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The International Journal on Drug Policy Aug 2023Nations wrestle with whether to prohibit products that can harm consumers and third parties but whose prohibition creates illegal markets. For example, cannabis is...
BACKGROUND
Nations wrestle with whether to prohibit products that can harm consumers and third parties but whose prohibition creates illegal markets. For example, cannabis is banned in most of the world, but supply for non-medical use has been legalized in Uruguay, Canada, and much of the United States and possession restrictions have been liberalized in other countries. Likewise, supply and possession of fireworks have been subject to varying degrees of prohibition in multiple countries, with those bans prompting significant evasion.
METHODS
Current and past history of fireworks regulations, sales, and harms are reviewed and contrasted with those for cannabis. The focus is on the United States, but literature from other countries is incorporated when possible and appropriate. This extends the insightful literature comparing drugs to other vices (such as gambling and prostitution) by comparing a drug to a risky pleasure that is not seen as a vice but which has been subject to prohibition.
RESULTS
There are many parallels between fireworks and cannabis in legal approaches, harms to "users", harms to others, and other externalities. In the U.S. the timing of prohibitions were similar, with prohibitions on fireworks being imposed a little later and repealed a little sooner. Internationally, the countries that are strictest with fireworks are not always those that are strictest with drugs. By some measures, harms are of roughly similar magnitude. During the last years of U.S. cannabis prohibition, there were about 10 emergency department (ED) events per million dollars spent on both fireworks and illegal cannabis, but fireworks generated very roughly three times as many ED events per hour of use/enjoyment. There are also differences, e.g., punishments were less harsh for violating fireworks prohibitions, fireworks consumption is heavily concentrated in just a few days or weeks per year, and illegal distribution is primarily of diverted legal products, not of illegally produced materials.
CONCLUSIONS
The absence of hysteria over fireworks problems and policies suggests that societies can address complex tradeoffs involving risky pleasures without excessive acrimony or divisiveness when that product or activity is not construed as a vice. However, the conflicted and time-varying history of fireworks bans also show that difficulty balancing freedoms and pleasure with harms to users and others is not restricted to drugs or other vices. Use-related harms fell when fireworks were banned and rose when those bans were repealed, so fireworks prohibitions can be seen as "working" from a public health perspective, but not well enough for bans to be employed in all times or places.
Topics: Humans; United States; Cannabis; Marijuana Use; Public Policy; Canada; Commerce; Legislation, Drug
PubMed: 37315476
DOI: 10.1016/j.drugpo.2023.104081 -
Journal of Cognition 2023Interacting with music is a uniquely pleasurable activity that is ubiquitous across human cultures. Current theories suggest that a prominent driver of musical pleasure...
Interacting with music is a uniquely pleasurable activity that is ubiquitous across human cultures. Current theories suggest that a prominent driver of musical pleasure responses is the violation and confirmation of temporal predictions. For example, the pleasurable urge to move to music (PLUMM), which is associated with the broader concept of groove, is higher for moderately complex rhythms compared to simple and complex rhythms. This inverted U-shaped relation between PLUMM and rhythmic complexity is thought to result from a balance between predictability and uncertainty. That is, moderately complex rhythms lead to strongly weighted prediction errors which elicit an urge to move to reinforce the predictive model (i.e., the meter). However, the details of these processes and how they bring about positive affective responses are currently underspecified. We propose that the intrinsic motivation for learning progress drives PLUMM and informs the music humans choose to listen to, dance to, and create. Here, learning progress reflects the rate of prediction error minimization over time. Accordingly, reducible prediction errors signal the potential for learning progress, producing a pleasurable, curious state characterized by the mobilization of attentional and memory resources. We discuss this hypothesis in the context of current psychological and neuroscientific research on musical pleasure and PLUMM. We propose a theoretical neuroscientific model focusing on the roles of dopamine and norepinephrine within a feedback loop linking prediction-based learning, curiosity, and memory. This perspective provides testable predictions that will motivate future research to further illuminate the fundamental relation between predictions, movement, and reward.
