Carbon Chemist

Tag: depression

  • Exposure to neighborhood violence linked to unmet health needs and increased care utilization in children

    Exposure to neighborhood violence linked to unmet health needs and increased care utilization in children

    [ad_1]

    A new collaborative study between Boston Medical Center, Brigham and Women’s Hospital, Boston Children’s Hospital, Hennepin Healthcare Research Institute, University of Pennsylvania, and Children’s Hospital of Philadelphia finds exposure to neighborhood violence among children was associated with unmet health needs and increased acute care utilization. Published in the American Journal of Preventive Medicine and based on nationally representative data on violence exposure and gold standard access to care measures from the National Health Interview Survey, this study shows that evidence-based interventions to improve access to care in communities impacted by violence are needed to mitigate long-term physical and mental health consequences for children.

    Millions of children in the U.S. are exposed to violence in their homes or communities. Research has shown that children exposed to violence have worse school performance in childhood, increased rates of substance use disorder in adolescence, increased rates of anxiety, depression, and post-traumatic stress disorder in adulthood, and increased risk of developing chronic medical conditions throughout their lives. Exposure to violence also deepens child health inequities, particularly in marginalized communities disproportionately exposed to violence due to systemic racism across generations.

    This study helps examine violence exposure at the population level as both a direct driver of health inequities and as a consequence of fundamental causes like racism, poverty, and other structural risk conditions. The researchers found that, even after controlling for the effects of other important factors like family income and insurance status, children exposed to neighborhood violence face unmet physical and mental health care needs, cost-related barriers, decreased access to prescription drugs, increased urgent care and emergency department utilization, and decreased access to preventive care, mental health care, and medications.

    The study also identified an association between exposure to neighborhood violence and mental health symptoms, including increased rates of depression and anxiety, which was consistent with multiple previous studies. Researchers also found that children exposed to violence have higher rates of delayed and forgone mental health care despite experiencing more mental health symptoms. Prior research shows how early access to care can mitigate the mental health consequences of violence exposure; improving access to high-quality, affordable mental health care services remains critical in communities impacted by neighborhood violence.

    Researchers call attention to built-in environment reforms like neighborhood greening and cleanup, poverty alleviation interventions like the expanded Child Tax Credit, insurance coverage protections like continuous Medicaid enrollment, and hospital-based violence prevention programs as opportunities to take action.

    Our findings highlight the profound impacts of limited access to care in communities affected by violence. We also identify specific opportunities for evidence-based clinician, health system, and policy actions that can reduce the incidence of neighborhood violence and mitigate its health consequences.”


    Rohan Khazanchi, MD, MPH, lead author, resident in the Harvard Internal Medicine-Pediatrics Residency Program at Brigham & Women’s Hospital, Boston Children’s Hospital, and Boston Medical Center

    “To improve health outcomes for the millions of children in the United States affected by neighborhood violence, we have to invest in their families and communities,” said senior author Aditi Vasan, MD, MSHP, a pediatrician at Children’s Hospital of Philadelphia and Assistant Professor of Pediatrics at the University of Pennsylvania Perelman School of Medicine. “Our findings underscore the need for both upstream policy interventions, like the expanded Child Tax Credit, which would provide essential economic support for families in low-income communities impacted by violence, and downstream health system interventions focused on improving access to high-quality, trauma-informed care for these children and their families.”

    Source:

    Journal reference:

    Khazanchi, R., et al. (2024) Health Care Access and Use Among U.S. Children Exposed to Neighborhood Violence. American Journal of Preventive Medicine. doi.org/10.1016/j.amepre.2024.01.009.

    [ad_2]

    Source link

  • Cognitive behavioral therapy helps prevent postpartum mental health challenges in low-resource settings

    Cognitive behavioral therapy helps prevent postpartum mental health challenges in low-resource settings

    [ad_1]

    Results from a large clinical trial funded by the National Institutes of Health show that an intervention for anxiety provided to pregnant women living in Pakistan significantly reduced the likelihood of the women developing moderate-to-severe anxiety, depression, or both six weeks after birth. The unique intervention was administered by non-specialized providers who had the equivalent of a bachelor’s degree in psychology-;but no clinical experience. The results suggest this intervention could be an effective way to prevent the development of postpartum mental health challenges in women living in low-resource settings.

    In low resource settings, it can be challenging for women to access mental health care due to a global shortage of trained mental health specialists. This study shows that non-specialists could help to fill this gap, providing care to more women during this critical period.”


    Joshua A. Gordon, M.D., Ph.D., Director of the National Institute of Mental Health, part of NIH

    Led by Pamela J. Surkan, Ph.D., Sc.D., of Johns Hopkins Bloomberg School of Public Health, Baltimore, the study was conducted in the Punjab Province of Pakistan between April 2019 and January 2022. Pregnant women with symptoms of at least mild anxiety were randomly assigned to receive either routine pregnancy care or a cognitive behavioral therapy (CBT)-based intervention called Happy Mother-Healthy Baby. The researchers assessed the participants (380 women in the CBT group and 375 women in the routine care group) for anxiety and depression six weeks after the birth of their child.

