Background: The prolonged conflict in Syria has increased psychosocial stress and contributed to high smoking rates. Despite healthcare providers’ critical role in smoking cessation, medical curricula lack adequate coverage of related competencies, and high physician smoking rates remain major barriers. This study evaluated the effectiveness and feasibility of the Smoking Cessation Strategy Course (SCSC), an online course aimed at enhancing Syrian healthcare professionals’ knowledge, perceived skills, and attitudes toward smoking cessation. Methods: This single-arm intervention involved a peer-led, asynchronous online course comprising 10 brief lessons (each 10 minutes long) and facilitated WhatsApp discussions. Participants (n=120) included medical, dental, and pharmacy students and graduates. Pre- and post-intervention questionnaires assessed smoking cessation knowledge, perceived skills, and attitudes. Paired t-tests evaluated changes (P<0.05). Finding: Ninety-four participants completed the post-test (78.3% retention). Knowledge improved significantly (pre-test 11.5±1.5 vs. post-test 17.4±1.55; P<0.001, d=0.86) and perceived skills (pre-test 3.53±0.60 vs. post-test 4.14±0.66; P<0.001, d=0.82). Attitudes showed slight, non-significant (pre-test 3.00±0.37 vs. post-test 3.24±0.40; P=0.19). Dropout analysis indicated no demographic differences, though non-completers held more negative baseline attitudes. Conclusion: The SCSC significantly improved knowledge and perceived confidence in delivering smoking cessation interventions, demonstrating feasibility in a low-resource, conflict-affected context. While attitude changes were limited, this online model offers a scalable, low-cost approach to strengthening tobacco treatment capacity in Syria and similar LMIC settings.
Background:Addiction is a chronic and debilitating condition associated with compulsive behaviors, cravings, and high relapse rates. Transcranial direct current stimulation (tDCS) is a neuromodulation technique for the treatment of substance use disorders by targeting brain areas involved in craving and inhibitory control. This study aimed to assess tDCS effectiveness in reducing cravings in opioid-dependent patients on methadone maintenance therapy (MMT). Methods:A total of 60 opioid-dependent participants were randomly assigned to either an active intervention group or a sham group. The intervention group received ten sessions of anodal tDCS applied to the left dorsolateral prefrontal cortex (DLPFC) and cathodal tDCS over the right DLPFC. Craving was measured using the Desire for Drug Questionnaire (DDQ) before and after the intervention. Findings:This study found no statistically significant differences in craving scores between the intervention and sham groups. There was no statistically significant difference in craving score changes between the two groups before and after the intervention. Conclusion:The findings of this study suggest that the specific tDCS protocol used, targeting the left DLPFC with anodal stimulation and the right DLPFC with cathodal stimulation, did not significantly reduce craving in opioid-dependent patients undergoing MMT. The study highlights the need for further research to optimize tDCS protocols and explore alternative brain targets for the treatment of substance craving and relapse prevention.
Background:Laser auricular acupuncture is a form of therapy that is non-invasive, aseptic, and painless, thus advantageous over the traditional form of acupuncture for tobacco cessation. The objective of the study is to evaluate and compare nicotine dependence, urinary cotinine level, physical effects, and quit rate among tobacco chewers before and one month after laser therapy and behavioral counseling, and to evaluate and compare extrinsic stains one month post-intervention. Methods:The present study was a randomized controlled trial, with laser therapy and behavioral counseling as the test and control interventions, respectively. The laser was focused on both ears once a week for four weeks. Counseling sessions were held once a week for four weeks. Nicotine dependence, urinary cotinine level, physical effects, as measured using the Visual Analog Scale, and quit rate were recorded before and after the intervention. Findings:The results showed significant reductions in nicotine dependence in both laser and counseling groups post-intervention (P<0.001). Urinary cotinine levels increased significantly in the counseling group post-intervention (P=0.010). Inter-group comparison revealed significant differences in pre- and post-intervention cotinine levels (P<0.05). Adjusted analysis confirmed significant post-intervention differences between the groups (P=0.048). Conclusion:This study demonstrates that combining laser auricular acupuncture therapy with behavioral counseling yields superior outcomes for smokeless tobacco cessation compared to behavioral counseling alone. The combined approach results in greater reductions in nicotine dependence, lower urinary cotinine levels, slightly higher quit rates, and significant improvements in various physical effects associated with tobacco use.
