Tag: nevin manimala

J Consult Clin Psychol. 2024 Mar 21. doi: 10.1037/ccp0000871. Online ahead of print.

ABSTRACT

OBJECTIVE: Recurrent depressive episodes are preceded by changing mean levels of repeatedly assessed emotions (e.g., feeling restless), which can be detected in real time using statistical process control (SPC). This study investigated whether monitoring changes in the standard deviation (SD) of emotions and negative thinking improves the early detection of recurrent depression.

METHOD: Formerly depressed adults (N = 41) monitored their emotions five times a day for 4 consecutive months. During the study, 22 individuals experienced recurrent depression. We used SPC to detect warning signs (i.e., changing means and SDs) of four emotions (positive and negative affect with high or low arousal) and negative thinking.

RESULTS: SD-based warning signs only preceded 23%-36% of recurrences, but almost never reflected a false alarm (0%-16%). Correspondingly, SD-based warnings had a high specificity (at the cost of sensitivity), while mean-based warnings had a higher sensitivity (but lower specificity). There was little overlap in mean- and SD-based warning signs. For the majority of emotions, monitoring for high SDs alongside monitoring changes in mean levels improved the detection of depression (p < .015) compared to when only monitoring for changing mean levels.

CONCLUSIONS: Warning signs for depression manifest not only in changing mean levels of emotions and cognitions but also in increasing SDs. These warnings could eventually be used to detect not just who is at increased risk for depression but also when risk is rising. Further research is needed to evaluate the clinical utility of depression SPC. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

PMID:38512172 | DOI:10.1037/ccp0000871

Psychol Trauma. 2024 Mar 21. doi: 10.1037/tra0001678. Online ahead of print.

ABSTRACT

OBJECTIVE: Homework has been shown to improve outcomes in cognitive-behavioral therapy, though less is known about the importance of homework during trauma-focused psychotherapy. Similarly, prior research suggests family context plays a key role in posttraumatic stress disorder (PTSD)-related distress and treatment engagement. One potential way that families can facilitate better treatment outcomes is by promoting homework engagement. This study examined the impact of a brief family intervention (BFI) for PTSD toward this aim. We hypothesized that veterans with PTSD whose family members (FMs) received the BFI would have better homework completion and quality than those who did not receive the BFI.

METHOD: This mixed-methods analysis examined 24 veteran-family dyads enrolled in a randomized clinical trial examining the BFI. All veterans were currently engaged in trauma-focused psychotherapy. Each veteran’s clinician rated their homework quality and completion after each therapy session. A subset of dyads also completed semistructured interviews posttreatment. A rapid qualitative analysis approach was used to examine themes in shifting family behavior post-BFI.

RESULTS: Quantitative analyses yielded partial support for our hypotheses: those in the BFI condition had significantly higher clinician-rated homework quality. While participants in the BFI condition had a higher homework completion rate, this difference did not reach statistical significance. Qualitative analyses suggested that the BFI prompted meaningful discussions about PTSD and increased FMs’ use of supportive (rather than accommodative) behavior when responding to PTSD-related distress.

CONCLUSIONS: Involving FMs in PTSD treatment appears to shift the family context in a manner that improves homework quality in veterans. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

PMID:38512169 | DOI:10.1037/tra0001678

Psychol Assess. 2024 Mar 21. doi: 10.1037/pas0001307. Online ahead of print.

ABSTRACT

Racial disparities in criminal justice outcomes are widely observed. In Canada, such disparities are particularly evident between Indigenous and non-Indigenous persons. The role of formal risk assessment in contributing to such disparities remains a topic of interest to many, but critical analysis has almost exclusively focused on actuarial or statistical risk measures. Recent research suggests that ratings from other common tools, based on the structured professional judgment model, can also demonstrate racial disparities. This study examined risk assessments produced using a widely used structured professional judgment tool, the Spousal Assault Risk Assessment Guide-Version 3, among a sample of 190 individuals with histories of intimate partner violence. We examined the relationships among race, risk factors, summary risk ratings, and recidivism while also investigating whether participants’ racial identity influenced the likelihood of incurring formal sanctions for reported violence. Spousal Assault Risk Assessment Guide-Version 3 risk factor totals and summary risk ratings were associated with new violent charges. Indigenous individuals were assessed as demonstrating more risk factors and were more likely to be rated as high risk, even after controlling for summed risk factor totals and prior convictions. They were also more likely to recidivate and to have a history of at least one reported act of violence that did not result in formal sanctions. The results suggest that structured professional judgment guidelines can produce disparate results across racial groups. The disparities observed may reflect genuine differences in the likelihood of recidivism, driven by psychologically meaningful risk factors which have origins in deep-rooted systemic and contextual factors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

