Understanding the nature of substance use in Zimbabwe: State of the art and ways forward: A scoping review protocol.

Reports of substance use in Zimbabwe paint a concerning picture of escalating prevalence of use, with over half of people admitted to inpatient mental health units reportedly experiencing a substance induced disorder. The country has gone through decades of significant political and socio-economical challenges, which are undoubtedly linked to the observed increases in substances use. Nevertheless, despite the resource constraints to adequately address substance use, the government has shown a renewed resolve to provide a comprehensive approach to address substance use in the country. However, there is a lack of clarity of the nature and extent of substance use and substance use disorders (SUDs), which in part is due to a lack of a national monitoring system for substance use in the country. Moreover, reports of a substance use crisis in Zimbabwe are predominantly based on anecdotal evidence, limiting the ability to gain an accurate picture of the situation. Therefore, a scoping review of the primary empirical evidence of substance use and SUDs is proposed in order to develop an adequately informed understanding of the nature of substance use and SUDs in Zimbabwe. Furthermore, the review will embed an assessment of the response to substance use, together with an analysis of the policy landscape on substance use in Zimbabwe. The PRISMA-ScR checklist will be utilised for the write up. The results of the scoping review will be essential for identifying the current state of knowledge around substance use, and identify gaps in knowledge and policy that would be a catalyst for further work to enhance knowledge and develop solutions situated within the local context. Thus the present work presents a timely effort that capitalises on current efforts by the government to address substance use in the country.

"Spice Was Made, by the Devil Himself": A Thematic Analysis of the Experience of an Addiction to Synthetic Cannabinoids.

Synthetic cannabinoids (SC) are the most common type of new psychoactive substances used predominantly as a replacement for cannabis. There is a wealth of literature on the negative effects experienced by users of SC. However, there is a paucity of research on the experience of addiction to SC from the users' perspectives. The present study qualitatively explored the experience of addiction to SC. Online blog entries detailing the experience of SC addiction were analyzed using thematic analysis. Users reported being stuck in a cycle of addiction which was composed of addiction hallmarks. They also experienced a range of significant physical, mental health and psychosocial problems. Suicidal ideation was also reported, with potential for its occurrence during withdrawal, due to shame of being addicted, and as the only way to stop the addiction cycle. Additionally, both psychotic and cognitive symptoms were reported to persist following cessation, enhancing current understanding of long-term SC effects. Therefore, users require both clinical and psychosocial support for these issues, most notably suicidal ideation.

Development of and Adherence to a Computer-Based Gamified Environment Designed to Promote Health and Wellbeing in Older People with Mild Cognitive Impairment.

BACKGROUND: The older population of Europe is increasing and there has been a corresponding increase in long term care costs. This project sought to promote active ageing by delivering tasks via a tablet computer to participants aged 65-80 with mild cognitive impairment. OBJECTIVES: An age-appropriate gamified environment was developed and adherence to this solution was assessed through an intervention. METHODS: The gamified environment was developed through focus groups. Mixed methods were used in the intervention with the time spent engaging with applications recorded supplemented by participant interviews to gauge adherence. There were two groups of participants: one living in a retirement village and the other living separately across a city. RESULTS: The retirement village participants engaged in more than three times the number of game sessions compared to the other group possibly because of different social arrangements between the groups. CONCLUSION: A gamified environment can help older people engage in computer-based applications. However, social community factors influence adherence in a longer term intervention.