Background:Poor sleep quality and its relationship with other sleep disorders and medical and psychiatric disorders have been noted in many individuals who use methadone as a maintenance treatment for drug abuse. This study aimed to investigate the quality of sleep and its related factors in people undergoing methadone maintenance treatment. Methods:This study was conducted on 80 individuals who were undergoing methadone maintenance treatment (MMT) in MMT clinics selected by the convenience sampling method. The researcher-made data collection form, the Pittsburgh Sleep Quality Index questionnaire, and the Depression, Anxiety, and Stress Scale questionnaire were completed by the participants. Kendall's tau-b correlation coefficient, chi-square, Mann-Whitney U, or Kruskal-Wallis tests were used for analyses. Findings:In the present study, 80 participants undergoing maintenance treatment (86.25% male) were studied. Most individuals (75%) had good sleep quality (average questionnaire score of 4.31). In addition, the majority of participants had anxiety (63.75%; average score of 6.2), depression (66.25%; average score of 7.45), and stress at a normal level (91.25%; average score of 6.25). Women had significantly lower sleep quality than men (P=0.009). The level of education (P=0.036) and the frequency of alcohol consumption influenced sleep quality (P=0.018). However, marital status, employment status, smoking, methamphetamine use, or use of drugs other than methadone were not significantly associated with sleep quality. The average score of sleep quality was significantly influenced by the level of anxiety (P<0.001), depression (P<0.001), and stress (P=0.008). The age of starting methadone had a weak negative but significant correlation with the sleep quality score (τ=-0.2 and P=0.01). The daily methadone dose had a weak but significant positive correlation with poorer sleep quality. (τ=0.173 and P=0.049). Conclusion:Considering the significant relationship found between the severity of anxiety, depression, and stress and the quality of sleep in the participants of this study, it is recommended to screen these disorders more carefully in this group of people so that the necessary interventions can be carried out to improve their conditions. In addition, patients should be warned about consuming alcohol and increasing the daily dose of methadone.
Background:Opioid use disorder (OUD) is a global health crisis, contributing to significant public health challenges and economic loss. Although existing treatments are available, there is a critical need for novel therapeutic strategies. This review examined the potential of glucagon-like peptide-1 (GLP-1) receptor agonists, primarily used in diabetes management, as a repurposed treatment for OUD. Methods:We explored preclinical studies that demonstrate how GLP-1 receptor agonists can modulate neurobiological pathways involved in opioid addiction, particularly dopaminergic signaling. We also reviewed initial human clinical trials examining the impact of GLP-1 receptor agonists on opioid self-administration, relapse behavior, and cravings. Findings:Preclinical data suggest that GLP-1 receptor agonists can reduce opioid self-administration and relapse behavior in animal models. Early human clinical trials indicate promising results, showing a potential role for GLP-1 receptor agonists in reducing opioid cravings and improving treatment outcomes. Conclusion:Although early findings are encouraging, further research is needed to confirm these results, optimize dosing regimens, and clarify the underlying mechanisms of action. Given the interplay between metabolic and neuropsychiatric factors in OUD, GLP-1 receptor agonists offer a unique therapeutic advantage. Large-scale clinical trials are essential to determine their long-term efficacy, safety, and integration into comprehensive OUD treatment plans.