    The researchers found that 9% of women in the intervention group developed moderate-to-severe anxiety compared with 27% of women in the routine care group. Additionally, 12% percent of women in the intervention group developed depression compared with 41% of women in the routine care group.

    “Postpartum depression not only harms mothers, it is also associated with poorer physical growth and delayed cognitive development in their children,” said Dr. Surkan. “The link between maternal and child health highlights the critical importance of developing effective ways to address postpartum anxiety and depression.”

    The Happy Mother-Healthy Baby intervention was created using input from pregnant women in a hospital in Rawalpindi, Pakistan. Pregnant women took part in six intervention sessions where they learned to identify anxious thoughts and behaviors, such as thoughts about possible miscarriage, and to practice replacing them with helpful thoughts and behaviors. The first five sessions were conducted in early to mid-pregnancy, and the sixth session occurred in the third trimester.

    Prior research suggests that up to 30% of women in the Global South, which includes South America, Africa, and most of southern Asia, report experiencing anxiety during pregnancy. Anxiety during pregnancy predicts the development of anxiety and depression after birth, making the prenatal period a prime target for intervention. However, it can be challenging for women living in low-resource settings to access trained clinical care. The findings from this study demonstrate that an intervention such as Happy Mother-Healthy Baby could be an effective way to help prevent the development of postpartum depression and anxiety in settings where specialist clinical care may be hard to access.

    “In the future, we can build on these findings through implementation research. Having identified an intervention that works, the next step is to figure out the best ways to deliver effective treatment to the people who need it, bridging the gap between science and practice,” said Dr. Surkan.

    Source:

    NIH/National Institute of Mental Health

    Journal reference:

    Surkan, P. J., et al. (2024). Anxiety-focused cognitive behavioral therapy delivered by non-specialists to prevent postnatal depression: a randomized, phase 3 trial. Nature Medicine. doi.org/10.1038/s41591-024-02809-x.

    [ad_2]

    Source link

  • Study finds sharp increase in antidepressant dispensing among adolescents and young adults during COVID-19 pandemic

    Study finds sharp increase in antidepressant dispensing among adolescents and young adults during COVID-19 pandemic

    [ad_1]

    Antidepressant dispensing to adolescents and young adults increased sharply after the COVID-19 pandemic began – particularly among females – a new study finds.

    While a growing number of young people ages 12 to 25 were receiving antidepressants before the pandemic, the antidepressant dispensing rate rose nearly 64% faster after March 2020, according to Michigan Medicine led findings in Pediatrics.

    Antidepressant dispensing to adolescents and young adults was already high and rising before March 2020. Our findings suggest these trends accelerated during the pandemic.”


    Kao Ping Chua, M.D., Ph.D., lead author, pediatrician and researcher at University of Michigan Health C.S. Mott Children’s Hospital and the Susan B. Meister Child Health Evaluation and Research Center

    Researchers analyzed data from a national database reporting 92% of prescriptions dispensed in U.S. pharmacies. They found that the increase in the antidepressant dispensing rate during the pandemic was driven by females. 

    After March 2020, this rate increased 130% faster among female adolescents ages 12-17 years and 60% faster among female young adults ages 18-25 years. 

    “Multiple studies suggest that rates of anxiety and depression among female adolescents increased during the pandemic,” Chua said. “These studies, coupled with our findings, suggest the pandemic exacerbated a pre-existing mental health crisis in this group.”

    In contrast to females, the antidepressant dispensing rate changed little among male young adults after March 2020 and declined among male adolescents, which Chua found surprising.

    “It’s hard to believe this decline reflects improved mental health,” he said.

    He believes a more likely explanation is that male adolescents may have skipped physicals and other health care visits during the pandemic, decreasing opportunities to diagnose and treat anxiety and depression.

    The transition away from in-person learning, he notes, may have also decreased opportunities for teachers and other school staff to detect mental health problems in male adolescents. 

    Chua said the overall rise in antidepressant dispensing to adolescents and young adults may not only be related to worsened mental health. Long waitlists for psychotherapy, for example, may have also played a role.

    “In my primary care clinic, I often heard from patients and families that they were facing 6-9 month wait lists for therapy during the pandemic. In those situations, it didn’t make sense to withhold antidepressants and recommend a therapy-only approach,” he said.

    Further studies, Chua says, should identify which interventions can best promote the mental health of adolescents and young adults. 

    Source:

    Michigan Medicine – University of Michigan

    Journal reference:

    Chua, K-P., et al. (2024) Antidepressant Dispensing to US Adolescents and Young Adults: 2016–2022. Pediatrics. doi.org/10.1542/peds.2023-064245.

    [ad_2]

    Source link

  • Study shines light on the well-being challenges faced by women in healthcare

    Study shines light on the well-being challenges faced by women in healthcare

    [ad_1]

    A recent Global Advances in Integrative Medicine and Health study assesses factors influencing the well-being of women in the healthcare profession.

