Strong, Recent Selective Sweeps Reshape Genetic Diversity in Freshwater Bivalve Megalonaias nervosa.

Freshwater Unionid bivalves have recently faced ecological upheaval through pollution, barriers to dispersal, harvesting, and changes in fish-host prevalence. Currently, over 70% of species in North America are threatened, endangered or extinct. To characterize the genetic response to recent selective pressures, we collected population genetic data for one successful bivalve species, Megalonaias nervosa. We identify megabase-sized regions that are nearly monomorphic across the population, signals of strong, recent selection reshaping diversity across 73 Mb total. These signatures of selection are greater than is commonly seen in population genetic models. We observe 102 duplicate genes with high dN/dS on terminal branches among regions with sweeps, suggesting that gene duplication is a causative mechanism of recent adaptation in M. nervosa. Genes in sweeps reflect functional classes important for Unionid survival, including anticoagulation genes important for fish host parasitization, detox genes, mitochondria management, and shell formation. We identify sweeps in regions with no known functional impacts, suggesting mechanisms of adaptation that deserve greater attention in future work on species survival. In contrast, polymorphic transposable elements (TEs) appear to be detrimental and underrepresented among regions with sweeps. TE site frequency spectra are skewed toward singleton variants, and TEs among regions with sweeps are present at low frequency. Our work suggests that duplicate genes are an essential source of genetic novelty that has helped this species succeed in environments where others have struggled. These results suggest that gene duplications deserve greater attention in non-model population genomics, especially in species that have recently faced sudden environmental challenges.

"They make it too hard and too many hoops to jump": system and organizational barriers to drug treatment during epidemic rates of opioid overdose.

INTRODUCTION: The United States is currently facing an opioid overdose crisis. Research suggests that multiple interventions are needed to reduce overdose deaths including increasing access and retention to medications to treat opioid use disorders (MOUD, i.e., methadone, buprenorphine, and naltrexone) and increasing the distribution and use of naloxone, a medication that can reverse the respiratory depression that occurs during opioid overdoses. However, barriers to MOUD initiation and retention persist and discontinuations of MOUD carry a heightened risk of overdose. Many times, MOUD is not sought as a first line of treatment by people with opioid use disorder (OUD), many of whom seek treatment from medically managed withdrawal (detox) programs. Among those who do initiate MOUD, retention is generally low. The present study examines the treatment experiences of people who use opioids in three states, Connecticut, Kentucky, and Wisconsin. METHODS: We conducted in-depth interviews with people who use opioids in a rural, urban, and suburban area of three states: Connecticut, Kentucky and Wisconsin. Data analysis was collaborative and key themes were identified through multiple readings, coding of transcripts and discussion with all research team members. RESULTS: Results reveal a number of systemic issues that reduce the likelihood that people initiate and are retained on MOUD including the ubiquity of detox as a first step in drug treatment, abstinence requirements and requiring patients to attend group treatment. MOUD-related stigma was a significant factor in the kinds of treatment participants chose and their experiences in treatment. CONCLUSIONS: Interventions to reduce MOUD stigma are needed to encourage MOUD as a first course of treatment. Eliminating abstinence-based rules for MOUD treatment may improve treatment retention and decrease overdose risk.

The effect of detox solution on color stability, roughness, and microhardness of monochromatic universal composite resins.

BACKGROUND: Currently, the advantages of monochromatic universal composite resin restorative materials have increased their use in dentistry. Accordingly, the optical, surface and mechanical properties of these materials have become more important. This study aimed to evaluate the effect of detox solution on discoloration, surface roughness (SR), and microhardness of different monochromatic universal composite resins (Omnichroma [O], Zenchroma [Z], Vittra [V], and Charisma Diamond One [CDO]). Another aim of this study was to evaluate the monomer conversion degree (DC) of the materials. METHODS: A total of 80 specimens were prepared to evaluate the materials (n = 10). After the initial measurements, the specimens were immersed in a red detox solution for 21 days. Statistical data analysis was performed using one-way ANOVA and Tukey's multiple comparisons. RESULTS: The ∆E values of Z were highest on the 21st day. There was an increase in the SR values of the materials immersed in the detox solution. On the 21st day, top surface microhardness of O was lower than the other materials. There was no statistically significant difference at DC values among material groups. CONCLUSIONS: The use of detox solutions for a commercially recommended period of 21 days is suggested. However, this usage period can cause discoloration in restorative materials. Furthermore, especially in the initial one-week period, detox solution may have a negative impact on the microhardness of the materials. In light of all these data, we recommend the cautious use of detox solutions to prevent adverse effects on restorative materials.

