Synthetic cannabinoid use in an adult male prison in the UK

INTRODUCTION

Synthetic cannabinoids (i.e. Spice) are a major public health problem in UK prisons, however, research in this area is limited. Here we aimed to draw comparisons between people with and without experience of using synthetic cannabinoids in prison, to characterise the features of, and motivations for use within this setting and evaluate support for different treatment interventions.

METHOD

Questionnaires were administered to 122 people in a category-B prison for adult males in England between July 2022 and March 2023. Participants were asked questions related to their sociodemographic and custodial characteristics, use of synthetic cannabinoids (and other drugs) inside and outside of prison and psychological distress was measured via the Brief Symptom Inventory (BSI-18). Those that had ever used synthetic cannabinoids in prison completed additional questions related to features of use, motivations for use and support for various interventions.

RESULTS

In total 46.7 % (n = 57) of participants reported use of synthetic cannabinoids in prison and this group experienced significantly greater levels of psychological distress compared to those reporting no use (mean (± standard deviation) BSI-18 scores = 23.7 (±16.7) vs 12.8 (±13.6), p < 0.001). Participants mostly reported using paper-based preparations (77.4 %) and use via e-cigarettes (75.9 %). The most strongly endorsed motivations for use included to alleviate boredom (91.1 % strongly agree/agree), to make the sentence pass faster (89.3 % strongly agree/agree) and to cope with stress (80.4 % strongly agree/agree). The interventions that received most support were strategies to better manage time and medication to manage withdrawal.

CONCLUSIONS

The use of synthetic cannabinoids in UK prisons typically involves the use of paper-based preparations via e-cigarettes, and use is associated with greater levels of psychological distress. Motivations for use were mostly pragmatic (e.g. to alleviate boredom or cope with stress) and interventions should prioritise increasing the time individuals spend out of cells and in meaningful activity.

Senolytics rejuvenate the reparative activity of human cardiomyocytes and endothelial cells

Background

Senescent cells have emerged as bona fide drivers of ageing and age-related cardiovascular disease, with senescent cells accumulating in the aged heart and following damage/injury. We have shown that removal of senescent cells using senolytics can rejuvenate the regenerative capacity of the aged heart.

Purpose

We investigate the effects of cell senescence and action of the senolytics, Dasatinib (D) and Quercetin (Q), on human cardiomyocyte and endothelial cell viability, survival, proliferation, angiogenesis and senescence in vitro.

Methods

We developed a transwell insert co-culture stress-induced premature senescence model system in vitro. Doxorubicin was used to induce premature senescence to cardiac stromal progenitor cells or HUVECs, which were seeded on the bottom chamber. In separate well plates, untreated cells (non-senescent) were seeded on the bottom chamber and acted as control. Human iPSC-cardiomyocytes (iPSC-CMs) or HUVECs were seeded on the top chamber insert. Co-cultures were left for 7 days and then iPSC-CMs or HUVECs in the top chamber were analysed for viability, proliferation and markers of senescence, and the conditioned medium analysed for SASP factors. The cultures were then treated with D+Q (0.5μM D with 20μM Q) for 3 days to clear the senescent cells in the bottom chamber. Then 7 days later the iPSC-CMs or HUVECs in the top chamber were analysed for viability, proliferation and the markers of senescence, and conditioned medium analysed for SASP factors (total of 17 days).

Results

Co-culture of iPSC-CMs with senescent cells led to decreased iPSC-CM viability (64±11% vs. 100±3% control; p&lt;0.05) and proliferation (5±2% vs. 11±1% control; p&lt;0.05). There was no increased senescence in co-cultured iPSC-CMs. Treatment with senolytics D+Q resulted in rescue of viability (79±23% 17d co-culture+D+Q; 64±9% 17d co-culture; 100±4% 17d control) and proliferation (7±2% 17d co-culture+D+Q; 3±0.3% 17d co-culture; 8±0.3% 17d control). Similar effects were observed with HUVECs, which showed decreased viability (83±5% vs. 100±6% control; p&lt;0.05) and proliferation (21±7% vs. 44±7% control; p&lt;0.05) when co-cultured with senescent HUVECs. Treatment with senolytics ameliorated HUVEC viability (61±22% 17d co-culture+D+Q; 21±12% 17d co-culture; 100±5% 17d control), proliferation (30±5% 17d co-culture+D+Q; 22±4% 17d co-culture; 48±4% 17d control) and angiogenesis (Score relative to control: 1.1±0.5 D+Q conditioned media; 0.2±0.1 senescent cell conditioned media; 1.0±0.3 control media). Luminex analysis of the senescent cell conditioned media revealed upregulation of SASP factors, but the level of SASP factors were reduced with application of D+Q.