    Study: The Well-Being of Women in Healthcare Professions: A Comprehensive Review. Image Credit: Ground Picture / Shutterstock.com Study: The Well-Being of Women in Healthcare Professions: A Comprehensive Review. Image Credit: Ground Picture / Shutterstock.com

    Background

    Since 2000, the number of full-time healthcare workers has almost doubled. Women account for a significant proportion of this growth and remain integral to the successful provision of healthcare services. Therefore, it is imperative to understand what contributes to the well-being of women in the workplace. 

    Due to the wide range of different roles that women play in society, they can be subject to immense pressure to be successful both at home and in the workplace. This can lead to adverse consequences, such as occupational burnout, psychological distress, anxiety, depression, or even suicidal thoughts.

    In the healthcare sector, these adverse effects can lead to loss of patient trust, lack of adherence to treatment protocols, and lower quality care. Thus, it is critical that female healthcare workers, in particular, receive appropriate support.

    About the study

    In the current study, a total of 71 studies published in 26 countries between 1979-2022 were reviewed. Adult female healthcare professionals between 18 and 74 years of age were enrolled in these studies and included mental healthcare providers, clinical social workers, nurses, and physicians. 

    Several well-being-related factors were investigated, including resilience, wellness, burnout, stress, and quality of life (QOL). For the current study, individuals who identified as women were included, irrespective of the sex assigned at birth.

    Study findings

    This extensive review examined different study designs related to the well-being of female professionals in the healthcare sector across different countries and social contexts. Previous research defined well-being as being disease-free or not having work dissatisfaction; however, this definition is inadequate, as well-being should also encompass promoting happiness, security, and comfort. 

    Several studies have reported a negative association between poor work-life balance and a sense of well-being. To this end, women have often been encouraged to prioritize the household’s and children’s needs rather than their professional development.

    About 25% of the reviewed studies suggested that limited professional autonomy and poor working conditions made women experience burnout at a faster rate than their male colleagues. However, the burnout rate was lower when women worked in a supportive environment and had flexible schedules. 

    Moreover, 20% of the studies highlighted the importance of personal relationships, in which familial relationships, romance, and friendship positively influenced a sense of well-being among women employed in the healthcare sector. The impact of environmental influence and the individual’s lived experience were vital to well-being.

    About 16% of the studies revealed that implicit gender bias was a key source of mental distress among female healthcare workers. This was manifested in various ways, including unequal pay, fewer opportunities to progress, and not addressing female colleagues by their professional titles. 

    Several studies discussed the positive association between intentional mindfulness, exercise, sleep, nutrition, and well-being. The findings from these studies highlight that lifestyle interventions could reduce stress levels, compassion fatigue, and burnout. 

    Opportunities to pursue mentoring and professional development had a positive impact in 11% of the reviewed articles. These activities foster a deeper connection with colleagues and lead to a greater sense of belonging, which subsequently provides fulfillment in professional opportunities and higher job satisfaction.

    Conclusions

    The current review explored the well-being of female professionals in the healthcare sector and further analyzed the correlation between well-being and work-related stressors. Several factors were found to lead to emotional turmoil and job dissatisfaction, which can have severe consequences for the affected individual and the quality of patient care.

    The study findings should motivate future research evaluating different levels of gender-sensitive interventions. More prophylactic methods, such as educational workshops, mindfulness practices, and institutional policy, should be implemented to study the effects of more holistic well-being practices for women.

    Furthermore, the definition of well-being could be made more inclusive by combining physical and mental health. Well-being should also incorporate a sense of meaning or purpose, life satisfaction, and the ability to manage stress.

    Journal reference:

    • Karakcheyeva, V., Willis-Johnson, H., Corr, P. G., & Frame, L. A. (2024) The Well-Being of Women in Healthcare Professions: A Comprehensive Review. Global Advances in Integrative Medicine and Health 13. doi:10.1177/27536130241232929

    [ad_2]

    Source link

  • Mediterranean diet linked to lower depression risk in older women

    Mediterranean diet linked to lower depression risk in older women

    [ad_1]

    The Mediterranean diet (MD) is a popular and medically accepted diet for weight management and health promotion; however, the potential mental health benefits associated with this diet remain unclear. A new study in the British Journal of Nutrition discusses the association between MD and depressive symptoms in a cohort of older men and women.

    Study: Adherence to Mediterranean diet is inversely associated with depressive symptoms in older women: findings from the NutBrain Study. Image Credit: PeopleImages.com - Yuri A / Shutterstock.com Study: Adherence to Mediterranean diet is inversely associated with depressive symptoms in older women: findings from the NutBrain Study. Image Credit: PeopleImages.com – Yuri A / Shutterstock.com

    Depression and aging

    Current estimates indicate that about 5% of the global population suffers from depression, with depression among the leading causes of disability throughout the world. Importantly, the prevalence of depression increases with age, with one-third of older people affected.

    Women are at greater risk for depressive symptoms from adulthood onwards, with this risk further increasing after the age of 60 years. In Italy, 10% of people over 65 years of age report depressive symptoms, with up to 14% of women 85 years and older experiencing depression.