Background:Inhalants are volatile organic compounds (VOCs) abused to achieve psychostimulant effects. VOCs are found in substances such as paint thinners, glues, and adhesives. Case Presentation:This case illustrates a 27-year-old unmarried, unemployed man from rural Andhra Pradesh with a three-year history of volatile inhalant use, specifically Fevicol. His inhalant use began during college and escalated from occasional use to daily consumption of up to 1 Liter per day through huffing and bagging. He reported a feeling of euphoria and occasional drowsiness accompanied by redness of the eyes. Parallel to the increase in his inhalant use, noticeable behavioral changes, including decreased social interaction, self-talking, irritability, frequent disputes with family members, and multiple job changes, were observed. Upon interview, psychotic symptoms including auditory hallucinations and persecutory delusions, started around one year ago, prompting inpatient psychiatric admission. A diagnosis of volatile inhalant-induced psychotic disorder (ICD-11) was made. Management relied on antipsychotics (risperidone) as the cornerstone, along with cognitive behavioral therapy, motivational enhancement therapy and relapse prevention for sustained recovery. Discussion:This case highlights distinctive aspects, including prolonged duration of psychotic symptoms following chronic inhalant exposure, as well as the aggravation of psychotic symptoms (mainly auditory hallucination) occurring 15-20 minutes after acute inhalant use. The nicotine self-medication hypothesis has been proposed to explain this phenomenon, suggesting that nicotine may alleviate distress during acute use. Conclusion:The focus was not only to explain the psychiatric sequelae of inhalant abuse but also to underscore the importance of comprehensive management strategies for adequate recovery and to unveil the roles of gamma-aminobutyric acid (GABA) disinhibition, glutamate, and dopamine dysregulation. Ultimately, the combination of pharmacotherapy and behavioral interventions is essential. To decrease experimentation with inhalants, regulation alone is insufficient without education and awareness-raising. A specific combination of strategies at three different levels, the government (consistent stringent rules at state and national levels, restriction of sales to minors, and community and school-based interventions), producers (adding deterrents and replacing harmful chemicals with safer alternatives), and consumers (education on health consequences and legal implications), can be implemented in India.
Substance abuse significantly impacts pulmonary health, with diverse complications arising from the use of tobacco, alcohol, opioids, and other illicit drugs. These substances can directly damage lung tissue and exacerbate chronic respiratory diseases through mechanisms like oxidative stress, inflammation, and immune dysfunction. This study reviewed current evidence on the prevalence, pathophysiology, and clinical manifestations of pulmonary complications associated with substance abuse. Key findings include the high prevalence of chronic obstructive pulmonary disease among heroin users, the association of cocaine with acute and chronic pulmonary conditions, and the role of alcohol in exacerbating respiratory infections and acute respiratory distress syndrome. The review highlights diagnostic challenges, emphasizing the need for comprehensive clinical assessments, advanced imaging, and biomarker utilization. Additionally, it outlines treatment strategies, including pharmacological interventions, smoking cessation programs, and pulmonary rehabilitation. Recognizing the public health implications, the review advocates preventive measures, harm reduction strategies, and integrated care models to mitigate the burden of substance-related pulmonary diseases.
Background:Methamphetamine is a common addictive industrial substance. Medicinal plants such as Artemisia absinthium L. with anti-inflammatory, antioxidant, analgesic, neuroprotective, antidepressant, and antipyretic properties may help patients reduce withdrawal syndrome symptoms. Methods:Five treatment groups received intraperitoneal (i.p.) injections of 3,4-methylenedioxymethamphetamine (MDMA) and an ethanolic extract of A. absinthium diluted in 0.9% normal saline for 7 days. The animals were assigned to five groups: Group I (Control): NaCl 0.9%+Naloxone (SN), administered daily via intraperitoneal (i.p.) injection; Group II: MDMA+NaCl 0.9%+Naloxone (MSN), administered daily via i.p. injection; Groups III, IV, and V: MDMA+NaCl 0.9%+Naloxone+ethanolic Artemisia absinthium extract at concentrations of 5%, 10%, and 25% (MSNA), respectively, administered daily via i.p. injection. To induce withdrawal syndrome, two hours after the last injection of MDMA on the 7th day, naloxone was injected (i.p.) at a dose of 1 mg/kg, and rats were quickly transferred to glass cylinders, and the symptoms of MDMA withdrawal syndrome based on stomach cramp, diarrhea, bruxism, body dragging, and wet dog shakes were recorded within 30 minutes. Findings:The MSN and MSNA 5% interventions may not be well-tolerated and could require reevaluation to minimize adverse effects; however, MSNA 10% and MSNA 25% showed reduced severity, suggesting potential for better tolerability and effectiveness in managing symptoms like writhing, body dragging, teeth chattering, and diarrhea. Conclusion:It appears that 10% and 25% ethanolic extracts of A. absinthium can lessen certain behavioral signs associated with animal addiction withdrawal. We need more research to optimize dosages for better results.
