Effect of a religious coping intervention of rational emotive behavior therapy on mental health of adult learners with type II diabetes.

BACKGROUND: Some previous studies have highlighted the high rate of mental health problems associated with type II diabetes (T2DM). The primary purpose of this study was to investigate the effect of a religious coping intervention of rational emotive behavior therapy (REBT) on the mental health of adult learners with T2DM. METHODS: This study utilized a randomized controlled trial to select 146 adult learners with T2DM and mental health-related problems. The treatment group was made up of 73 adult learners, while the control group was also made up of 73 adult learners. The experimental group received 8 sessions of a religious coping intervention of REBT, while the control group received usual care. Data were collected using the patient health questionnaire, Warwick-Edinburgh mental well-being scale, and Kessler psychological distress scale. Repeated ANOVA and univariate analysis of covariance were used for data analyses. RESULTS: The religious coping intervention of REBT substantially enhanced the mental health of adult learners with T2DM as measured by Warwick-Edinburgh mental well-being scale (P < .000) and patient health questionnaire (P < .000). The religious coping intervention of REBT significantly alleviated the psychological distress of adult learners with T2DM as measured by Kessler psychological distress scale (P < .000). CONCLUSION: In this study, it has been demonstrated that a religious coping intervention of REBT effectively improves the mental health of adult learners with T2DM. The study concludes that the religious coping intervention of REBT is a practical alternative medicine approach to enhancing the mental health of adult learners with T2DM.

Association between spine injury and opioid misuse in a prospective cohort of Level I trauma patients.

Objective: To explore patient and treatment factors explaining the association between spine injury and opioid misuse. Design: Prospective cohort study. Setting: Level I trauma center in a Midwestern city. Participants: English speaking patients aged 18 to 75 on Trauma and Orthopedic Surgical Services receiving opioids during hospitalization and prescribed at discharge. Exposure: Spine injury on the Abbreviated Injury Scale. Main outcome measures: Opioid misuse was defined by using opioids: in a larger dose, more often, or longer than prescribed; via a non-prescribed route; from someone other than a prescriber; and/or use of heroin or opium. Exploratory factor groups included demographic, psychiatric, pain, and treatment factors. Multivariable logistic regression estimated the association between spine injury and opioid misuse when adjusting for each factor group. Results: Two hundred eighty-five eligible participants consented of which 258 had baseline injury location data and 224 had follow up opioid misuse data. Most participants were male (67.8%), white (85.3%) and on average 43.1 years old. One-quarter had a spine injury (25.2%). Of those completing follow-up measures, 14 (6.3%) developed misuse. Treatment factors (injury severity, intubation, and hospital length of stay) were significantly associated with spine injury. Spine injury significantly predicted opioid misuse [odds ratio [OR] 3.20, 95% confidence interval [CI] (1.05, 9.78)]. In multivariable models, adjusting for treatment factors attenuated the association between spine injury and opioid misuse, primarily explained by length of stay. Conclusion: Spine injury exhibits a complex association with opioid misuse that predominantly operates through treatment factors. Spine injury patients may represent a subpopulation requiring early intervention to prevent opioid misuse.

Editor's Highlight: PPARß/δ and PPARγ Inhibit Melanoma Tumorigenicity by Modulating Inflammation and Apoptosis.

Skin tumorigenesis results from DNA damage, increased inflammation, and evasion of apoptosis. The peroxisome proliferator-activated receptors (PPARs) can modulate these mechanisms in non-melanoma skin cancer. However, limited data exists regarding the role of PPARs in melanoma. This study examined the effect of proliferator-activated receptor-ß/δ (PPARß/δ) and PPARγ on cell proliferation, anchorage-dependent clonogenicity, and ectopic xenografts in the UACC903 human melanoma cell line. Stable overexpression of either PPARß/δ or PPARγ enhanced ligand-induced expression of a PPARß/δ/PPARγ target gene in UACC903 cell lines as compared with controls. The induction of target gene expression by ligand activation of PPARγ was not altered by overexpression of PPARß/δ, or vice versa. Stable overexpression of either PPARß/δ or PPARγ reduced the percentage of cells in the G1 and S phase of the cell cycle, and increased the percentage of cells in the G2/M phase of the cell cycle in UACC903 cell lines as compared with controls. Ligand activation of PPARß/δ did not further alter the distribution of cells within each phase of the cell cycle. By contrast, ligand activation of PPARγ enhanced these changes in stable UACC903 cells overexpressing PPARγ compared with controls. Stable overexpression of either PPARß/δ or PPARγ and/or ligand activation of either PPARß/δ or PPARγ inhibited cell proliferation, and anchorage-dependent clonogenicity of UACC903 cell lines as compared with controls. Further, overexpression of either PPARß/δ or PPARγ and/or ligand activation of either PPARß/δ or PPARγ inhibited ectopic xenograft tumorigenicity derived from UACC903 melanoma cells as compared with controls, and this was likely due in part to induction of apoptosis. Results from these studies demonstrate the antitumorigenic effects of both PPARß/δ and PPARγ and suggest that targeting these receptors may be useful for primary or secondary melanoma chemoprevention.