    Biological, psychological, social, and environmental factors contribute to the development of depression; therefore, diet can be considered a modifiable risk factor for this condition. Previous research has shown that following the MD is related to a lower risk of depressive symptoms overall.

    The current study examined the association between MD, due to its ideal nutritional and antioxidant profile, and depressive symptoms. More specifically, the researchers were interested in clarifying the existence of this association, and especially sex-related differences, in older people, with the added contribution of separating these associations by dietary components.

    Data were obtained from a food frequency questionnaire intended to semi-quantitatively assess adherence to the MD in the form of the Mediterranean diet score (MDS) and a depression measurement scale. Study participants were part of the population-based community-dwelling Nutrition, Gut Microbiota, and Brain Aging (NutBrain) cohort, and the study was conducted from October 2019 to January 2023.

    What did the study show?

    A total of 325 men and 473 women were included in the study, 60% of whom were between 65 and 74 years of age. The mean age was 73 years, with about 66% of study participants married and living with others, whereas 50% were considered underprivileged.

    About 20% of the study cohort suffered from depressive symptoms, with 8% of men and 28% of women reporting depressive symptoms. Men with and without depression differed only in the significantly greater number of medications used in those with depression.

    Among women, unmarried women, those living alone, those prescribed more drugs, and those who considered themselves to be sicker were more likely to experience symptoms of depression, as were those who ate less fish, vegetables, and healthy fats relative to saturated fat. About 33% of men reported adherence to the MD compared to 25% of women.

    Study participants with the top third of MDS scores were 55% less likely to report depressive symptoms. When stratified by sex, women with the top third of MDS scores were at a 60% reduced risk of depression.

    High fish consumption was associated with a 44% reduced risk of depressive symptoms in men and women. When stratified by sex, women with high fish consumption were 56% less likely to experience depressive symptoms. With each additional gram of fish consumption, the likelihood of depression declined by 2% overall and in women but not men.

    The type of fish associated with a reduced risk of depression when three or more servings were consumed each week included shellfish, sole, trout, sea bream, cod, hake, and sea bass. This reduction was 62% overall for fish and 4% for shellfish.

    When stratified by sex, women were associated with a reduced risk of depression by 43% with two to three servings of these fish each week; however, this risk further declined by 70% with three or more servings each week as compared to those consuming two or fewer servings of fish. This association was not observed in men.

    Women with a high ratio of monounsaturated fatty acids to saturated fatty acids (MUFA/SFA) in their diet were 42% less likely to report depressive symptoms. For both men and women, nut and fruit consumption was associated with a reduced risk of depressive symptoms by 82% and 42%, respectively.

    With each one-point increase in MDS, the risk of depressive symptoms decreased by 16% overall and by 18% in women. When only men were considered, this reduction was not significant.

    What are the implications?

    Adherence to the highest tertile of the MD is inversely associated with depressive symptoms and, in particular, this is only evident in women.”

    The negative association of the MD, particularly fresh fish and higher MUFA/SFA, with depression corroborates earlier research.

    The association of fresh fish with a reduced risk of depressive symptoms could be due to reduced inflammation, regulation of hypothalamic and pituitary hormones, which regulates other endocrine functions, reduced oxidative stress, gut microbiota profile, as well as other metabolic and intracellular pathways related to mental health.

    The differential effects in women may be due to a higher prevalence of vitamin D deficiency in women, which is associated with poor mental health, including depression and psychosis, as well as changes in brain cell membranes caused by the supply of omega-3 fatty acids abundant in the MD. However, further research is needed to confirm these hypotheses.

    While these findings cannot be experimentally confirmed, and the inclusion of study subjects may show multiple biases, the study cohort was representative of the older community in each locality. Despite these limitations, the study findings emphasize the key role of a healthy diet in promoting mental health in older people. Thus, public health efforts towards this goal will likely be productive, even as further studies are conducted to understand the biological processes responsible for these benefits.

    [ad_2]

    Source link

  • Novel technique could transform the treatment landscape for brain disorders

    Novel technique could transform the treatment landscape for brain disorders

    [ad_1]

    The human brain’s adaptability to internal and external changes, known as neural plasticity, forms the foundation for understanding cognitive functions like memory and learning, as well as various neurological disorders. New research conducted by a team led by Dr. PARK Joo Min of the Center for Cognition and Sociality within the Institute for Basic Science (IBS) unveils a novel technique that could transform the treatment landscape for brain disorders. The team developed a non-invasive brain stimulation method called Patterned Low-Intensity Low-Frequency Ultrasound (LILFUS), which holds tremendous potential for inducing long-lasting changes in brain function.

    Traditionally, magnetic and electrical brain stimulation methods have been used to modulate brain function. However, these methods come with inherent limitations that restrict their spatial resolution and penetration depth, making it challenging to precisely stimulate specific brain regions with optimal efficacy. More invasive methods, such as those that require surgical procedures, exhibit superior control and therapeutic effects for specific deep brain stimulation, but they come with risks such as tissue damage, inflammation, and infection. These limitations have fueled the search for alternative approaches that can overcome these constraints and provide more efficient and precise modulation of brain function.

