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The American Association of Critical-Care Nurses (AACN) has developed a guide to help those who have been vaccinated against COVID-19 to engage in constructive conversations with family members and friends who are hesitant about getting the vaccine, according to a press release.

The toolkit is associated with AACN’s Hear Us Out campaign to report nurses’ reality from the front lines of the COVID-19 pandemic and help the unvaccinated reconsider their decisions.

“COVID-19 is still here. The majority of patients with COVID we’re seeing in ICUs haven’t been vaccinated, and their journey often ends with a nurse holding their hand as they die,” said Beth Wathen, AACN president and a clinical practice specialist in Denver, Colorado, in a press release. “Nurses need allies to end this pandemic, and productive conversations about the vaccine among family, friends and those who trust each other can open minds.”

Included in the toolkit are tips to help individuals prepare for potentially challenging conversations with those who are hesitant about getting vaccinated. The toolkit includes resources such as tip sheets, links to trusted information sources, and short videos of nurses sharing profound experiences of taking care of unvaccinated patients with COVID-19.

“This toolkit offers straightforward tips to keep sensitive conversations from becoming confrontational,” said Stephanie Burdick, a community health strategist in Salt Lake City, Utah, in a press release. “It fills a critical gap in community health education as the public prepares to celebrate the upcoming holidays with friends and loved ones.”

In a recent AACN survey of more than 6500 acute and critical care nurses, 76% of respondents claim that people who have yet to be vaccinated threaten nurses’ physical and mental well-being. Additionally, 92% of nurses surveyed said they think that the COVID-19 pandemic has depleted nurses at their hospitals and has led to the shortening of their careers than intended.

“We know that people in communities with low vaccination rates are at greater risk for becoming seriously ill with COVID-19 and dying from what is now largely a preventable disease,” said Amanda Bettencourt, AACN president-elect and an assistant professor in Philadelphia, Pennsylvania, in a press release. “The pandemic has brought the nursing profession into crisis, and the public is a critical part of the solution. The fastest way out of this is by more people getting vaccinated.”

Toolkit provides tips for COVID vaccination conversations. American Association of Critical-Care Nurses. Published November 9, 2021. Accessed November 15, 2021. 

https://www.aacn.org/newsroom/toolkit-provides-tips-for-covid-vaccination-conversations

Articles

Included in the toolkit are tips to help individuals prepare for potentially challenging conversations with those who are hesitant about getting vaccinated. 

New Toolkit Provides Tips for COVID-19 Vaccination Conversations

 interviewed Rita Wise, DEd, MSN, RN, the program director of the Masters in Nursing Education and Nursing Administration programs at Pennsylvania College of Health Sciences, on the national nurse staffing crisis, which is not only effecting hospitals, but also nursing faculty at academic institutions.

During this discussion, Wise addressed the extent of the nurse staffing crisis occurring across the country and what the possible causes of the crisis may be.

Videos

Rita Wise, DEd, MSN, RN, program director of the Masters in Nursing Education and Nursing Administration programs at Pennsylvania College of Health Sciences, discusses the national nurse staffing crisis and its possible causes.

Assessing the Extent of the National Nurse Staffing Crisis, Possible Causes

About 1 in 4 individuals, aged 20 to 39 years, with attention-deficit/hyperactivity disorder (ADHD) have generalized anxiety disorder (GAD), the results of a study show.

“There are many studies linking adult ADHD to depression and suicidality, but less attention has been paid to generalized activity disorders and other adverse outcomes across the life course,” Esme Fuller-Thomson, professor at the University of Toronto’s Factor-Inwentash Faculty of Social Work and director of the Institute for Life Course & Aging, said in a statement.

Individuals with ADHD are 4 times more likely to have GAD at some point in their lives than those who do not have the disorder.

Even after controlling for other relevant factors, such as adverse childhood experiences, a history of major depressive disorders or substance use disorder, or sociodemographic factors, individuals with ADHD still had more than double the risk of developing GAD than those who do not have the disorder.

The results also show that females with ADHD were nearly 5 times more likely to develop GAD.

Individuals who had experienced adverse childhood experiences, such as chronic parental violence or physical or sexual abuse, were 3 times more likely to develop GAD.

In addition, 60% of those with ADHD with anxiety disorders had experienced at least 1 of these adverse childhood experiences.