PubMed: 37720891
DOI: 10.5334/joc.320 -
Current Pain and Headache Reports Aug 2023Music therapy has seen increasing applications in various medical fields over the last decades. In the vast range of possibilities through which music can relieve... (Review)
Review
PURPOSE OF REVIEW
Music therapy has seen increasing applications in various medical fields over the last decades. In the vast range of possibilities through which music can relieve suffering, there is a risk that-given its efficacy-the physiological underpinnings are too little understood. This review provides evidence-based neurobiological concepts for the use of music in perioperative pain management.
RECENT FINDINGS
The current neuroscientific literature shows a significant convergence of the pain matrix and neuronal networks of pleasure triggered by music. These functions seem to antagonize each other and can thus be brought to fruition in pain therapy. The encouraging results of fMRI and EEG studies still await full translation of this top-down modulating mechanism into broad clinical practice. We embed the current clinical literature in a neurobiological framework. This involves touching on Bayesian "predictive coding" pain theories in broad strokes and outlining functional units in the nociception and pain matrix. These will help to understand clinical findings in the literature summarized in the second part of the review. There are opportunities for perioperative practitioners, including anesthesiologists treating acute pain and anxiety in emergency and perioperative situations, where music could help bring relieve to patients.
Topics: Humans; Music; Acoustic Stimulation; Pain, Procedural; Bayes Theorem; Pain
PubMed: 37410336
DOI: 10.1007/s11916-023-01138-x -
JAMA Network Open Jan 2024Heart failure (HF) affects more than 6 million adults in the US and more than 64 million adults worldwide, with 50% prevalence of depression. Patients and clinicians... (Randomized Controlled Trial)
Randomized Controlled Trial
IMPORTANCE
Heart failure (HF) affects more than 6 million adults in the US and more than 64 million adults worldwide, with 50% prevalence of depression. Patients and clinicians lack information on which interventions are more effective for depression in HF.
OBJECTIVE
To compare the effectiveness of behavioral activation psychotherapy (BA) vs antidepressant medication management (MEDS) on patient-centered outcomes inpatients with HF and depression.
DESIGN, SETTING, AND PARTICIPANTS
This pragmatic randomized comparative effectiveness trial was conducted from 2018 to 2022, including 1-year follow-up, at a not-for-profit academic health system serving more than 2 million people from diverse demographic, socioeconomic, cultural, and geographic backgrounds. Participant included inpatients and outpatients diagnosed with HF and depression, and data were analyzed as intention-to-treat. Data were analyzed from 2022 to 2023.
INTERVENTIONS
BA is an evidence-based manualized treatment for depression, promoting engagement in personalized pleasurable activities selected by patients. MEDS involves the use of an evidence-based collaborative care model with care managers providing coordination with patients, psychiatrists, and primary care physicians to only administer medications.
MAIN OUTCOMES AND MEASURES
The primary outcome was depressive symptom severity at 6 months, measured using the Patient Health Questionnaire 9-Item (PHQ-9). Secondary outcomes included physical and mental health-related quality of life (HRQOL), measured using the Short-Form 12-Item version 2 (SF-12); heart failure-specific HRQOL, measured using the Kansas City Cardiomyopathy Questionnaire; caregiver burden, measured with the Caregiver Burden Questionnaire for Heart Failure; emergency department visits; readmissions; days hospitalized; and mortality at 3, 6, and 12 months.