Background:Metabolic dysfunction-associated steatotic liver disease (MASLD), previously referred to as non-alcoholic fatty liver disease (NAFLD), is a common liver disorder associated with metabolic abnormalities. This study aimed to evaluate the effectiveness of N-acetylcysteine (NAC) in improving liver function and metabolic profile in patients with MASLD. Methods:In this randomized controlled trial (RCT), 69 patients with MASLD were randomly assigned to either the NAC group (600 mg, administered three times daily, n=34) or the placebo group (n=35) for eight weeks. The severity of hepatic steatosis, liver enzymes, and metabolic profile were measured at baseline and the final trial. Data were analyzed using SPSS. Findings:Following eight weeks of NAC administration in patients with MASLD, no significant changes were observed compared to the placebo in hepatic steatosis grade (P=0.215), serum aspartate aminotransferase (AST) (P=0.21), alanine transaminase (ALT) (P=0.28), malondialdehyde (MDA) (P=0.79), total antioxidant capacity (TAC) (P=0.56), triglycerides (P=0.15), total cholesterol (P=0.28), low-density lipoprotein cholesterol (P=0.32), and high-density lipoprotein cholesterol (P=0.16). However, NAC administration resulted in significant reductions in fasting blood glucose (FBG) (P=0.01), fasting insulin levels (P<0.001), homeostatic model assessment for insulin resistance (HOMA-IR) (P<0.001), and C-reactive protein (CRP) (P<0.001), along with a significant increase in total glutathione levels (P=0.003), compared to the placebo group. Conclusion:NAC administration in patients with MASLD does not significantly impact hepatic steatosis, liver enzymes, or lipid profiles; however, it improves oxidative, glycemic, and inflammatory markers. Therefore, NAC may be a beneficial adjunct therapy for managing metabolic parameters and reducing inflammation and oxidative stress in MASLD patients. Trial Registration:The trial was registered with the Iranian Registry of Clinical Trials (IRCT20201220049772N1) on February 20, 2021.
Background:Staying in Juvenile Correctional and Rehabilitation Centers (JCRCs) exposes adolescents to high levels of stress, potentially increasing the risk of substance use cravings and drug-seeking behaviors. Preventive programs should prioritize enhancing protective factors and mitigating risk factors. This research aimed to identify the risk and protective factors related to substance use among adolescents in JCRCs in Iran. Methods:This study was a content analysis based on individual semi-structured, in-depth interviews with volunteer adolescents (aged 12-18 years) who had experienced JCRCs in Iran within the past 12 months. Snowball sampling was used to identify the participants. Open coding was initially conducted by reading transcripts. Then, similar codes were grouped and placed into categories. We ensured the utmost trustworthiness using constant comparison, member checks, peer debriefing, and revisiting the data multiple times. Findings:Twenty-three eligible adolescents participated in the study. There was no substance use treatment protocol to treat adolescent substance users. Buprenorphine was the most accessed substance in JCRCs. Risk factors included peer substance use, substance offers during high-stress situations, stress, depression, hopelessness, slow passage of time, positive past substance use experiences, curiosity, poverty, financial problems, and myths about quitting. Protective factors included establishing rapport, providing counseling and social work services, engaging the adolescents in daily recreational activities, and assigning them responsibilities. Conclusion:Shifting from punitive to supportive and preventive approaches within JCRCs by addressing peer influence, training staff in adolescent substance use treatment, and facilitating meaningful leisure activities could promote healthier behaviors among adolescents in these facilities.