The perceptions of social media users of digital detox apps considering personality traits.

The purpose of this study was to investigate the perceptions of users about using digital detox applications and to display relationships among personality traits and technology-related variables. This study was designed using survey approach and employed Generalized Structured Component Analysis (GSCA). As such, 11 hypotheses were constructed and tested. The study recruited 263 participants who utilize detox applications to avoid social media distractions. Data were collected through Google Form and analyzed using GSCA Pro 1.1 to better understand whether the proposed conceptual model fits the data. The results of the study indicated that behavioral intention predicted usage behavior significantly; performance expectancy, effort expectancy, and social influence positively affected behavioral intention; in turn, agreeableness and extroversion positively influenced performance expectancy, and extroversion affected effort expectancy; finally, neuroticism had a statistically significant and negatively associated with effort expectancy of using social media detox apps. The significant exceptions were that facilitating conditions were not predictive of behavioral intention, openness to experience did not influence performance expectancy, and conscientiousness was not linked to effort expectancy. The proposed conceptual model explained 56.68% of the amount of variation, indicating that instructors, policy makers and software designers should consider personal factors for preparing practical intervention approaches to mitigate learning issues related to social media distraction.

The Effects of Fresh Detox Juices on Color Stability and Roughness of Resin-Based Composites.

PURPOSE: To evaluate the effects of three fresh detox juices, including an orange, green, and red beverage, on the color stability and surface roughness of three anterior esthetic resin-based composites (RBCs). MATERIALS AND METHODS: Disk-shaped specimens were prepared with three different esthetic RBCs (Amaris, G-aenial Anterior, Clearfil Majesty ES-2) according to the manufacturers' instructions. Forty specimens were prepared for each RBC, and all specimens were stored in artificial saliva at 37°C for 24 hours. The initial color values and surface roughness measurements of the specimens were taken using a spectrophotometer and a profilometer. The specimens were then divided into 4 subgroups (n = 10). All specimens except the control specimens were immersed in their designated fresh detox juices (green, red, or orange) for 10 minutes twice a day. Color and surface roughness measurements were taken on day 15 and day 30, and the results were analyzed by one-way ANOVA and Tukey HSD test. The association between color change and surface roughness was evaluated by Spearman's Rank Correlation analysis. RESULTS: Color changes and surface roughness increased upon exposure to fresh detox juices for 15 and 30 days for all of the RBCs. All of the G-aenial and Amaris groups displayed color changes above the threshold of acceptability, whereas Clearfil Majesty ES-2 displayed a color change above the threshold of acceptability only after exposure to the red beverage for 30 days (ΔE > 3.7). With regard to surface roughness, Clearfil Majesty ES-2 outperformed the other RBCs (p < 0.001). According to Spearman's Rank Correlation analysis, there was no correlation between color change and surface roughness (p > 0.001). CONCLUSIONS: Exposure to the fresh detox juices used in this study led to similar color changes in the RBCs used in this study.

Discourses on disconnectivity and the right to disconnect.

Taking the "right to disconnect" discussion as a starting point, this article considers how the im/possibility of "opting out" is ruminated in scholarly discourses on technology non-use, media resistance, and media disruption. I argue that while very different in scope, these discourses converge in that they all revolve around a structuring paradox. On one hand, this paradox is set in place by the paradox of dis/connectivity itself (no disconnectivity without connectivity). On the other hand, I argue, it is incited and reinforced by the use of scholarly methods that appear to be at odds with the gesture of disconnectivity itself, whether they be empirical, discursive, or technical (or legislative). This article stakes a claim for the importance looking at these discourses on dis/connectivity from the point of view of this structuring paradox, for it is here, I argue, that the limits of our current "culture of connectivity" are most forcefully negotiated.