“It is crucial that those with ADHD who are struggling with mental health issues reach out for help from their family doctor or other mental health professional, including social workers, psychologists, and psychiatrists. Effective treatments, such as [cognitive behavioral therapy], are available, and these can dramatically improve one’s quality of life,” Fuller-Thomson said.

Other factors that were associated with GAD included having an income below $40,000, fewer close relationships, and a lifetime history of major depressive disorder. The odds of individuals with ADHD developing GAD were 6-fold for those with a history of major depressive disorder.

Investigators examined a sample of 6898 individuals from the Canadian Community Health Survey-Mental Health, aged 20 to 30 years.

The investigators did not have access to information on what treatments respondents were receiving to address their anxiety.

Adults with ADHD four times more likely to have generalized anxiety disorder. EurekAlert. News release. November 18, 2021. Accessed November 18, 2021. 

https://www.eurekalert.org/news-releases/935302

Those with attention-deficit/hyperactivity disorder are much more likely to have GAD at some point in their lives than others who do not have it.

1 in 4 Individuals With ADHD Have a Generalized Anxiety Disorder

Perinatal mood and anxiety disorders may be linked with significantly higher rates of first-time cesarean deliveries (C-section) among women who are otherwise at a low risk of having one, according to a study from researchers at Michigan Medicine.

Earlier research had linked perinatal mood and anxiety disorders with adverse pregnancy outcomes such as low birth weight and preterm birth, but the new findings suggest they may be connected with the type of delivery a woman has. The findings were published in 

“Our findings reinforce the importance of better identifying and treating perinatal depression and anxiety disorders in pregnant women,” said senior author Vanessa Dalton, MD, MPH, an obstetrician gynecologist at University of Michigan Health Von Voigtlander Women’s Hospital, in the press release. “It’s critical to better understand how these mood disorders increase the likelihood of cesarean section deliveries, which we know have both short and long-term health consequences for both expecting moms and their babies.”

The study is one of the largest to document a link between predated mood and anxiety disorders and first-time C-sections among low-risk pregnant women. Previous research on this topic is limited and often includes patients who had prior C-sections, which is one of the more significant predictors of a repeat C-section.

C-sections have numerous risks, including blood clots, hemorrhaging, infection, and risks to future pregnancies. Most women who undergo a C-section for their first birth will have a repeat C-section as well.

“Cesarean sections are a major contributing factor to maternal morbidity events after a delivery with many adverse downstream effects,” Dalton said in the press release. “We need to understand all factors that may increase a woman’s chance of a C-section delivery so we can avoid any unnecessary risks.”

Perinatal mood and anxiety disorders affect as many as 20% of reproductive-aged women in the United States, and the prevalence of these disorders more than doubled between 2006 and 2015 among childbearing women in the United States. Significantly, the prevalence of suicidal ideation and intentional self-harm in the year before or after birth also rose during that time period, and suicide was a leading cause of maternal mortality.

“There’s been growing recognition that mental health is really important during the time of pregnancy,” Dalton said in the press release. “Maternal suicide risk is especially high the year following delivery.”

In the study, investigators analyzed national data for 360,225 delivery hospitalizations among commercially insured women between the ages of 15 and 44 between 2008 and 2017. Among those, 24% were a first-time delivery by C-section. Reducing the rate of first-time C-sections by 2.3% is a Health People 2030 goal in the United States, and the authors noted that women with a prenatal diagnosis of anxiety or depression had a predicted probability of having a C-section that was about 3.5% higher than women without those conditions.

Women with anxiety or depression were more likely to be older, white, and reside in a household with income more than 400% over the poverty line compared with those without perinatal mood and anxiety disorders. Although reasons for the link between mental health and C-sections are speculative, some unproven theories include the idea that prenatal anxiety is sometimes focused on the delivery itself—which may prompt providers to turn to C-sections to reduce the labor process. Other researchers have posited that maternal distress may impact placental development, which could lead to symptoms of fetal distress during labor.

“We need more research to clarify the relationship between perinatal mood and anxiety disorders and primary cesarean section rates to enhance our understanding of the consequences of these disorders for health outcomes,” Dalton said in the press release. “This could potentially inform efforts to develop and evaluate effective treatments and policy interventions.”

Depression, anxiety may be linked to c-section risk among pregnant women. News release. Michigan Health Lab; October 19, 2012. Accessed November 17, 2021. 

https://labblog.uofmhealth.org/rounds/depression-anxiety-may-be-linked-to-c-section-risk-among-pregnant-women

The study is one of the largest to document a link between predated mood and anxiety disorders and first-time cesarean sections among low-risk pregnant women.