Background:This study aimed to investigate the impact of opium on liver function and the biliary tract in patients with bile duct stones, comparing outcomes with non-addicted individuals. Methods:This case-control study was conducted in Iran from 2016 to 2017. A total of 86 patients with bile duct stones were divided into two groups: opium-addicted (n=40) and non-opium-addicted (n=46). The patient's hepatobiliary system was evaluated using liver function tests (LFTs) and endoscopic ultrasound (EUS). Data were collected and analyzed using SPSS software. Findings:LFTs showed significantly elevated levels of aspartate aminotransferase (AST) (90.67±46.99 vs 55.28±45.53 U/L, P=0.036) and aspartate aminotransferase (ALT) (120.47±90.15 vs 51.83±35.21 U/L, P=0.005) in the opium-addicted group compared to controls, and higher direct (4.05±2.84 vs 2.30±1.66 mg/dL, P=0.002) and total bilirubin levels (5.02±3.94 vs 2.93±2.35 mg/dL, P=0.007). Furthermore, the common bile duct (CBD) diameter was significantly larger in the opium-addicted group (12.21±3.42 vs 7.80±2.62 mm, P=0.007). In contrast, pancreatic duct diameters (P=0.289) and alanine aminotransferase (ALP) levels (P=0.842) showed no significant differences. Conclusion:The study revealed that opium addiction is associated with significantly elevated levels of liver enzymes (AST and ALT), higher bilirubin levels, and an increased common bile duct diameter in patients with bile duct stones, while the pancreatic duct diameter and ALP levels remained unaffected. These findings highlight the potential impact of opium use on the hepatobiliary system and underscore the importance of further research to understand its long-term effects and improve clinical management.
Background:Internet Gaming Disorder (IGD) is defined by a loss of control over gaming habits, prioritizing gaming above daily responsibilities, and persistent engagement despite detrimental outcomes. As a rising public health challenge, IGD significantly disrupts individuals' lives. Investigating attentional biases in IGD is vital for designing targeted interventions. Methods:Attentional bias was measured in individuals with IGD using the Addiction Stroop Task. The participants were classified into three cohorts: IGD, Recreational Game Users, and non-gaming controls. Electroencephalography/event-related potential (EEG/ERP) data were collected and analyzed from electrodes Pz, Cz, and CPz. Findings:Compared to the RGU and control groups, the IGD group displayed significantly greater P300 amplitudes and prolonged response latencies to both gaming-related and neutral stimuli. Furthermore, the IGD group reported elevated impulsivity, anxiety, and depression levels relative to the other groups. Conclusion:Contrary to conventional attentional bias models in addiction-which emphasize preferential attention to addiction-related cues-individuals with IGD exhibited intensified neural reactivity to all stimuli. This suggests excessive cognitive resource mobilization, potentially indicative of hyperarousal or dysregulated neurobiological processes.
Background:Electronic cigarettes (e-cigarettes) have become significantly popular, especially among young people. E-cigarettes are a form of tobacco use in which the smoke produced by the vaporization of nicotine is inhaled. The increase in the consumption of these cigarettes causes many concerns about their long-term and unknown adverse effects on general and oral health. The present study was conducted to determine the level of awareness of dentists participating in the 15th Annual Scientific Congress of the Iranian General Dentists Association about e-cigarettes. Methods:In this cross-sectional study, the dentists selected by convenience sampling were given a questionnaire including 14 awareness questions. After the participants completed it, the data were statistically analyzed using Pearson's correlation coefficient and an independent samples t-test. Findings:A total of 347 dentists participated in the present study, and 36.9% stated that they had no familiarity with e-cigarettes. The answers of more than half of the participants to questions regarding the relative risk of using this type of smoking as a suitable method to quit other types of tobacco, long-term adverse effects on health, and the risk of explosion of these cigarettes were incorrect. The average score of awareness was 7.88±3.25 out of a total of 14, indicating an overall moderate level of knowledge. Conclusion:The average knowledge score related to the subject under investigation was moderate, and the knowledge in some aspects was not satisfactory.
Background:HIV partner notification is known as one of the methods to increase HIV testing. Evaluating the barriers, facilitators, and recommendations to improve it can lead to the increased uptake of HIV testing, as well as achieving the 95-95-95 UNAIDS targets. Therefore, the present study aimed to evaluate the approaches, barriers, and facilitators of HIV partner notification from different aspects. Methods:The barriers and facilitators of HIV partner notification were evaluated. Also, some recommendations were presented to improve the HIV partner notification program in Iran. Findings:Based on the results, HIV stigma and discrimination were identified as the most important barriers, and the main facilitator was the support from the spouse or sexual/injection partner and family. Also, the results showed that the HIV partner notification program in Iran was in line with the international guidelines introduced by the World Health Organization. However, it had weaknesses and challenges in various aspects such as the content, the method of implementation, monitoring, and evaluation. Conclusion:Overall, this study has shown a critical need to strengthen the HIV partner notification program in Iran. HIV partner notification program can be strengthened by considering the introduced facilitators, from different aspects including content, implementation, monitoring, and evaluation. These measures will ultimately increase HIV testing and thus achieve UNAIDS targets.