Popular Weight Loss Strategies: a Review of Four Weight Loss Techniques.

PURPOSE OF REVIEW: The purpose of this paper is to review the epidemiology of obesity and the most recent literature on popular fad diets and exercise regimens that are used for weight loss. The weight loss plans that will be discussed in this article include juicing or detoxification diets, intermittent fasting, the paleo diet, and high intensity training. RECENT FINDINGS: Despite the growing popularity of fad diets and exercise plans for weight loss, there are limited studies that actually suggest these particular regimens are beneficial and lead to long-term weight loss. Juicing or detoxification diets tend to work because they lead to extremely low caloric intake for short periods of time, however tend to lead to weight gain once a normal diet is resumed. Both intermittent fasting and the paleo diet lead to weight loss because of overall decreased caloric intake as well. Lastly, studies on short bursts of high intensity training have shown remarkable weight loss and improvements in cardiovascular health. Review of the literature does suggest that some fad diets and exercise plans do lead to weight loss; however, the studies are quite limited and are all based on the concept of caloric restriction.

A Comprehensive Review on Digital Detox: A Newer Health and Wellness Trend in the Current Era.

This research investigates the effects of an electronic detox treatment on the utilization of social media and smartphones, addiction levels, and the general health of individuals. Remarkably, individuals discovered that the digital detox was less challenging than anticipated, with a significant number expressing sensations of pleasure and alleviation. Although a few individuals encountered instances of alienation and solitude, the majority managed to adapt to the limited availability of the internet. Notably, individuals saw heightened tedium and replaced their use of social networking sites with additional tasks using screens. After the procedure, measures demonstrated favorable or neutral enhancements in addictions and health-related results. The quantitative findings indicate an increased understanding of online conduct and the use of self-regulating strategies. Concrete recommendations put forward by respondents include reducing stringent deadlines, implementing personalized limitations, and devising tactics to regulate alerts and their use. These observations may be used to shape subsequent digital detox programs in order to improve their efficacy and increase participation from participants.

A sodium alginate intervention strategy to enhance therapeutic effects of bone-targeted alpha therapy via remodeling 223RaCl2 distribution.

Radium-223 dichloride is the first approved alpha particle-emitting radiopharmaceutical for patients with castration-resistant prostate cancer with symptomatic bone metastases and no known visceral metastases. A large percentage of intestinal enrichment and a slow clearance rate were the main causes of gastrointestinal adverse events after 223RaCl2 administration. The molecular weight of sodium alginate in aqueous solution was determined to be 656 kDa. Sodium alginate exhibits a higher affinity for adsorbing Ra2+ compared to other metal ions belonging to the second main group. Sodium alginate as low as 0.5 g/rat reduced intestinal damage by remodeling 223RaCl2 distribution without affecting bone resorption. Intestinal villi were preserved and enterocyte activity was maintained after sodium alginate intervention. Sodium alginate reduced DNA oxidative damage and lipid peroxidation and maintained endogenous antioxidant status by increasing superoxide dismutase levels and total antioxidant capacity. Furthermore, sodium alginate treatment mitigated DNA damage and apoptosis. The administration of sodium alginate effectively maintained the integrity of the intestinal microbiota, which had undergone perturbations due to radiation exposure. This study demonstrated that sodium alginate could be applied to reduce the adverse effects caused by radiation exposure to the intestine during 223RaCl2-treated and reduced intestinal damage resulted from 223RaCl2 accumulation without affecting bone uptake.

Effect of digital detox program on electronic screen syndrome among preparatory school students.