Depression, Anxiety Among Pregnant Women Linked to Higher Risk of C-Section

New studies have shown that although mindfulness is centered on both accepting and engaging with life’s challenges, many popular concepts of the practice tend to miss this mark, according to a University of Waterloo press release.

The research team found that many people confuse the practice of passive acceptance of problems in their use of mindfulness concepts, which is a misconception the study authors said ignores the important work of engaging with them.

“Scientific understanding of mindfulness goes beyond mere stress-relief and requires a willingness to engage with stressors,” said corresponding project author Igor Grossmann in the press release. “It is, in fact, the engagement with stressors that ultimately results in stress relief. More specifically, mindfulness includes two main dimensions: awareness and acceptance.”

Grossman and colleagues worked to compare critics’ claims about popular interpretations of mindfulness to evaluate how people understand and apply the concept in their daily lives, finding that most people blend acceptance with passivity or avoidance in their practice.

The research team organized an extensive empirical project that examined the meaning of mindfulness in 3 parts: analyses of the semantic meaning of the term mindfulness in the English language; meta-analysis of the results from a widely used mindfulness measure; and empirical tests of association with markers of wisdom and effective emotion regulation.

“While we found that people seem to conceptually understand that mindfulness involves engagement, the general public is not walking the talk,” said lead study author Ellen Choi in the press release. “Our results suggest that laypeople may understand what awareness is, but the next step of acceptance may not be well understood- limiting potential for engaging with problems.”

Grossman added that with algorithms curating increasingly hateful content using social media, the idea of being mindful of others’ perspectives has never been more critical.

“Mindfulness might not provide an easy answer to the divisiveness that surrounds us, but an accurate understanding that includes the practice of acceptance may herald the re-emergence of sincere discussion and authentic connection,” Grossman said in the press release.

Despite understanding the concept of mindfulness, people are applying it incorrectly, research finds. University of Waterloo. November 8, 2021. Accessed November 10, 2021. 

https://uwaterloo.ca/news/media/despite-understanding-concept-mindfulness-people-are

New Research Finds Most People Applying Concept of Mindfulness Incorrectly

Households in Australia and New Zealand eat more discretionary and junk food than recommended by dietary guidelines, which contributes to food-related greenhouse gas emissions (GHGe) and other environmental effects, the results of a new review show.

A review of 20 studies shows the environmental impact of food consumption in both countries, and the findings highlight the need for more sustainable dietary choices.

"Meat also emits greenhouse gases, although its water scarcity footprint is lower compared to dairy products, cereals, grains, fruit, and vegetables," Sara Forbes, a dietitian from the University of South Australia, said in a statement. "It is time we better acknowledged the environmental impacts of the type and amount of food we eat, considering the planet as well as our health.

The existing Australian Dietary Guidelines recommends daily servings of “core foods,” such as cheese, eggs, fish, fruits, grains, lean meats, legumes, milk, nuts, seeds, vegetables, and yoghurt.

“Core foods” are estimated to contribute to 67% to 73% of food-related GHGe in Australia, dairy, grains, and meat contributing the most.

Discretionary foods, such as alcohol, confectionary, processed meats, and sugar-sweetened drinks, contribute to 27% to 33% of food-related GHGe.

Even though “core foods” account for more food-related GHGe, investigators said that discretionary foods can be avoided to cut back on emissions.

In New Zealand, the foods that contribute to the highest greenhouse emissions are meat, seafood, and eggs, followed by highly processed foods.

Australia emitted an estimated 510 metric tons of carbon dioxide, with food-related emissions accounting for 14.2%, according to a federal government report in 2020.

The report also found that the average Australian produces the equivalent of 43.43 lbs of carbon dioxide each day.

In 2017, another report showed that food waste comprises about 6% of Australia’s GHGe, considering that energy, pesticides, and water used in food production and packaging ends up in landfills, where even more methane is released as it decomposes.

Save the planet (and your health) by steering clear of sweets and pastries. Science Daily. News release. November 5, 2021. Accessed November 9, 2021. 

https://www.sciencedaily.com/releases/2021/11/21110510380

Even though “core foods” account for more greenhouse gas emissions, discretionary nutrition choices should also be avoided, the results of a new review show.

