An Interpretive Description of Drug Withdrawal Among Pregnant Women in Jail.

OBJECTIVE: To explore the experience of drug withdrawal among pregnant women in jail. DESIGN: A qualitative interpretive descriptive approach. SETTING/PROBLEM: The care of incarcerated pregnant women constitutes a complex and significant public health problem. Many have substance use disorder (SUD) and cycle in and out of jails in their community, resulting in repeated experiences of drug withdrawal. Most jails do not provide medication-assisted therapy for management of withdrawal, a situation that violates standards of care set by leading health organizations. The experience of drug withdrawal among pregnant women in jail has not been qualitatively explored in the literature. PARTICIPANTS: Five women completed interviews for the study. INTERVENTION: In-depth, qualitative interviews. RESULTS: Five themes with subthemes emerged from the interviews: Framing the Story Through Life History: I Need You to Know Where I Come From, Patterns of Thinking About Substance Use, The Manifestations of Withdrawal: Body and Mind, Perceived Punishment for Drug Use During Pregnancy, and Mixed Perceptions of Withdrawal Treatment. CONCLUSION: Participants told a story beyond that of the physical withdrawal symptoms, revealing new insights into their maternal distress and the need for compassionate, nonstigmatized care to address physical and mental symptoms, as well as advocacy for the provision of an evidence-based standard of care. Nurses who care for pregnant women with SUD in the jail setting could benefit from collaborative relationships with other health care professionals in the community to reduce disparate health outcomes for this vulnerable population.

Association of adherence to high-intensity physical activity and the Mediterranean-dietary approaches to stop hypertension intervention for neurodegenerative delay diet with cognition: A cross-sectional study.

BACKGROUND: Prevention is a priority in the absence of a cure for dementia. Physical activity and a neuroprotective diet such as the Mediterranean-Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) diet are healthy lifestyle behaviors that may slow the onset of dementia. However, research on the relationship between the combination of physical activity and the MIND diet and cognition is rare. OBJECTIVES: The purpose of this study was to investigate whether the combination of high-intensity physical activity and the MIND diet is associated with better cognition compared with either behavior alone or neither behavior. DESIGN: A population-based, cross-sectional study was conducted using data from the Health and Retirement Study. METHODS: Using information from a total of 3463 participants (age 68.0 ±â€¯10.0 years), multivariate linear regression models and binary logistic regression models with interaction terms between high-intensity physical activity (PA) and the MIND diet (MIND) were used to assess associations of PA and MIND with global cognition and odds of cognitive decline. Group comparisons were conducted among four groups: PA-/MIND-, PA+/MIND-, PA-/MIND+, and PA+/MIND+. RESULTS: PA+/MIND- did not predict cognitive outcomes (versus PA-/MIND-). PA-/MIND+ was associated with better global cognition (mean difference [d] = 0.81; 95% confidence interval [CI] = 0.50-1.11; p < 0.001) and lower odds of cognitive decline (odds ratio [OR] = 0.68; 95% CI = 0.54-0.86; p = 0.001) (versus PA-/MIND-). PA+/MIND+ predicted better global cognition (d = 0.98; 95% CI = 0.59-1.36; p < 0.001) and lower odds of cognitive decline (OR = 0.69; 95% CI = 0.50-0.94; p = 0.004) (versus PA-/MIND-). PA+/MIND+ was associated with better global cognition (d = 0.60; 95% CI = 0.08-1.12; p < 0.001), but did not predict lower odds of cognitive decline (versus PA+/MIND-). PA+/MIND+ did not predict cognitive outcomes (versus PA-/MIND+). CONCLUSIONS: Combining high-intensity physical activity and the MIND diet was associated with better cognitive health than high-intensity physical activity alone or non-adherence to both behaviors. To potentially exert additive effects, it will be important to encourage these two healthy habits. More research on the role of combined physical activity and dietary change is necessary to further inform policy and clinical guidance.

A Concept Analysis of Dependence Using Rodgers' Evolutionary Method.

The concept of dependence covers a broad range of experiences. Many health-related professions, including nursing, use the concept in the context of substance use and addiction; however, the use of the concept is often confusing and lacks distinct boundaries. Researchers and theorists in nursing require conceptual clarification and definition because it helps ensure effective theory development and operationalization of the concept as a research variable. A concept analysis using Rodgers' Evolutionary Method is presented, resulting in a revised definition of dependence, as it relates to substance use disorders and addiction. This analysis and resultant definition are timely to the nation's opioid use disorder epidemic. Surrogate terms, related concepts, attributes, assumptions, consequences, and a model case of dependence support the assertion for a change in terminology and culminate with clarification of a new definition for use in nursing.