Conclusion

We show that D+Q senolytics have therapeutic potential in rejuvenating the reparative activity of cardiomyocytes and endothelial cells. These results open the path to further studies on using senolytic therapy in age-related cardiac deterioration and rejuvenation.

Funding Acknowledgement

Type of funding sources: Other. Main funding source(s): Heart Research UK

Evaluation of the effect of adding a high-fidelity simulation to an existing didactic lecture to teach pharmacy undergraduates the management of sepsis in secondary care

Introduction

Sepsis is potentially life-threatening, requiring rapid identification and treatment. ‘Sepsis Six’ (1) has become the recognised treatment pathway and has traditionally been taught to our undergraduate pharmacy students in didactic fashion. Interactive teaching methods, such as simulation, are the most effective forms of education to improve patient safety (2). Such approaches might be beneficial in the teaching of sepsis management.

Aim

To evaluate the effect of adding simulation-based teaching to an existing didactic lecture on the management of sepsis.

Methods

Year 4 students at the University of Bath (n=92) attended a sepsis lecture given by a teacher practitioner with experience in managing sepsis in March 2020. Students completed an online survey that used Likert scales to evaluate understanding of sepsis and confidence in managing it (see table).

One week later, small groups of students completed a 30-minute simulation using a SimMan ALS ‘patient’ programmed to show physiological signs of sepsis. Simulations were facilitated by a teacher practitioner with experience of operating SimMan ALS. Each group had a brief outlining the required tasks: reviewing the patient; assessing sepsis risk; summarising a treatment plan and priority actions. After the simulation, students underwent de-brief and completed the same online survey a second time. Changes in students’ responses between surveys were analysed using Wilcoxon signed-rank tests in SPSS, therefore data from students who completed only one survey were not included.

Results

26 students completed both surveys (response rate: 28%). Likert scores for questions 1, 2, 4 and 5 were significantly higher following the simulation, indicating improved confidence and knowledge (see table).

Conclusion

Adding a high-fidelity simulation to an existing didactic lecture increased student confidence in identifying and managing sepsis. Self-reported knowledge of sepsis red flags also increased (indicated by the responses to Statement 1). This study should encourage future sepsis teaching to include a blend of didactic and simulated learning. Limitations include the low response rate, evaluation at only one university and reliance on student self-assessment of knowledge.

References

(1) Daniels, R, Nutbeam, T. et al (2019) The Sepsis Manual 5th Edition. UK Sepsis Trust. www.sepsistrust.org

(2) Yu A, Fontana G, Darzi A (2016). Evaluation of Education and Training Interventions for Patient Safety. A report by the Centre for Health Policy at Imperial College London, an academic partner to Health Education England and the Commission on Education and Training for Patient Safety. London.

Primary prevention program clearinghouse : Prevention issue: Journal of pediatric psychology

The Clearinghouse has been redesigned so that whenever possible abstracts are focused on one theme rather than on an assortment of topics. In this Clearinghouse we are pleased to provide the authors' abstracts of articles published in theJournal of Pediatric Psychology special issue on Health Promotion and Problem Prevention in Pediatric Psychology (Vol. 11, No. 2). The articles demonstrate general and specific approaches to health promotion and prevention of injury, death, and disease in children. In addition, we have included a list of the books reviewed in the special issue.Addresses for requesting individual reprints are provided with each abstract. Alternatively you can order the entire special issue from Plenum Press, 233 Spring Street, New York, NY 10013.

Survey of Hawaii physicians' attitudes on health care reform

Hawaii is more important in health care that its size suggests. It is the first state in the U.S. to have mandated employer-funded health insurance for all workers, and to realize near universal coverage for residents. Because of that, the U.S. can benefit from the experience of those who deliver health services to the people of Hawaii. To determine some of the problems in the current system and what physicians see as solutions, a study of the attitudes and experiences of local physicians was conducted.

Normal ventricles in young schizophrenics

The CT scans of 11 schizophrenics and 26 controls were evaluated for both linear (Evan's and cella media ratios) and volume (planimetry and grid ratios) measurements of ventricular size. There were no differences between the two groups on any of the measures obtained. These results are discussed in relation to previous reports showing ventricular enlargement in schizophrenics. The relatively younger age and briefer period of hospitalization in this present sample are suggested as variables possibly associated with these findings.