Junk Food Can Affect Both the Environment and Health

New research from Brigham and Women’s Hospital and Massachusetts General Hospital found that newborns who sleep longer and wake up less throughout the night are less likely to be overweight in infancy, according to a study published in 

"While an association between insufficient sleep and weight gain is well-established in adults and older children, this link has not been previously recognized in infants," said study co-author Susan Redline, MD, MPH, in a press release. "In this study, we found that not only shorter nighttime sleep, but more sleep awakenings, were associated with a higher likelihood of infants becoming overweight in the first 6 months of life."

The researchers evaluated 298 newborns born at Massachusetts General Hospital between 2016 and 2018. The babies’ sleep patterns were monitored using ankle actigraphy watches, which are devices that measure patterns of activity and rest over multiple days. The researchers then extracted 3 nights’ worth of data at the 1- and 6-month marks from sleep diaries, in which parents recorded their child’s sleep and wake episodes.

Infant height, weight, and body mass index were measured to collect growth measurements, and infants were classified as overweight if they were in or above the 95th percentile on the World Health Organization’s growth charts.

The results found that just 1 additional hour of sleep correlated with a 26% decrease in infants’ risk of being overweight. Further, infants who woke up less throughout the night faced a lower risk of excess weight gain. The research team estimated that getting more sleep promotes routine feeding practices and self-regulation, which help to ease overeating.

Study limitations include underrepresentation of African American individuals and families of lower socioeconomic statuses in their dataset. Additionally, factors such as breastfeeding duration were not included and could have possibly impacted infant growth, according to the study authors.

The investigators said that future research will evaluate how sleep patterns impact growth within the first 2 years of life and identify key factors that mediate the correlation between sleep and weight gain. This would also analyze interventions for promoting healthy sleep habits.

"This study underscores the importance of healthy sleep at all ages,” Redline said in a press release. "Parents should consult their pediatricians on the best practices to promote healthy sleep, like keeping consistent sleep schedules, providing a dark and quiet space for sleeping, and avoiding having bottles in bed."

A Good Night’s Sleep May Mitigate Infant Obesity Risks [email]. Brigham and Women’s Hospital. October 20, 2021. Accessed October 28, 2021.

Study Finds Good Night’s Sleep Can Ease Infant Obesity Risks

A higher amount of time sitting was associated with increased symptoms of depression, according to a study published in 

. The study was designed to assess how changes in activity related to the COVID-19 pandemic affected the mental health of participants.

“In March 2020, we knew COVID was going to affect our behavior and what we could do in lots of weird, funky ways that we couldn't predict,” said Jacob Meyer, PhD, assistant professor of kinesiology at Iowa State University, in a press release. “We know when people's physical activity and screen time changes, that's related to their mental health in general, but we haven't really seen large population data like this in response to an abrupt change before.”

The investigators surveyed 3000 participants from all 50 states who self-reported activities such as sitting, exercising, and screen time. Participants were also asked to compare their current rate of behavior to before the beginning of the pandemic, indicating changes to their mental wellbeing using standard clinical scales.

According to the study, participants who were meeting the US Physical Activity Guidelines (2.5 to 5 hours of moderate to vigorous physical activity each week) prior to the pandemic decreased their physical activity by 32% on average shortly after COVID-19 restrictions were put in place. Further, these same participants reported increases in feelings of depression, anxiety, and loneliness. In a follow-up study, participants filled out the same survey each week between April and June 2020.

“In the second study, we found that, on average, people saw their mental health improve over the 8-week period,” Meyer said in the release. “People adjusted to life in the pandemic. But for people whose sitting times stayed high, their depressive symptoms, on average, didn't recover in the same way as everyone else's.”

The investigators emphasize that an association between time spent sitting and mental health is not the same as a causal link. Further, they noted it is possible that individuals who were more depressed sat more or that individuals who sat more became more depressed. Additionally, there may be other factors responsible for this connection that were left unaddressed by the study.

“It's certainly worthy of more investigation,” Meyer said in the release. “I think being aware of some of the subtle changes we've made during the pandemic and how they might be beneficial or detrimental is really important as we look to the other side of pandemic life.”

Sitting more linked to increased feelings of depression, anxiety [news release]. Science Daily; November 8, 2021. Accessed November 9, 2021. 

https://www.sciencedaily.com/releases/2021/11/211108114830.htm

The study was designed to assess how changes in activity related to the COVID-19 pandemic affected the mental health of participants.

Sedentary Lifestyle Associated With Increased Symptoms of Depression During Pandemic

 interviewed Nate Royster, RN, an emergency department (ED) charge nurse at Ohio State, on how to encourage vaccinations without offending patients or making them feel belittled to help address disparities and hesitancy around COVID-19 immunizations.

