cu, 60.4; Zn, 82.2; Fe, 15,700; Mn, 224; Ni, 18.9; and Cr, 42.4 microg x g(-1). In plant leaves, concentrations were: Pb, 7.25; Cd, 0.10; Cu, 10.6; Zn, 47.6; Fe, 730; Mn, 140; Ni, 4.87; and Cr, 7.03 microg x g(-1). Roadside contamination was obvious by the significant negative correlations between concentrations of metals in soil and plant samples and distance from road edge. Only cadmium concentrations in soil and plant samples were not associated with roadside pollution. Roadside contamination in plants and soil did not extend much beyond a 20 m distance from road. I. viscosa reflected roadside contamination better than soil and their metal concentrations showed much less fluctuations than those in soil samples. Washing plant leaves decreased Pb and Fe concentrations significantly, indicating a significant aerial deposition of both. I. viscosa can be considered as a good biomonitor for roadside metal pollution.