AIM: The aim of this study was to determine the digital detox programme's impact on the electronic screen syndrome among preparatory school students. DESIGN: A quasi-experimental pre- and posttest group was used. METHODS: Two preparatory governmental schools. SAMPLE: purposive sample consists of 105 students. TOOLS: Two tools used for data collection: Student's datasheet and Electronic Screen Addiction Scale. The data collection period took six months, from September 2021 to February 2022. RESULTS: The high rate of screen addiction among students dropped to 14.3% in the posttest compared with 20.0% in the pre-test. Moreover, the students' proportion with moderate screen addiction dropped from 65.7% on the pre-test to 43.8% on the posttest. Furthermore, screen addiction students with lower levels were about 41.9% in the posttest and 14.3% in the pre-test. CONCLUSIONS: There was a highly statistically significant difference between school students' total electronic screen scores in the pre- and posttest. A preventive care programme is recommended for high school children and helps raise screen addiction's awareness and its negative consequences. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Digitally Assisted Peer Recovery Coach to Facilitate Linkage to Outpatient Treatment Following Inpatient Alcohol Withdrawal Treatment: Proof-of-Concept Pilot Study.

BACKGROUND: Alcohol use disorder (AUD), associated with significant morbidity and mortality, continues to be a major public health problem. The COVID-19 pandemic exacerbated the impact of AUD, with a 25% increase in alcohol-related mortality from 2019 to 2020. Thus, innovative treatments for AUD are urgently needed. While inpatient alcohol withdrawal management (detoxification) is often an entry point for recovery, most do not successfully link to ongoing treatment. Transitions between inpatient and outpatient treatment pose many challenges to successful treatment continuation. Peer recovery coaches-individuals with the lived experience of recovery who obtain training to be coaches-are increasingly used to assist individuals with AUD and may provide a degree of continuity during this transition. OBJECTIVE: We aimed to evaluate the feasibility of using an existing care coordination app (Lifeguard) to assist peer recovery coaches in supporting patients after discharge and facilitating linkage to care. METHODS: This study was conducted on an American Society of Addiction Medicine-Level IV inpatient withdrawal management unit within an academic medical center in Boston, MA. After providing informed consent, participants were contacted by the coach through the app, and after discharge, received daily prompts to complete a modified version of the brief addiction monitor (BAM). The BAM inquired about alcohol use, risky, and protective factors. The coach sent daily motivational texts and appointment reminders and checked in if BAM responses were concerning. Postdischarge follow-up continued for 30 days. The following feasibility outcomes were evaluated: (1) proportion of participants engaging with the coach before discharge, (2) proportion of participants and the number of days engaging with the coach after discharge, (3) proportion of participants and the number of days responding to BAM prompts, and (4) proportion of participants successfully linking with addiction treatment by 30-day follow-up. RESULTS: All 10 participants were men, averaged 50.5 years old, and were mostly White (n=6), non-Hispanic (n=9), and single (n=8). Overall, 8 participants successfully engaged with the coach prior to discharge. Following discharge, 6 participants continued to engage with the coach, doing so on an average of 5.3 days (SD 7.3, range 0-20 days); 5 participants responded to the BAM prompts during the follow-up, doing so on an average of 4.6 days (SD 6.9, range 0-21 days). Half (n=5) successfully linked with ongoing addiction treatment during the follow-up. The participants who engaged with the coach post discharge, compared to those who did not, were significantly more likely to link with treatment (83% vs 0%, χ2=6.67, P=.01). CONCLUSIONS: The results demonstrated that a digitally assisted peer recovery coach may be feasible in facilitating linkage to care following discharge from inpatient withdrawal management treatment. Further research is warranted to evaluate the potential role for peer recovery coaches in improving postdischarge outcomes. TRIAL REGISTRATION: ClinicalTrials.gov NCT05393544; https://www.clinicaltrials.gov/ct2/show/NCT05393544.

The Outbreak of Digital Detox Motives and Their Public Health Implications for Holiday Destinations.