Background:Dependence and withdrawal syndrome caused by opioids are the most important and unambiguous factors in the clinical use of narcotic painkillers. Some evidence indicates the beneficial effects of herbal fragments in attenuating this complication. In the current study, the impact of black seed oil (BSO) and opium poppy oil (OPO) was investigated on the symptoms of morphine withdrawal syndrome in mice. Methods:For three days, morphine was administrated to induce dependence in mice. To induce the withdrawal syndrome, on the 4th day, naloxone was injected. Thirty minutes before naloxone administration, various doses of BSO (250, 500 mg/kg) and OPO (150, 300 mg/kg) were given as active treatments, along with saline and clonidine, to 6 groups. The data obtained were compared to those from other groups that received clonidine and saline separately (n=8). The levels of excitability, anxiety-like behavior, and pain threshold were assessed using the open field test, elevated plus maze (EPM), and hot plate tests. Findings:Clonidine and both studied doses of BSO significantly increased the presence of mice in the light arm of the EPM (P<0.05). The irritability and locomotion in animals with withdrawal syndrome in the groups that received BSO and clonidine considerably reduced and the pain sensitivity was elevated (P<0.05). There was no significant difference between the BSO and clonidine groups. OPO did not significantly improve symptoms. Conclusion:The present results revealed that the administration of BSO is effective in relieving the manifestations of morphine withdrawal syndrome, including anxiety, irritability, and motor activity, in a manner comparable to clonidine.
Background:The issue of street children and adolescents represents a significant global challenge, often interconnected with issues such as substance abuse. The present research aims to ascertain the prevalence of substance abuse and its associated determinants within the population of street children and adolescents in Zahedan, Iran. Methods:This cross-sectional study, conducted between December 2021 and May 2022, focused on street children and adolescents. A validated questionnaire was administered through face-to-face interviews to evaluate the prevalence of substance abuse and associated factors within this population. The collected data were analyzed using bivariable and multivariable logistic regression models. Additionally, penalized logistic regression techniques were employed in the statistical analysis. Findings:A cohort of 200 street children, with a mean age of 13.6 years, was examined. The majority of the sample comprised male individuals (n=156, 98.15%). The study revealed that 27% of the participants (95% confidence interval [CI]: 0.21-0.33) reported a history of substance abuse (n=54). Key risk factors identified encompassed increasing age (odds ratio [OR]=1.32, 95% CI: 1.12-1.55), prior detention (OR=5.45, 95% CI: 1.92-15.42), and a family history of substance abuse (OR=7.53, 95% CI: 3.02-18.77), indicating a heightened likelihood of substance abuse with each of these factors. The logistic regression model exhibited satisfactory predictive accuracy (area under the curve [AUC]=0.78, 95% CI: 0.72-0.86). Conclusion:This study identified age, a familial history of substance use, and prior incarceration as significant predictors of substance abuse among street children and adolescents. Consequently, there is a demonstrated need for focused interventions that address familial, social, and psychological determinants to mitigate substance abuse within this at-risk demographic.
Background:Disturbance in the sense of taste can destroy appetite and change eating habits, causing a significant decrease in the quality of life. The use of opium causes a disturbance in the sense of taste. Opium is a narcotic drug that can cause temporary or permanent damage to the taste system, making it a source of concern in dentistry. This research was conducted to determine the effects of opium consumption on the sensation of the four main tastes. Methods:This study was conducted in a single-masked and descriptive-analytical manner. The study population included 107 opium addicts and 113 smokers who were in the same age group. None of the studied subjects had any systemic disease or consumed herbal or chemical drugs. The four substances, citric acid, sodium chloride, sucrose, and caffeine, were used to evaluate sourness, saltiness, sweetness, and bitterness, respectively. Finally, the obtained data were analyzed using SPSS version 26 and the Mann-Whitney U test. P values<0.05 were considered statistically significant. Findings:Opium use did not have a significant effect on the perception of sweetness (P=0.437), saltiness (P=0.536), or sourness (P=0.8), but a significant effect was seen concerning the perception of bitterness (P=0.0000002). Conclusion:It seems that opium addicts do not have significant problems in perceiving the taste of sweetness, sourness, and saltiness, but impairment was observed in the perception of bitterness.