During the interview, Royster addressed how to approach addressing vaccination disparities in an emergency department, what some common challenges are when trying to support ongoing vaccinations in an emergency department, and what impact nurses can have as educators of patients on factual data pertaining to COVID-19 vaccines.

Nate Royster, RN, an emergency department charge nurse at Ohio State, discusses the impact nurses can have as educators of patients on factual data pertaining to COVID-19 vaccines.

Expert: Nurses Have a Critical Role as Educators on the Facts of COVID-19 Vaccinations

Cerebral palsy (CP) is defined as a group of disorders that affect an individual’s motor function, including a movement, muscle tone and posture.

CP is caused by abnormal brain development or damage to the developing brain in early years. This can occur prenatally or during birth, known as congenital CP, or during the first few years of a child’s life as the brain is growing, known as acquired CP.

 There are 4 major types of CP: ataxic CP, dyskinetic CP (includes athetoid, choreoathetoid, and dystonic), mixed CP (includes spastic-dyskinetic), and spastic CP (includes spastic diplegia, spastic hemiplegia, and spastic quadriplegia).

 Classification is based on the clinical features of motor abnormalities.

Patients with CP can have many comorbid conditions. Epilepsy occurs in 25% to 45% of these patients.

 The brain damage that causes CP typically occurs in 1 part of the brain, so these patients are most susceptible to developing a focal epilepsy. Most patients with CP begin having seizures before aged 2 years.

 Focal seizures start in one part of the brain and either stay in that part or spread to other parts of the brain or the whole brain. The commonly used medication choices for patients with focal-onset epilepsy include: brivaracetam (Briviact), carbamazepine (Tegretol), cenobamate (Xcopri), eslicarbazepine (Aptiom), lacosamide (Vimpat), lamotrigine (Lamictal), oxcarbazepine (Trileptal), topiramate (Topamax), and zonisamide (Zonegran).

 Many children with severe CP can have multiple seizure types. For patients with generalized seizures, which affect both sides of the brain, the following medications may be considered: cannabidiol (Epidiolex), clobazam (Onfi), levetiracetam (Keppra), rufinamide (Banzel), and valproic acid (Depakote).

 Adverse effects profile, age of patient, comorbidities, formulation, and insurance coverage are all factors when choosing an anti-seizure medication. Other treatment options that may help in reducing seizure burden include the ketogenic or modified Atkins diets.

When a patient with CP continues to have seizures, despite having tried 2 anti-seizure medications, they should quickly be referred to an epileptologist, who is a neurologist with specific training in epilepsy. Epileptologists often work at hospitals with a comprehensive epilepsy program where patients whose seizures are intractable to medications can be evaluated for potential epilepsy surgery. Several pre-surgical tests can help localize where in the brain the seizures are starting. If all the seizures are starting in the same area, a resective surgery, where the epileptogenic tissue is ablated or removed, can be a good option to help decrease the seizure burden or in some cases provide the patient with seizure freedom. Depending on the seizure types and extent of early brain damage, other surgical options include a corpus callosotomy (cutting a band of fibers so that the nerves cannot send signals between the 2 halves of the brain) or functional hemispherectomy (disconnecting the damaged and seizure-causing part of the brain from the normal hemisphere). When the seizure onset zone cannot be determined, implanting a vagus nerve stimulation device under the skin in the chest can decrease the frequency and intensity of seizures.

Children with CP can have many medical problems throughout their lives that are often complicated for caregivers and health care professionals to manage. For the common comorbidity of epilepsy, it is important to recognize and diagnose seizures as early as possible. All medication and surgical options should be considered for these patients to provide them with the best chance of seizure freedom and thus improvement in quality of life.

Sula Gillespie, MSN, PNP; Jennifer Glenn, MSN, PNP; and Mallory Murphy, MSN, PNP are nurse practitioners at Children’s of Alabama Epilepsy Monitoring Unit in Birmingham, Alabama.

1. Glader L, Barkoudah E. Cerebral palsy: clinical features and classification. 

. Updated September 21, 2021. Accessed November 2, 2021. https://www.uptodate.com/contents/cerebral-palsy-clinical-features-and-classification

2. What is cerebral palsy. CDC. Updated September 2, 2021. Accessed November 2, 2021. 

3. Pavone P, Gulizia C, Le Pira A, et al. Cerebral palsy and epilepsy in children: clinical perspectives on a common comorbidity. 