    In the latest study unveiled by the IBS, researchers used ultrasound to enable precise stimulation of specific brain areas. Unlike electromagnetic waves, ultrasound has the advantage of being able to penetrate deep into the brain tissues. The researchers discovered that ultrasound stimulation can modulate neural plasticity – the brain’s ability to rewire itself – through the activation of key molecular pathways. Specifically, the study pinpointed the ultrasound’s effect on mechanosensitive calcium channels in astrocytes, which controls the cells’ ability to uptake calcium and release neurotransmitters.

    LILFUS was designed based on specific ultrasound parameters that mimic the brainwave patterns of theta (5 Hz) and gamma (30 Hz) oscillations observed during learning and memory processes. The new tool allowed the researchers to either activate or deactivate specific brain regions at will – intermittent delivery of the ultrasound was found to induce long-term potentiation effects, while continuous patterns resulted in long-term depression effects.

    One of the most promising aspects of this new technology is its ability to facilitate the acquisition of new motor skills. When the researchers delivered ultrasound stimulation to the cerebral motor cortex in mice, they observed significant improvements in motor skill learning and the ability to retrieve food. Interestingly, researchers were even able to change the forelimb preference of the mice. This suggests potential applications in rehabilitation therapies for stroke survivors and individuals with motor impairments.

    The implications of this research extend far beyond motor function. It may be used to treat conditions such as depression, where altered brain excitability and plasticity are prominent features. With further exploration, LILFUS could be adapted for various brain stimulation protocols, offering hope for various conditions ranging from sensory impairments to cognitive disorders.

    This study has not only developed a new and safe neural regulation technology with long-lasting effects but has also uncovered the molecular mechanism changes involved in brainwave-patterned ultrasound neural regulation. We plan to continue follow-up studies to apply this technology for the treatment of brain disorders related to abnormal brain excitation and inhibition and for the enhancement of cognitive functions.”


    Dr. Park Joo Min of the Center for Cognition and Sociality, Institute for Basic Science

    Source:

    Institute for Basic Science

    Journal reference:

    Kim, H-J., et al. (2024) Long-lasting forms of plasticity through patterned ultrasound-induced brainwave entrainment. Science Advances. doi.org/10.1126/sciadv.adk3198.

    [ad_2]

    Source link

  • Identifying antiviral protein IFN-γ as a potential biomarker for Long COVID

    Identifying antiviral protein IFN-γ as a potential biomarker for Long COVID

    [ad_1]

    SARS-CoV-2 triggers the production of the antiviral protein IFN-γ, which is associated with fatigue, muscle ache and depression. New research shows that in Long COVID patients, IFN-y production persists until symptoms improve, highlighting a potential biomarker and a target for therapies.

    Identifying antiviral protein IFN-γ as a potential biomarker for Long COVID
    Woman sitting on sofa in the dark, placing a hand to her forehead. Image Credit: Annie Spratt via Unsplash

     A University of Cambridge-led study identifies the protein interferon gamma (IFN-γ) as a potential biomarker for Long COVID fatigue and highlights an immunological mechanism underlying the disease, which could pave the way for the development of much needed therapies, and provide a head start in the event of a future coronavirus pandemic.

     The study, published today in Science Advances, followed a group of patients with Long COVID fatigue for over 2.5 years, to understand why some recovered and others did not.

    Long COVID continues to affect millions of people globally and is placing a major burden on health services. An estimated 1.9 million people in the UK alone (2.9% of the population) were experiencing self-reported Long COVID as of March 2023, according to the ONS. Fatigue remains by far the most common and debilitating symptom and patients are still waiting for an effective treatment.

    The study shows that initial infection with SARS-CoV-2 triggers production of the antiviral protein IFN-γ, which is a normal reaction from the immune system. For most people, when their infection clears, COVID-19 symptoms cease and production of this protein stops, but the researchers found that high levels of IFN-γ persisted in some Long COVID patients for up to 31 months.

    We have found a potential mechanism underlying Long COVID which could represent a biomarker – that is, a tell-tale signature of the condition. We hope that this could help to pave the way to develop therapies and give some patients a firm diagnosis.”

    Dr Benjamin Krishna, Co-author, Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID).

    The research began in 2020 when Dr Nyarie Sithole set up a Long COVID clinic in Cambridge’s Addenbrooke’s Hospital, where he started collecting blood samples from patients and set about studying their immunology. Sithole soon enlisted the support of Dr Benjamin Krishna and Dr Mark Wills from the University of Cambridge’s Dept. of Medicine.

    “When the clinic started, a lot of people didn’t even believe Long COVID was real,” Dr Sithole said. “We are indebted to all the patients who volunteered for this study, without whose support and participation we would obviously not have accomplished this study.”

    The team studied 111 COVID-confirmed patients admitted to Addenbrooke’s Hospital CUH, Royal Papworth Hospital and Cambridge and Peterborough NHS Foundation Trusts at 28 days, 90 days and 180 days following symptom onset. Between August 2020 and July 2021, they recruited 55 Long COVID patients – all experiencing severe symptoms at least 5 months after acute COVID-19 – attending the Long COVID clinic at Addenbrooke’s.