RESULTS
A total of 416 patients (mean [SD] age, 60.71 [15.61] years; 243 [58.41%] male) were enrolled, with 208 patients randomized to BA and 208 patients randomized to MEDS. At baseline, mean (SD) PHQ-9 scores were 14.54 (3.45) in the BA group and 14.31 (3.60) in the MEDS group; both BA and MEDS recipients experienced nearly 50% reduction in depressive symptoms at 3, 6, and 12 months (eg, mean [SD] score at 12 months: BA, 7.62 (5.73); P < .001; MEDS, 7.98 (6.06); P < .001; between-group P = .55). There was no statistically significant difference between BA and MEDS in the primary outcome of PHQ-9 at 6 months (mean [SD] score, 7.53 [5.74] vs 8.09 [6.06]; P = .88). BA recipients, compared with MEDS recipients, experienced small improvement in physical HRQOL at 6 months (mean [SD] SF-12 physical score: 38.82 [11.09] vs 37.12 [10.99]; P = .04), had fewer ED visits (3 months: 38% [95% CI, 14%-55%] reduction; P = .005; 6 months: 30% [95% CI, 14%-40%] reduction; P = .008; 12 months: 27% [95% CI, 15%-38%] reduction; P = .001), and spent fewer days hospitalized (3 months: 17% [95% CI, 8%-25%] reduction; P = .002; 6 months: 19% [95% CI, 13%-25%] reduction; P = .005; 12 months: 36% [95% CI, 32%-40%] reduction; P = .001).
CONCLUSIONS AND RELEVANCE
In this comparative effectiveness trial of BA and MEDS in patients with HF experiencing depression, both treatments significantly reduced depressive symptoms by nearly 50% with no statistically significant differences between treatments. BA recipients experienced better physical HRQOL, fewer ED visits, and fewer days hospitalized. The study findings suggested that patients with HF could be given the choice between BA or MEDS to ameliorate depression.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT03688100.
Topics: Adult; Humans; Male; Middle Aged; Female; Depression; Quality of Life; Psychotherapy; Antidepressive Agents; Heart Failure
PubMed: 38231511
DOI: 10.1001/jamanetworkopen.2023.52094 -
PloS One 2023The life quality of about two-thirds of patients with COVID-19 is affected by related olfactory dysfunctions. The negative impact of olfactory dysfunction ranged from...
Effect of any form of steroids in comparison with that of other medications on the duration of olfactory dysfunction in patients with COVID-19: A systematic review of randomized trials and quasi-experimental studies.
BACKGROUND
The life quality of about two-thirds of patients with COVID-19 is affected by related olfactory dysfunctions. The negative impact of olfactory dysfunction ranged from the decreased pleasure of eating to impaired quality of life. This research aimed to provide a comprehensive understanding of the effects of corticosteroid treatments by comparing that to other currently available treatments and interventions.
METHODS
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist's 27-point checklist was used to conduct this review. PubMed (Public/Publisher MEDLINE), PubMed Central and EMBASE (Excerpta Medica Database) databases were conveniently selected and Boolean search commands were used for a comprehensive literature search. Five core search terms were "effects of treatments", " COVID-19-related olfactory dysfunction", "corticosteroids", "treatments" and "interventions". The reporting qualities of the included studies were appraised using JBI (Joanna Briggs Institute) appraisal tools. The characteristics of the 21 experimental studies with a total sample (of 130,550) were aggregated using frequencies and percentages and presented descriptively. The main interventions and their effects on the duration of the COVID-19-related olfactory dysfunction were narratively analyzed.
RESULTS
Among patients with COVID-19, the normal functions of the olfactory lobe were about 23 days earlier to gain with the treatments of fluticasone and triamcinolone acetonide nasal spray compared with that of mometasone furoate nasal spray and oral corticosteroid. The smell loss duration was reduced by fluticasone and triamcinolone acetonide nasal spray 9 days earlier than the inflawell syrup and 16 days earlier than the lavender syrup. The nasal spray of corticosteroids ended the COVID-19-related smell loss symptoms 2 days earlier than the zinc supplementation, about 47 days earlier than carbamazepine treatment and was more effective than palmitoylethanolamide (PEA) and luteolin and omega-3 supplementations and olfactory training. Treatment with oral corticosteroid plus olfactory training significantly improved Threshold, Discrimination and Identification (TDI) scores compared with olfactory training alone. A full dose of the COVID-19 vaccination was not uncertain to reduce the COVID-19-related smell loss duration.
CONCLUSION
Corticosteroid treatment is effective in reducing the duration of COVID-19-related smell loss and olfactory training, the basic, essential and effective intervention, should be used as a combination therapy.