Background:Tobacco control efforts face substantial obstacles from industry interference and regulatory weaknesses. This review synthesizes qualitative evidence on barriers to implementing effective tobacco control measures, offering actionable recommendations for policymakers and practitioners. Objective:To identify barriers to implementing tobacco control measures, specifically Article 5.3 of the WHO FCTC, and propose solutions to overcome them. Methods:A systematic search was conducted across PubMed, EBSCO, and the Cochrane Library, using keywords like "tobacco," "industry," and "interference." The search, limited to English-language studies published until July 15, 2024, included qualitative studies addressing barriers to implementing Article 5.3. Eligible studies focused on government policies, institutional actions, economic measures, and public awareness. The protocol was registered in PROSPERO (CRD42024565548). Study quality was assessed using the CASP checklist, and confidence in findings was evaluated with GRADE-CERQual. Findings:Twelve qualitative studies were included, covering regions such as Bangladesh, Ethiopia, India, Uganda, and the UK Overseas Territories. Key barriers identified were conflicts of interest involving government officials, lobbying by the tobacco industry, resource constraints, weak regulatory frameworks, and limited awareness of Article 5.3. Economic considerations often overshadowed public health priorities, further enabling industry influence. Conclusion:Addressing these barriers requires strengthened regulations, improved coordination, and enhanced support for tobacco control initiatives. Efforts should prioritize reducing conflicts of interest, increasing awareness of Article 5.3, and balancing public health and economic interests. Public health dentists and policymakers must collaborate to ensure effective tobacco control measures are implemented and sustained.
Background:Gamification refers to the use of game elements and game design techniques in non-game contexts. Using gamification in education makes educational materials available to learners in a new and attractive way. To this end, the present study sought to investigate the effectiveness of gamification in the field of addiction information literacy. Methods:This applied study was conducted using a quasi-experimental method. The research population consisted of students at Shahid Bahonar University of Kerman in 2023. A total of 32 students were randomly selected as the participants using purposive sampling and were randomly placed in either a control or an intervention group. To conduct the study and collect data, a researcher-made game was used to teach addiction information literacy, and a researcher-made questionnaire was used to assess addiction in the participants. The collected data were analyzed with SPSS-21 software. Findings:The data in this study revealed an average level of addiction information literacy in the students in the control group, who completed the questionnaire without playing the game, while a higher level of addiction information literacy was found in the students in the intervention group, who played the game and completed its stages. Conclusion:The findings showed that the implementation of gamification positively affected the students' addiction to information literacy. Providing educational content in the field of addiction through games is more appealing to them and motivates them to pay attention and learn more about addiction. Besides, since students and young people are always busy with their phones, gamification can be implemented anywhere, transferring content to the audience more easily and quickly.
Background:A well-constructed hypothesis is central to scientific knowledge, guiding the research process from a problem to its potential solution. This paper aims to provide a brief history of the scientific hypothesis, emphasize its central role in hypothesis-driven research, and outline the characteristics of a well-formulated scientific hypothesis. Methods:We conducted a narrative review of philosophical and scientific literature to examine the evolution of hypothesis formulation within the hypothetico-deductive (HD) framework, with emphasis on Karl Popper's principles of falsifiability and deduction. Findings:The HD method remains the cornerstone of scientific inquiry, with hypothesis formulation serving as a critical link between theory and empirical testing. The 5E rule, which is a framework that defines an effective research hypothesis as Explicit, Evidence-based, Ex-ante, Explanatory, and Empirically testable, ensures that hypotheses are clear, relevant, and actionable within scientific investigation. Conclusion:Despite its importance, hypothesis formulation is often underemphasized in modern biomedical research, where many struggle to construct well-defined, testable hypotheses.