    The researchers analysed blood samples for signs of cytokines, small proteins crucial to the functioning of immune system cells and blood cells. They found that the white blood cells of individuals infected with SARS-CoV-2 produced IFN-γ, a pro inflammatory molecule, and that this persisted in Long COVID patients.

    Dr Krishna said: “Interferon gamma can be used to treat viral infections such as hepatitis C but it causes symptoms including fatigue, fever, headache, aching muscles and depression. These symptoms are all too familiar to Long COVID patients. For us, that was another smoking gun.”

    By conducting ‘cell depletion assays’, the team managed to identify the precise cell types responsible for producing IFN-γ. They pinpointed immune cells known as CD8+ T cells but found that they required contact with another immune cell type: CD14+ monocytes.

    Previous studies have identified IFN-γ signatures using different approaches and cohorts, but this study’s focus on fatigue revealed a much stronger influence. Also, while previous studies have noticed IFN-y levels rising, they have not followed patients long enough to observe when they might drop back down.

    The Cambridge team followed its Long COVID cohort for up to 31 months post-infection. During this follow up period, over 60% of patients experienced resolution of some, if not all, of their symptoms which coincided with a drop in IFN- γ.

    Vaccination helping Long COVID patients

    The team measured IFN-γ release in Long COVID patients before and after vaccination and found a significant decrease in IFN-γ post vaccination in patients whose symptoms resolved.

    “If SARS-CoV-2 continues to persist in people with Long COVID, triggering an IFN-γ response, then vaccination may be helping to clear this. But we still need to find effective therapies,” Dr Krishna said.

    “The number of people with Long COVID is gradually falling, and vaccination seems to be playing a significant role in that. But new cases are still cropping up, and then there is the big question of what happens when the next coronavirus pandemic comes along. We could face another wave of Long COVID. Understanding what causes Long COVID now could give us a crucial head start.”

    Microclotting

    Some well-publicised previous studies have proposed microclotting as a principle cause of Long COVID.

    While not ruling out a role of some kind, these new findings suggest that microclotting cannot be the only or the most significant cause.

    Classifying long COVID

    This study argues that the presence of IFN-γ could be used to classify Long COVID into subtypes which could be used to personalise treatment.

    “It’s unlikely that all the different Long COVID symptoms are caused by the same thing. We need to differentiate between people and tailor treatments. Some patients are slowly recovering and there are those who are stuck in a cycle of fatigue for years on end. We need to know why,” Dr Krishna said.

    Source:

    Journal reference:

    Krishna, B. A., et al. (2024) Spontaneous, persistent, T cell–dependent IFN-γ release in patients who progress to Long Covid. Science Advances. doi.org/10.1126/sciadv.adi9379.

    [ad_2]

    Source link

  • Delta opioid receptor agonist reduces anxiety-like behavior in mice

    Delta opioid receptor agonist reduces anxiety-like behavior in mice

    [ad_1]

    Anxiety-related disorders can have a profound impact on the mental health and quality of life of affected individuals. Understanding the neural circuits and molecular mechanisms that trigger anxiety can aid in the development of effective targeted pharmacological treatments. Delta opioid receptors (DOP), which localize in the regions of the brain associated with emotional regulation, play a key role in the development of anxiety. Several studies have demonstrated the therapeutic effects of DOP agonists (synthetic compounds which selectively bind to DOPs and mimic the effect of the natural binding compound) in a wide range of behavioral disorders. One such selective DOP agonist-;KNT-127-;has been shown to exert ‘anxiolytic’ or anxiety-reducing effects in animal models, with minimal side effects. However, its mechanism of action is not clearly understood, thereby limiting its widespread clinical application.

    To bridge this gap, Professor Akiyoshi Saitoh, along with Ms. Ayako Kawaminami and team from the Tokyo University of Science, Japan, conducted a series of experiments and behavioral studies in mice. Explaining the rationale behind their work, Prof. Saitoh says, “There are currently no therapeutic drugs mediated by delta opioid receptors (DOPs). DOPs likely exert anti-depressant and anti-anxiety effects through a mechanism of action different from that of existing psychotropic drugs. DOP agonists may, therefore, be useful for treatment-resistant and intractable mental illnesses which do not respond to existing treatments.”  Their study was published on 29 December 2024, in Neuropsychopharmacology Reports,

    The neuronal network projecting from the ‘prelimbic cortex’ (PL) of the brain to the ‘basolateral nucleus of the amygdala’ (BLA) region, has been implicated in the development of depression and anxiety-like symptoms. The research team has previously shown that KNT-127 inhibits the release of glutamate (a key neurotransmitter) in the PL region. Based on this, they hypothesized that DOP activation by KNT-127 suppresses glutamatergic transmission and attenuates PL-BLA-mediated anxiety-like behavior. To test this hypothesis, they developed an ‘optogenetic’ mouse model wherein they implanted a light-responsive chip in the PL-BLA region of mice and activated the neural circuit using light stimulation. Further, they went on to assess the role of PL-BLA activation on innate and conditioned anxiety-like behavior.