This paper aims to analyze the external and objective barriers of the digital difference between being at home and being on holiday, and the intrinsic and subjective inhibitors to remaining online once at a destination. In this study, the literature is thoroughly reviewed, going beyond the traditional economic and technological explanations, along with those related to skill, to consider those rooted in well-being and psychology. Hence, a more integrative and exhaustive framework deals with how tourists approach their perceived hazardous and oversaturating digital environment. Finally, the role played by sociodemographics is studied by profiling those who are predisposed toward disconnecting in order to preserve their wellness. In total, 346 tourists were surveyed at random, with proportional stratification, on the island of Gran Canaria. The measuring instrument comprised a questionnaire whose scales gathered information about more than eighteen devices, twenty-eight social media platforms, and sixteen device and social media barriers. The obtained evidence demonstrates how crucial "detox" motivations are when trying to elucidate the differences in digital behavior between their home and holiday destination. Similarly, the evidence highlights that while gender, age, nationality, and income are associated with these differences, education is not. This study pioneers an analysis of the detox barrier regarding staying connected while on holiday and provides insight into how this intrinsic and subjective inhibitor interacts with other external hindrances to people's health, both where they live and where they travel.

Addiction of High Dose of Benzodiazepine: Verona Detox Approach With Flumazenil.

Introduction: Since the 1990s there has been evidence of the significant role Flumazenil (FLU) has in benzodiazepines (BZD) detoxes. The Verona Detox approach has been developed for high dose BZD and Z-drug detoxification via continuous subcutaneous infusion of FLU, a selective BZD receptor antagonist acting on the BZD subunit of the GABA-A receptor. Flumazenil is licensed in the United Kingdom and other countries to treat only BZD overdose although numerous studies have demonstrated its effectiveness in rapidly resetting GABA-A receptors, quickly reducing tolerance and dependence from BZD, and providing a safe and rapid detox from benzodiazepines. Objective: The aim of this article is to provide all healthcare professional who are interested in BZD detoxification with an approach and clear practical information on how to administer FLU. Method: In this article we outline the approach in detail, describing all medical and nursing procedures day by day. This detox treatment is indicated for patients abusing from at least 5 Defined Daily Dose (DDD) of BZDs or Z-drugs. The process lasts 7 days, and is conducted under medical supervision (daily reviews) and continuous nursing (24/7). During this period, 7mg of FLU is administered (1 mg/24) through an elastomeric pump, via continuous subcutaneous infusion. Conclusion: To this day, the largest database of FLU detoxification was published by our group, showing how this treatment is safe, with very little side effects even in patients with significant medical comorbidities.

Population-level impact of initiating pharmacotherapy and linking to care people with opioid use disorder at inpatient medically managed withdrawal programs: an effectiveness and cost-effectiveness analysis.

BACKGROUND AND AIMS: Medications for opioid use disorder (MOUD) are shown to reduce opioid use and the risk of overdose. People with opioid use disorder (OUD) who exit inpatient medically managed withdrawal programs (detox) without initiating MOUD and linking to outpatient care have high rates of overdose. While detox encounters provide a theoretical opportunity for MOUD initiation, this is not ubiquitous in the United States. We used simulation modeling to estimate the population-level health effects and cost-effectiveness of a policy encouraging MOUD initiation during inpatient detox encounters. DESIGN, SETTING AND PARTICIPANTS: We employed a dynamic population state-transition model to evaluate the effectiveness and cost-effectiveness of using detox programs as venues for initiating MOUD in Massachusetts, United States. We compared standard of care, where no detox patients initiate MOUD or link to outpatient MOUD providers, to strategies of offering MOUD to detox patients and linking those patients to outpatient MOUD. MEASURES: Budgetary impact to the Massachusetts health-care sector, incremental cost-effectiveness ratios (ICER) and total counts and percentage differences of fatal overdoses prevented. FINDINGS: Initiating MOUD in detox with perfect linkage to outpatient MOUD would reduce fatal overdoses by 4.5% [95% confidence interval (CI) = 2.3-5.9], at an ICER of $56 000 per quality-adjusted life-year (QALY) gained, compared with the standard of care. With moderate linkage, fatal overdoses would be reduced by 2.3% (95% CI= 1.2-3.1) with an ICER of $78 500 per QALY gained, compared with standard of care. Budgetary increase to Massachusetts health-care spending ranged from 0.5-1%. CONCLUSION: A simulation model indicates that initiation of medications for opioid use disorder and linkage policies among detox patients in Massachusetts, USA could prevent fatal opioid overdoses in the opioid use disorder population and would be cost-effective from a health-care sector perspective.