Topics: Humans; Nasal Sprays; Anosmia; Quality of Life; Triamcinolone Acetonide; COVID-19; Randomized Controlled Trials as Topic; Steroids; Adrenal Cortex Hormones; Fluticasone
PubMed: 37531338
DOI: 10.1371/journal.pone.0288285 -
BMJ Open Jul 2023Hypertension affects 40%-60% of adults with hypertrophic cardiomyopathy (HCM), the most common inherited cardiac condition. It can be a diagnostic confounder for HCM,... (Review)
Review
INTRODUCTION
Hypertension affects 40%-60% of adults with hypertrophic cardiomyopathy (HCM), the most common inherited cardiac condition. It can be a diagnostic confounder for HCM, contributing to delayed diagnosis. Clinically, treatment of co-occurring hypertension and HCM poses challenges as first-line and second-line antihypertensive medications are often contraindicated in HCM. The clinical course in adults with hypertension and HCM is also not well understood, and studies examining patient outcomes in this population are equivocal. In this paper, we aim to outline the protocol of a scoping review, a type of literature review, to systematically synthesise existing knowledge on adults with co-occurring HCM and hypertension, highlighting knowledge and evidence gaps, and identifying future research directions to optimise outcomes in this population.
METHODS AND ANALYSIS
This review is guided by Arksey and O'Malley's conceptual framework on conducting scoping reviews. We will search five electronic databases (PubMed, CINAHL, Scopus, Embase and Web of Science) and reference lists of publications to identify eligible articles focusing on medical therapy, clinical course or outcomes in adults with HCM and hypertension, between 2011 and 2023. Our search strategy and presentation of results will be guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Scoping Review guideline. First, two independent reviewers will screen articles, by title and abstract, followed by a full-text screen to identify eligible articles. Relevant data will be extracted and synthesised.
ETHICS AND DISSEMINATION
Ethical approval is not required for this review as it is a secondary data collection of published articles and does not involve human subject participation. We will present results of this review at relevant professional conferences and patient-centred educational events. Results will be published in a peer-reviewed journal.
TRIAL REGISTRATION NUMBER
https://osf.io/cy8qb/?view_only=98197f4850584e51807ff9b62533a706.
Topics: Adult; Humans; Cardiomyopathy, Hypertrophic; Disease Progression; Hypertension; Research Design; Review Literature as Topic; Systematic Reviews as Topic
PubMed: 37463810
DOI: 10.1136/bmjopen-2023-075087 -
Frontiers in Neuroscience 2023Enjoying music consistently engages key structures of the neural auditory and reward systems such as the right superior temporal gyrus (R STG) and ventral striatum (VS)....
Enjoying music consistently engages key structures of the neural auditory and reward systems such as the right superior temporal gyrus (R STG) and ventral striatum (VS). Expectations seem to play a central role in this effect, as preferences reliably vary according to listeners' uncertainty about the musical future and surprise about the musical past. Accordingly, VS activity reflects the pleasure of musical surprise, and exhibits stronger correlations with R STG activity as pleasure grows. Yet the reward value of musical surprise - and thus the reason for these surprises engaging the reward system - remains an open question. Recent models of predictive neural processing and learning suggest that forming, testing, and updating hypotheses about one's environment may be intrinsically rewarding, and that the constantly evolving structure of musical patterns could provide ample opportunity for this procedure. Consistent with these accounts, our group previously found that listeners tend to prefer melodic excerpts taken from real music when it either validates their uncertain melodic predictions (i.e., is high in uncertainty and low in surprise) or when it challenges their highly confident ones (i.e., is low in uncertainty and high in surprise). An independent research group (Cheung et al., 2019) replicated these results with musical chord sequences, and identified their fMRI correlates in the STG, amygdala, and hippocampus but not the VS, raising new questions about the neural mechanisms of musical pleasure that the present study seeks to address. Here, we assessed concurrent liking ratings and hemodynamic fMRI signals as 24 participants listened to 50 naturalistic, real-world musical excerpts that varied across wide spectra of computationally modeled uncertainty and surprise. As in previous studies, liking ratings exhibited an interaction between uncertainty and surprise, with the strongest preferences for high uncertainty/low surprise and low uncertainty/high surprise. FMRI results also replicated previous findings, with music liking effects in the R STG and VS. Furthermore, we identify interactions between uncertainty and surprise on the one hand, and liking and surprise on the other, in VS activity. Altogether, these results provide important support for the hypothesized role of the VS in deriving pleasure from learning about musical structure.