    They used the elevated-plus maze (EPM) test, which consists of two open arms and two closed arms on opposite sides of a central open field, to assess behavioral anxiety in the mice. Notably, mice with PL-BLA activation spent lesser time in the central region and open arms of the maze, compared to controls, which was consistent with innate anxiety-like behavior. Next, the researchers assessed conditioned fear response of the animals by exposing them to foot shocks and placing them in the same shock chamber the following day without re-exposing them to current. They recorded the freezing response of the animals which reflects fear. Notably, animals with PL-BLA activation and controls exhibited similar behavior, suggesting that distinct neural pathways control innate anxiety-like behavior and conditioned fear response.

    Finally, they examined the effects or KNT-127 treatment on anxiety-like behavior of mice using the EPM test. Remarkably, animals treated with KNT-127 exhibited an increase in the percentage time spent in the open arms and central field of the maze, compared to controls. These findings suggest that KNT-27 reduces anxiety-like behavior induced by the specific activation of the PL-BLA pathway.

    Overall, the study reveals the role of the PL-BLA neuronal axis in the regulation of innate anxiety, and its potential function in DOP-mediated anxiolytic effects. Further studies are needed to understand the precise underlying molecular and neuronal mechanisms, for the development of novel therapies targeting DOP in the PL-BLA pathway.

    Highlighting the long-term clinical applications of their work, Prof. Saitoh remarks, “The brain neural circuits focused on in this study are conserved in humans, and research on human brain imaging has revealed that the PL-BLA region is overactive in patients with depression and anxiety disorders. We are optimistic that suppressing overactivity in this brain region using DOP-targeted therapies can exert significant anxiolytic effects in humans.”

    Source:

    Tokyo University of Science

    Journal reference:

    Saitoh, A., et al. (2018). The delta opioid receptor agonist KNT-127 in the prelimbic medial prefrontal cortex attenuates veratrine-induced anxiety-like behaviors in mice. Behavioural Brain Research. doi.org/10.1016/j.bbr.2017.08.041.

    [ad_2]

    Source link

  • An under-recognized contributor to the mortality of new mothers

    An under-recognized contributor to the mortality of new mothers

    [ad_1]

    Painting a sobering picture, a research team led by Children’s National Hospital culled years of data demonstrating that maternal mental illness is an under-recognized contributor to the death of new mothers. They are calling for urgent action to address this public health crisis in the latest edition of JAMA Psychiatry. 

    Backed by dozens of peer-reviewed studies and health policy sources, the journal’s special communication comes as maternal mortality soars in the United States to as much as three times the rate of other high-income countries. 

    The contribution of mental health conditions to the maternal morbidity and mortality crisis that we have in America is not widely recognized. We need to bring this to the attention of the public and policymakers to demand action to address the mental health crisis that is contributing to the demise of mothers in America.”


    Katherine L. Wisner, M.D., associate chief of Perinatal Mental Health and member of the Center for Prenatal, Neonatal & Maternal Health Research at Children’s National 

    The evidence review laid out the risks facing new mothers: More than 80% of maternal deaths in the United States are preventable, particularly the nearly 1 in 4 maternal fatalities that are attributable to mental health disorders. Overdose and other maternal mental health conditions are taking the lives of more than twice as many women as postpartum hemorrhage, the second leading cause of maternal death. For non-Hispanic Black mothers, the mortality rate is a striking 2.6 times higher than non-Hispanic White mothers. 

    Yet the research team found that recent national efforts to combat maternal mortality have failed to address maternal mental health as “the public health crisis that it represents.” Even methodologies to measure maternal health statistics are inconsistent, which challenges efforts to shape health policy. 

    In examining 30 recent studies and another 15 historical references, the team – which included Caitlin Murphy, MPA, PNP, research scientist at the Milken School of Public Health at George Washington University, and Megan Thomas, M.D., FACOG, obstetrician at the University of Kansas School of Medicine – found ample data to support the need to elevate maternal mental health as a priority. Some examples: 

    • Multiple studies show that the perinatal period puts women at higher risk for new and recurrent psychiatric disorders, with 14.5% of pregnant mothers having a new episode of depression and another 14.5% developing an episode three months after birth. 

    • Nationwide, more than 400 maternity healthcare centers closed between 2006 and 2020, creating “maternity care deserts” that left nearly 6 million women with limited or no access to maternity care. 

    • Mental health conditions such as suicide or opioid overdose are to blame for nearly 23% of maternal deaths in America, according to reports from three dozen Maternal Morbidity and Mortality Review Committees, which are state-based organizations that review each maternal death within a year of pregnancy. That’s followed by hemorrhage (13.7%), cardiac conditions (12.8%) and infection (9.2%). 

    Even with these sobering statistics, Dr. Wisner says that only 20 percent of women are screened for depression postpartum. “Given that this is a time that many mothers have contact with healthcare professionals, it’s critically important that all mothers are screened and offered treatment,” she said. “Mental health is fundamental to health – of the mother, the child and the entire family.” 