High levels of benzodiazepines after treatment of moderate alcohol withdrawal syndrome: the problem of incomplete detoxification.

Purpose: Some alcohol-dependence relapses occur soon after a concluded detoxification treatment. A popular agent used in that treatment is diazepam, which effectively relieves withdrawal symptoms due to its long half-life and affinity to the same receptors. It is hypothesized here that these attributes, after nominally completed detoxification, result in, respectively, persisting benzodiazepine (BZD) influence and a distorted (optimistic) clinical presentation. This could contribute to later reemergence of withdrawal symptoms caused by delayed final elimination of BZDs, as the evidence puts into doubt the concept of a gentle self-taper of a long-acting drug. Methods: Serum-BZD concentration levels were measured with a radioimmunoassay at the end of routine treatment of moderately- intense alcohol withdrawal syndrome. These data were cross-referenced with individual diazepam administration schedules, including the maximal daily dose and the day of its administration, and the day of overall diazepam cessation. Results: Most patients revealed clinically relevant serum-BZD levels. These correlated with the doses but also with the day of maximal- dose administration and the day of diazepam withdrawal. Conclusions: The confrontation with actual abstinence comes after detoxification. Delayed elimination of diazepam may be a contributing factor in the re-emergence of symptoms and early post-detox relapses. The optimization of the procedure has been discussed in terms of concentration evolution and known treatment schedules. Maximal initial dosage compression and further decisive counteracting the tendencies of diazepam towards accumulation increase the patient's chance of going through the low-concentration crisis under medical assistance.

'Digital Wellbeing': The Need of the Hour in Today's Digitalized and Technology Driven World!

The constant contact and usage of technology in today's world have brought about the dire consequences of digital addiction and its effects. This has led to a serious dilemma of management of screentime by an individual. Studies have shown a negative impact of excessive gadget use leading to a decline in performance rates, effect on sleep patterns, and reduction in workplace achievements thereby causing hindrance in unlocking the maximum potential of an individual. This has paved the way for the introduction of a novel concept known as 'Digital well-being' for tackling this underlying issue to bring about screen time reduction as well as to establish an ideal work-life balance. Digital well-being enhances the usage of technology itself to combat increased screen time by using restraints and promotes wellness by enabling productive and healthy lifestyles. In a new era where smartphones and technology have begun to dictate our lives, it is necessary to apply restraints and ensure there is a balance of wellness as well as productivity outflow. Digital well-being can be achieved by interventions that should be administered with the use of apps and healthy practices. The use of new-age apps acts as positive reinforcement and helps in providing a restrictive environment as well as maintains the time invested for useful and productive engagements. There is a lot of research yet to be done regarding this topic empirically regarding its success and this review article aims to approach the effectiveness of digital wellbeing and its applications in combating stress and increasing work performance and preventing digital addiction.

Reported firearm access among patients admitted to a dual diagnosis medically-assisted withdrawal unit over five years.

Background: Up to one-third of firearm-related suicides were carried out by individuals who had consumed alcohol shortly before their death. Despite the critical role of firearm access screening in suicide risk assessment, few studies have examined firearm access among patients with substance use disorders. This study examines the rates of firearm access among those admitted to a co-occurring diagnosis unit over a five year period. Methods: All patients admitted to a co-occurring disorders inpatient unit from 2014 to mid-2020 were included. An analysis contrasting the differences among patients reporting firearms was performed. A multivariable logistic regression model using factors from initial admission were chosen based on clinical relevance, past firearms research, and statistical significance on bivariate analysis was used. Results: Over the study period there were 7332 admissions representing 4055 patients. Documentation of firearm access was completed in 83.6% of admissions. Firearm access was reported in 9.4% of admissions. Patients reporting firearm access were more likely to report never having suicidal ideation (p = 0.001), be married (p = <0.001), and report no past history of suicide attempts (p = <0.001). The full logistic regression model revealed that being married (OR: 2.29 and p < 0.0001) and employed (OR: 1.51 and p = 0.024) were factors associated with firearms access. Conclusions: This is one of the largest reports assessing factors associated with firearm access among those admitted to a co-occurring disorders unit. Firearm access rates in this population appear lower than rates in the general population. The roles employment and marital status play in firearm access deserve future attention.