PMID:38512165 | DOI:10.1037/pas0001307

MCN Am J Matern Child Nurs. 2024 Mar 21. doi: 10.1097/NMC.0000000000001020. Online ahead of print.

ABSTRACT

PURPOSE: To explore how perinatal nurses perceive the effects of visitor restrictions on patient care within a hospital setting.

STUDY DESIGN AND METHODS: We distributed a cross-sectional survey online to perinatal nurses in May of 2022. Characteristics of respondents were analyzed using descriptive statistics. Responses to an open-ended question were analyzed via conventional content analysis.

RESULTS: Among our sample of 101 nurses, we identified seven codes representing positive effects and seven codes representing negative effects. The most frequently reported positive effects were ability to provide person-centered care (n = 36, 35.6%) and less patient stress and more rest (n = 29, 28.7%). The most frequently reported negative effects were limited patient support (n = 22, 21.8%) and emotional distress to the patient (n = 15, 14.9%). Fourteen percent (n = 14) of respondents cited both positive and negative effects.

CLINICAL IMPLICATIONS: Nurses perceived that visitor restrictions resulted in both positive and negative patient experiences. Balancing clinical needs and safety considerations with emotional needs of the childbearing individual requires careful consideration by maternity care clinicians and health care systems. Subsequent research is needed to determine optimal visitation policies during intrapartum and postpartum with consideration to hospital context and patient preferences for optimal care.

PMID:38512154 | DOI:10.1097/NMC.0000000000001020

Int J Neurosci. 2024 Mar 21:1-12. doi: 10.1080/00207454.2024.2334375. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the variations in serum levels of microRNA-21 (miR-21) and S-100B protein in neonates with hypoxic-ischemic encephalopathy (HIE) after receiving hypothermia therapy and explore the correlation of these biomarkers with the neurodevelopmental prognosis of the infants.

METHODS: This retrospective analysis included 90 neonatal HIE patients diagnosed and treated between January 2019 and December 2022. Real-time quantitative PCR and enzyme-linked immunosorbent assay (ELISA) methods were used to measure miR-21 and S-100B protein levels. Neurodevelopmental assessments were conducted at one year, and follow-up was performed using the Bayley Scales of Infant and Toddler Development third edition. Statistical analysis was carried out using SPSS software, with t-tests for continuous variables, chi-square tests for categorical data, Pearson correlation coefficient for correlation analysis, and multivariate regression analysis to adjust for confounding factors.

RESULTS: After hypothermia therapy, the observation group showed a significant decrease in miR-21 and S-100B protein levels (P < 0.001), and neurodevelopmental scores were significantly higher than the control group (P < 0.05). Correlation analysis indicated a negative correlation between miR-21 and neurodevelopmental scores (r=-0.62, P < 0.001), as well as a negative correlation between S-100B protein levels (r=-0.76, P < 0.001). Multivariate regression analysis demonstrated that miR-21 levels and S-100B protein levels maintained independent negative correlations with neurodevelopmental scores (P < 0.001).

CONCLUSION: Hypothermia therapy significantly reduces serum levels of miR-21 and S-100B protein in neonatal HIE patients and may be associated with better prognosis. miR-21 and S-100B serve as prognostic biomarkers, aiding in predicting and improving the treatment outcomes and long-term prognosis of neonatal HIE.

PMID:38512134 | DOI:10.1080/00207454.2024.2334375

Int J Neurosci. 2024 Mar 21:1-18. doi: 10.1080/00207454.2024.2334368. Online ahead of print.