    Source:

    Children’s National Hospital

    [ad_2]

    Source link

  • Research reveals disparities in workplace experiences for minority ethnic NHS staff during the pandemic

    Research reveals disparities in workplace experiences for minority ethnic NHS staff during the pandemic

    [ad_1]

    Minority ethnic NHS staff were more likely to face workplace harassment, discrimination, and unavailability of personal protective equipment (PPE) than their White British colleagues during the pandemic, reveals research published online in the journal Occupational & Environmental Medicine.

    Urgent action is needed to redress ongoing race inequalities in the health service, insist the researchers, who call for the inclusion of diversity and inclusion training in professional development, and the expansion of the NHS Workforce Race Equality Standard.

    Staff from minority ethnic groups make up nearly a quarter of the NHS workforce in England-;half in London-;but continue to be underrepresented in leadership roles and are more likely to face disciplinary action, note the researchers.

    And evidence suggests that pressurised working environments with high workload and staff shortages can worsen bullying and discrimination. The pandemic created extreme and unprecedented pressures for all NHS staff, they point out.

    To explore this further, the researchers drew on the responses of 4622 NHS staff from 18 trusts to the TIDES Inequalities Survey. This is a partnership between the Tackling Inequalities and Discrimination Experiences in Health Services (TIDES) and NHS CHECK, which sought to capture the psychosocial impact of the pandemic on NHS staff.

    They analysed the survey responses to estimate the prevalence of negative workplace experiences during the pandemic among minority ethnic groups and to find out whether these experiences were associated with mental and physical health issues.

    Of the total, 3741 staff identified as White British; 392 as White Other; 136 as Black; 220 as Asian; and 133 as Mixed Race. The over 50s made up the highest proportion of staff in all racial groups, bar Asian and Mixed. 

    Most of the sample were women (75%), born in the UK (84%), worked in clinical roles (68%) and had a permanent employment contract (90%). Almost half of the staff identifying as Black worked in non-clinical roles compared with a third of those identifying as White British. 

    On the other hand, staff identifying as Asian were predominantly employed in clinical roles and had the highest proportion of doctors (20%). Staff identifying as Mixed/Other had the highest proportion of nurses (33%).

    Nearly 1 in 4 (23%) staff indicated probable depression; nearly 1 in 5 (18%) indicated probable anxiety; and nearly 1 in 4 (23%) reported medium/severe somatic symptoms. 

    The difference in the likelihood of experiencing probable depression among those who faced bullying, harassment and discrimination varied by ethnicity. 

    Staff who identified as Mixed/Other had a higher prevalence of probable depression (36%), anxiety (28%), and somatic symptoms (33%) than all the other ethnic groups.

    A third of all the respondents reported experiences of workplace bullying, harassment, and abuse, and 1 in 5 reported facing discrimination from other members of staff.

    Staff identifying as Black and Mixed/Other were more than twice as likely to experience bullying, harassment, and abuse as their White British colleagues, and they were around 4 times as likely to face discrimination from other staff.

    While Black staff were 4 times as likely to be risk assessed during the pandemic as White British staff, they were also twice as likely to report a lack of available PPE. Asian staff, however, were 52% less likely to report PPE unavailability compared with White British Staff.

    Lack of available PPE was associated with an approximate doubling in the reporting of probable depression, probable anxiety, and moderate/severe somatic symptoms. Bullying, harassment, and abuse were associated with a tripling in each of these health outcomes. 

    Just over a third of respondents (35%;1123) said they were redeployed during the pandemic. Of these, Black staff were less likely to feel able to challenge their redeployment, while staff identifying as Mixed/Other were less likely to be forewarned about the plans.

    Staff identifying as Asian were 3 times as likely as White British staff to feel they could challenge their redeployment decision. And regardless of whether they were redeployed, Black staff were less likely to understand their redeployment rights than their White British colleagues.

    But among those who were redeployed, involvement in redeployment decisions–including feeling able to challenge them-;understanding their rights, and being given a heads up about the move were associated with lower odds of probable depression and moderate/severe somatic symptoms. 

    The researchers acknowledge the relatively low participation rate of staff from non-White ethnicities, but emphasise that their findings are in line with those of previous studies and staff surveys.

    “Our study found alarmingly high exposure to negative workplace experiences related to harassment and discrimination among ethnically minoritised NHS staff during the pandemic.

    “The short-term and long-term impacts of such experiences are likely to take a toll on the mental and physical health of employees, as well as their dependents and social networks, with implications for career progression, intention to remain at the NHS and salary,” they write.

    “It is crucial to prioritise racial discrimination as a public health issue, not just an ethical imperative, and ensure that decision-makers from ethically minoritised groups are involved in processes that affect their health and wellbeing,” they insist.

    “These approaches are urgently required to address racism and inequalities in the UK healthcare system, which have long been recognised as both ‘avoidable and unjust’,” they conclude.

    Source:

    Journal reference:

    Rhead, R., et al. (2024). Ethnic inequalities among NHS staff in England: workplace experiences during the COVID-19 pandemic. Occupational and Environmental Medicine. doi.org/10.1136/oemed-2023-108976.

    [ad_2]

    Source link