PubMed: 37928727
DOI: 10.3389/fnins.2023.1209398 -
Frontiers in Psychiatry 2023The previous literature has demonstrated that depression, anxiety, and stress are significant predictors of problematic social media use. However, the manifestation of...
BACKGROUND
The previous literature has demonstrated that depression, anxiety, and stress are significant predictors of problematic social media use. However, the manifestation of problematic social media use varies, and the predictive relationship between depression, anxiety, and stress with different subgroups of problematic social media use remains unclear. The aim of this research was to evaluate latent subgroups of problematic social media use among college students and to investigate the impact of depression, anxiety, and stress on these latent subgroups.
METHODS
A survey was carried out among college students in China using a cross-sectional approach. A total of 955 participants were included, with a mean age of 19.50 ± 1.22 years. Participants completed questionnaires containing the Bergen Social Media Addiction Scale (BSMAS) and the Depression, Anxiety, and Stress Scale-21 (DASS-21). The study employed latent profile analysis (LPA) to investigate latent subgroups of Chinese college students with problematic social media use, and a robust three-step approach was used to develop predictive regression mixed models of depression, anxiety, and stress on latent subgroups.
RESULTS
Problematic social media use of Chinese college students can be categorized into four latent subgroups, namely, the high-risk group, the moderate-risk with pleasure group, the moderate-risk with compulsion group, and the low-risk group. The regression model showed that there was a significant difference between the high-risk group and the low-risk group on the stress scale. There was a significant difference between the moderate-risk with pleasure group and the moderate-risk with compulsion group on the depression scale.
CONCLUSION
Problematic social media use is heterogeneous, with depression and stress being potentially key factors influencing problematic social media use. Depression would make college students more likely to be moderate-risk with compulsion problematic social media users than moderate-risk with pleasure problematic social media users, and stress would make college students more likely to be high-risk problematic social media users than low-risk problematic social media users.
PubMed: 38098636
DOI: 10.3389/fpsyt.2023.1306152 -
Frontiers in Psychology 2023Pleasant and comforting bodily contacts characterized intimate and affective interactions. Affective touch informs us about others' emotions and intentions, sustains...
INTRODUCTION
Pleasant and comforting bodily contacts characterized intimate and affective interactions. Affective touch informs us about others' emotions and intentions, sustains intimacy and closeness, protecting from loneliness and psychological distress. Previous evidence points to an altered experience of affective touch in clinical populations reporting interpersonal difficulties. However, there is no investigation of affective touch in obesity, which is often associated with negative affective-relational experiences since childhood.
METHODS
This study aimed to provide the first evidence about the experience of affective touch in obesity by comparing 14 women with obesity with 14 women with healthy weight. Participants rated the pleasantness of both imagined and actual tactile stimuli, which consisted of () soft-brush strokes, () touches of the experimenter's hand, and () of a plastic stick (as control, non-affective, stimulation). Participants should report the pleasantness of each kind of touch. Moreover, we explored lifespan experiences of affective touch and interpersonal pleasure in social contexts through self-report questionnaires.
RESULTS
No differences emerged for the pleasantness of affective touch (in both the real and imagery task) between the two groups. However, participants with obesity reported less frequent and less satisfying early experiences of affective touch when compared with the controls.
DISCUSSION
Our results spoke in favor of a preserved experience of affective touch when experimentally probed in obesity, despite a limited early exposure to bodily affective contacts. We interpreted our results in the light of the . Nevertheless, we provided crucial methodological considerations for future research, considering that both the experimenter's and the brush touch may not resemble adequately real-life experiences, in which affective touch involves intimate people.
PubMed: 37701865
DOI: 10.3389/fpsyg.2023.1171070