ABSTRACT

OBJECTIVE: This study focuses on exploring the efficacy observation, complications, and nursing aspects of using enteral nutrition suspension in patients with acute ischemic stroke.

METHODS: This study retrospectively analyzed clinical data from 188 patients with acute ischemic stroke treated in the Neurology Department of our hospital from October 2022 to September 2023. Patients who received routine treatment and nursing interventions were included in the control group (96 cases), while patients who received additional treatment with enteral nutrition suspension on top of the control group were included in the treatment group (92 cases). Relevant indicators data changes before and after treatment were recorded for each patient, along with the occurrence of complications in both groups, and statistical analysis was conducted.

RESULTS: The treatment group had fewer days in the ICU and total hospitalization days compared to the control group, with P < 0.05. Patients in the treatment group had higher levels of serum albumin (ALB) and serum prealbumin (PA) than those in the control group, with P < 0.05. The occurrence of abdominal pain, diarrhea, constipation, bloating, and acid reflux in the treatment group was lower than in the control group, with P < 0.05. There was no significant difference in the occurrence of adverse outcomes at discharge, death at discharge, cerebral hemorrhage, lung infection, and gastrointestinal bleeding between the two groups (P > 0.05).

CONCLUSION: The application of enteral nutrition suspension in patients with acute ischemic stroke effectively provides the necessary nutrients, maintains nutritional balance, promotes tissue repair and recovery, and reduces the length of hospital stay.

PMID:38512133 | DOI:10.1080/00207454.2024.2334368

Elife. 2024 Mar 21;12:RP93246. doi: 10.7554/eLife.93246.

ABSTRACT

The link between metabolic syndrome (MetS) and neurodegenerative as well as cerebrovascular conditions holds substantial implications for brain health in at-risk populations. This study elucidates the complex relationship between MetS and brain health by conducting a comprehensive examination of cardiometabolic risk factors, brain morphology, and cognitive function in 40,087 individuals. Multivariate, data-driven statistics identified a latent dimension linking more severe MetS to widespread brain morphological abnormalities, accounting for up to 71% of shared variance in the data. This dimension was replicable across sub-samples. In a mediation analysis, we could demonstrate that MetS-related brain morphological abnormalities mediated the link between MetS severity and cognitive performance in multiple domains. Employing imaging transcriptomics and connectomics, our results also suggest that MetS-related morphological abnormalities are linked to the regional cellular composition and macroscopic brain network organization. By leveraging extensive, multi-domain data combined with a dimensional stratification approach, our analysis provides profound insights into the association of MetS and brain health. These findings can inform effective therapeutic and risk mitigation strategies aimed at maintaining brain integrity.

PMID:38512127 | DOI:10.7554/eLife.93246

Drug Chem Toxicol. 2024 Mar 20:1-8. doi: 10.1080/01480545.2024.2329752. Online ahead of print.

ABSTRACT

Human red blood cell acetylcholinesterase (RBC-AChE) activity is valuable for detecting potential exposure to cholinesterase inhibiting substances (CIS). A reliable population-based RBC-AChE activity reference range is critical for early and massive clinical and occupational toxicology screening. Previous published studies were often limited to small numbers of subjects, various testing methods, and crude statistical data analyses. We tested 4818 adult subjects with a well-established 17-minute modified Michel method over a 2-year period. We conducted a retrospective data analysis and systematically investigated on the influences to testing values from gender, age, age group, and their combinations and interactions. No significant difference was observed in the testing values between males (mean, medium, interquartile range = 0.76, 0.76, 0.71-0.80 ΔpH/h, respectively) and females (mean, medium, interquartile range = 0.76, 0.76, 0.71-0.81 ΔpH/hour, respectively), when gender was the only factor considered (p = 0.7238). However, with age progression, male testing values exhibited a consistent upward trend, while females did not show any clear patterns. Linear regression analysis of the data revealed that gender, age, and age group more or less affected testing values either as independent variables or with their combinations and interactions. However, more potential factors need to be included to achieve better testing value predictions. We recommend the toxicological testing community to adopt a new set of age group specific RBC-AChE activity reference ranges for males (0.68-0.80, 0.69-0.81, 0.70-0.83, 0.71-0.84, and 0.73-0.87 ΔpH/h for 18-29, 30-39, 40-49, 50-59, and ≥60 years old, respectively) while keeping the current reference range (0.63-0.89 ΔpH/hour) for females.

