Despite the limitations of this review, there is beginning evidence that HRVB and CB training can be of significant therapeutic potential. Larger clinical trials are needed with methodological improvements such as longer treatment duration, adequate control conditions, measures of adherence and compliance, longitudinal examination of craving changes, and more comprehensive methods of craving measurement.

Heart rate variability biofeedback (HRV BFB) shows promise as an adjunct intervention for individuals receiving treatment for substance use disorder (SUD), potentially due to its capacity to reduce craving and negative affect. The present study sought to examine the utility of integrating HRV biofeedback into a college recovery housing program and gauging its ability to reduce craving and negative affect in young adults in remission from SUD. Forty-six residents of an SUD recovery house at a public university in the northeastern United States took part in a non-randomized controlled trial. The active intervention was 12 weeks of HRV BFB performed over a college semester. The control intervention was a semester-long, waitlist condition. Changes in craving, perceived stress, anxiety, and depressive symptoms were measured across time during the active HRV BFB intervention and compared to changes that occurred during the waitlist period using piecewise regression analyses. Significant reductions in craving were noted during HRV BFB, but not during the waitlist control condition; however, the difference in slopes between conditions was not statistically significant. Levels of self-reported craving, stress, anxiety, and depression varied substantially between participants and across time. The results suggest that use of HRV BFB in the college recovery setting as a tool to help reduce craving warrants further examination, particularly among individuals with elevated craving. Added value of HRV BFB comes from the fact that it can be easily and affordably implemented in everyday life.

Although there is a vast literature on the concept of well‐being, there appears to be no consensus regarding its meaning. A clear conceptualization of adolescent well‐being is necessary as the foundation for interventions and research addressing this phenomenon. Adolescence is a transitional period characterized by rapid growth, gaining independence, and learning social skills as well as behaviours that lay the foundations for future well‐being. Therefore, the purpose of this paper was to analyse the concept of adolescent well‐being and identify its attributes, antecedents, and empirical referents based on the literature. The Walker and Avant (2019) method was used. Ninety‐four articles were included in the final review. The defining attributes of adolescent well‐being were identified as autonomy, connectedness, optimism and competency. The antecedents were grouped under internal and external factors. Internal factors included the behavioural, physical, psychological, and spiritual domains. External factors included the environmental, economic, education, leisure, social, and safety as well as security domains. For the adolescent to reach well‐being, all these domains must be present, albeit, the social domain was highly stressed. The consequences of adolescent well‐being included eudaimonia, having high resilience as well as low risk‐taking behaviours and delinquency. Empirical referents were discussed in terms of ways of measuring the defining attributes. Stemming from the eudaimonic perspective, to promote adolescent well‐being, care providers need to integrate in education, practice, and research the importance of establishing positive relations and connectedness, to enhance adolescent autonomy and optimism and assist them to grow into competent and self‐fulfilled beings.

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This study examined the psychometric characteristics of a 32-item modified version of the Ethical Issues Scale (EIS). Data were collected from 59 registered nurses at the American University of Beirut Medical Centre (AUBMC). Data were analyzed using WINSTEPS Rasch analysis software. The four-category EIS rating scale needs modification for future studies in Lebanon. All EIS scale items need rewording prior to translation into Arabic to avoid confusion among Lebanese nurses. Principal component analysis (PCA) of residuals indicated the possible presence of additional dimensions. Additional EIS items are needed to improve targeting.

NPs have a key role in screening for adolescent substance use in school settings. This article provides evidence-based information on the prevalence and consequences of adolescent substance use, discusses standardized substance use screening and brief interventions using the CRAFFT tool, and suggests relevant practice and policy implications.

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Introduction: Substance use among adolescents is on the rise globally. Adolescents rarely seek help for problematic substance use and healthcare professionals can easily fail to identify adolescents with risky substance use. There is therefore a significant global need for substance use screening by healthcare professionals followed by appropriate intervention. Screening, brief intervention, and referral to treatment (SBIRT) is an evidence-based practice that enables clinicians to determine adolescents’ risk for substance use and intervene accordingly. However, little effort has been placed on empowering primary care clinicians to use it in Lebanon. We explored the attitudes, perceptions, and practices of primary care nurses and physicians regarding adolescent SBIRT use. Methods: The study used a cross-sectional multisite survey design targeting urban and rural areas in Lebanon. A national sample of 140 physicians and nurses was recruited using random sampling stratified by governorate. Participants completed mailed or online surveys addressing their practices, attitudes, role perceptions, and self-efficacy regarding SBIRT use. Results: This study revealed that 57.8% of healthcare professionals were not familiar with the SBIRT model and that 76.2% did not practice SBIRT in their setting. The majority addressed the problem of substance use through educating and counseling adolescents about the dangers of substance use (84.2%) and encouraged them to stop (82%) but only 2% reported using standardized instruments for substance use screening. Most participants (88.1%) reported their willingness to use SBIRT in their clinical practice and 92.4% expressed an interest in receiving SBIRT training. Overall, the results showed positive attitudes ( M = 4.38, SD = 0.89) and role responsibility ( M = 4.47, SD = 1.62) toward addressing substance use in adolescents, in addition to a high level of perceived self-efficacy in addressing substance use ( M = 4.04, SD = 0.92). Our results showed minimal differences between nurses’ and physicians’ perceptions and self-efficacy regarding SBIRT use. Conclusions: Our study confirms the lack of a standardized approach toward adolescent substance use screening and intervention by primary healthcare providers in Lebanon but revealed the readiness and willingness to receive training and proper support to adopt an evidence-based approach such as SBIRT.