Sociodemographic characteristics associated with hepatitis C among patients admitted for medically managed opioid withdrawal in east Tennessee.

BACKGROUND: While Opioid use disorder (OUD)-related mortality is epidemic in the United States, regions like Appalachia are disproportionately affected. Moreover, a dual epidemic of Hepatitis C virus (HCV) infections and OUD-related admissions has been observed. OBJECTIVE: To evaluate sociodemographic characteristics of opioid-dependent patients admitted for medically managed withdrawal in East Tennessee and compare those with and without HCV. METHODS: Cross-sectional study of patients with an OUD admitted for treatment, comparing those with and without a history of HCV. RESULTS: The studied population was found to have high rates of HCV (36%), intravenous drug use (IVDU) (77%), polysubstance use (84%), previous incarceration (87%), and unemployment (80%). Patients with HCV, compared to those without, were significantly more likely to have a history of IVDU, IVDU complications, and polysubstance use. CONCLUSIONS: This sample reflects the significant morbidity of OUD in East Tennessee. To prevent mortality, contributing factors such as polysubstance use and OUD treatment during incarceration need to be specifically addressed.

Digital-Free Tourism Holiday as a New Approach for Tourism Well-Being: Tourists' Attributional Approach.

Digital-free tourism (DFT) has recently attracted tourism service providers' attention for its benefits in terms of enhancing tourists' experiences and well-being at destinations. DFT refers to tourists who are likely to voluntarily avoid digital devices and the Internet on holiday, or travel to destinations without network signals. DFT has advantages for tourists in increasing well-being, mental health, and social networking during their journeys. DFT also has a benefit for tourism marketers in that they can consider it as a new tourism approach. However, there is a lack of studies into tourists' locus of control (LOC) while experiencing DFT holidays. LOC refers to how individuals assign the responsibility of event outcomes-whether they assign it to themselves (internal LOC) or they say it is beyond their control (external LOC). Therefore, the current study contributes to investigating tourists' LOC impacts while experiencing DFT holidays. The study relies on semi-structured interviews with millennial tourists who have experienced DFT holidays. The study findings reveal that millennial tourists with an internal LOC (vs. external) are more likely to perceive the DFT advantages (vs. obstacles) during and after the DFT holidays. However, millennial tourists with external LOC incrementally change their attitudes and perceive the DFT holiday benefits through their self-efficacy enhancement. The findings propose managerial strategies for developing effective DFT holidays for millennial tourists regarding their LOC.

From cognitive overload to digital detox: Psychological implications of telework during the COVID-19 pandemic.

For most people, telework during the COVID-19 pandemic necessitates the increased use of digital tools. Although working from home can enhance flexibility, it comes with various psychological challenges, all of which can be substantially exacerbated for people during the COVID-19 pandemic. The increased need to use digital tools can create cognitive overload that may negatively impact work productivity and well-being. The idea of digital detox has received increasing attention in the last few years as a means for recovering from stress caused by the use of digital media. This paper presents an analysis of the relationships between the use of digital work tools, the feeling of cognitive overload, digital detox measures, perceived work performance, and well-being. Results from an online survey (N = 403) conducted during the period of strict lockdown measures in Germany in April and May 2020 indicate that the relationship between the use of text-based tools and well-being, but not perceived job performance, is mediated by cognitive overload. These relationships were not found for the use of videoconferencing tools. However, for users of these tools, the number of digital detox measures moderates the relationship between cognitive overload and the perception of work demands.