PMID:38508709 | DOI:10.1080/01480545.2024.2329752

J Med Genet. 2024 Mar 20:jmg-2023-109725. doi: 10.1136/jmg-2023-109725. Online ahead of print.

ABSTRACT

BACKGROUND: The ZFHX3 gene plays vital roles in embryonic development, cell proliferation, neuronal differentiation and neuronal death. This study aims to explore the relationship between ZFHX3 variants and epilepsy.

METHODS: Whole-exome sequencing was performed in a cohort of 378 patients with partial (focal) epilepsy. A Drosophila Zfh2 knockdown model was used to validate the association between ZFHX3 and epilepsy.

RESULTS: Compound heterozygous ZFHX3 variants were identified in eight unrelated cases. The burden of ZFHX3 variants was significantly higher in the case cohort, shown by multiple/specific statistical analyses. In Zfh2 knockdown flies, the incidence and duration of seizure-like behaviour were significantly greater than those in the controls. The Zfh2 knockdown flies exhibited more firing in excitatory neurons. All patients presented partial seizures. The five patients with variants in the C-terminus/N-terminus presented mild partial epilepsy. The other three patients included one who experienced frequent non-convulsive status epilepticus and two who had early spasms. These three patients had also neurodevelopmental abnormalities and were diagnosed as developmental epileptic encephalopathy (DEE), but achieved seizure-free after antiepileptic-drug treatment without adrenocorticotropic-hormone/steroids. The analyses of temporal expression (genetic dependent stages) indicated that ZFHX3 orthologous were highly expressed in the embryonic stage and decreased dramatically after birth.

CONCLUSION: ZFHX3 is a novel causative gene of childhood partial epilepsy and DEE. The patients of infantile spasms achieved seizure-free after treatment without adrenocorticotropic-hormone/steroids implies a significance of genetic diagnosis in precise treatment. The genetic dependent stage provided an insight into the underlying mechanism of the evolutional course of illness.

PMID:38508705 | DOI:10.1136/jmg-2023-109725

BMJ Ment Health. 2024 Mar 20;27(1):e300897. doi: 10.1136/bmjment-2023-300897.

ABSTRACT

BACKGROUND: Use of personal sensing to predict mental health risk has sparked interest in adolescent psychiatry, offering a potential tool for targeted early intervention.

OBJECTIVES: We investigated the preferences and values of UK adolescents with regard to use of digital sensing information, including social media and internet searching behaviour. We also investigated the impact of risk information on adolescents’ self-understanding.

METHODS: Following a Design Bioethics approach, we created and disseminated a purpose-built digital game (www.tracingtomorrow.org) that immersed the player-character in a fictional scenario in which they received a risk assessment for depression Data were collected through game choices across relevant scenarios, with decision-making supported through clickable information points.

FINDINGS: The game was played by 7337 UK adolescents aged 16-18 years. Most participants were willing to personally communicate mental health risk information to their parents or best friend. The acceptability of school involvement in risk predictions based on digital traces was mixed, due mainly to privacy concerns. Most participants indicated that risk information could negatively impact their academic self-understanding. Participants overwhelmingly preferred individual face-to-face over digital options for support.

CONCLUSIONS: The potential of digital phenotyping in supporting early intervention in mental health can only be fulfilled if data are collected, communicated and actioned in ways that are trustworthy, relevant and acceptable to young people.

CLINICAL IMPLICATIONS: To minimise the risk of ethical harms in real-world applications of preventive psychiatric technologies, it is essential to investigate young people’s values and preferences as part of design and implementation processes.

PMID:38508686 | DOI:10.1136/bmjment-2023-300897