4. Epilepsy. Epilepsy Foundation. Accessed November 2, 2021. https://www.epilepsy.com/

For the common comorbidity of epilepsy, it is important to recognize and diagnose seizures as early as possible.

Help Pediatric Patients With Cerebral Palsy

New research from the University of British Columbia (UBC) suggests that living in areas with high exposure to greenspace can help set children up for success later in life.

The research team at the UBC Faculty of Forestry and Faculty of Medicine analyzed the developmental scores of 27,372 children in Metro Vancouver who attended kindergarten between 2005 and 2011. The team estimated the amount of greenspace around each child’s residence from birth to 5 years of age and they assessed levels of traffic-related air pollution and community noise.

The findings highlight the fundamental importance of natural green spaces such as street trees, parks, and community gardens, according to the study authors.

“Most of the children were doing well in their development, in terms of language skills, cognitive capacity, socialization and other outcomes,” said study author Ingrid Jarvis, a PhD candidate in the department of forest and conservation sciences at UBC, in a press release. “But what’s interesting is that those children living in a residential location with more vegetation and richer natural environments showed better overall development than their peers with less greenspace.”

The ability of greenspace to reduce the harmful effects of air pollution and noise are environmental changes that may have a potentially negative impact on children’s health and development through increased stress, sleep disturbances, and central nervous system damage, according to the study authors.

“Few studies have investigated this pathway linking greenspace and developmental outcomes among children, and we believe this is the first Canadian study to do so,” Jarvis said in the press release.

The research team used the Early Development Instrument tool to assess the children’s development, which is a survey completed by kindergarten teachers for each child and measures a child’s ability to meet age-appropriate developmental expectations.

“More research is needed, but our findings suggest that urban planning efforts to increase greenspace in residential neighborhoods and around schools are beneficial for early childhood development, with potential health benefits throughout life,” said senior study author Matilda van den Bosch in the press release. “Time in nature can benefit everyone, but if we want our children to have a good head start, it’s important to provide an enriching environment through nature contact. Access to greenspace from a very young age can help ensure good social, emotional and mental development among children.”

Spending time in nature promotes early childhood development. UBC News. October 21, 2021. Accessed October 27, 2021.

The team estimated the amount of greenspace around each child’s residence from birth to 5 years of age and they assessed levels of traffic-related air pollution and community noise.

Study: More Time in Nature Beneficial to Early Childhood Development

Depression in early adulthood can lead to issues with cognition later in life, according to a study published in the 

. The research suggests that depression can lead to lower cognition in 10 years and to cognitive decline in old age.

“Several mechanisms explain how depression might increase dementia risk,” said Willa Brenowitz, PhD, MPH, in a press release. “Among them is that hyperactivity of the central stress response system increases production of the stress hormones glucocorticoids, leading to damage of the hippocampus, the part of the brain essential for forming, organizing and storing new memories.”

The investigators predicted the average trajectories of depressive symptoms for approximately 15,000 participants between 20 and 89 years of age, divided into the categories “older,” “midlife,” and “young adulthood.” Then, the researchers applied these predicted trajectories and found that the odds of cognitive impairment were 73% higher for patients estimated to have elevated depressive symptoms in early adulthood and 43% higher for those estimated to have these symptoms in later life among approximately 6000 older participants.

Participants were screened for depression using the CESD-10, a 10-question assessment evaluating symptoms throughout the past week. Moderate or high depressive symptoms were found in 13% of young adults, 26% of midlife adults and 34% of older participants. To estimate depressive symptoms across each life stage, the investigators pooled data from younger participants with data from the approximately 6000 older participants and predicted average trajectories.

According to the study, 1277 participants were diagnosed with cognitive impairment following neuropsychological testing, evidence of global decline, documented use of a dementia medication, or hospitalization with dementia as a primary or secondary diagnosis.

“Generally, we found that the greater the depressive symptoms, the lower the cognition and the faster the rates of decline,” Brenowitz said in the release. “Older adults estimated to have moderate or high depressive symptoms in early adulthood were found to experience a drop in cognition over 10 years.”

Happiness in early adulthood may protect against dementia [news release]. Science Daily; September 28, 2021. Accessed October 28, 2021. 

https://www.sciencedaily.com/releases/2021/09/210928121341.htm

The research suggests that depression can lead to lower cognition in 10 years and to cognitive decline in old age.

Early Adulthood Depression Associated With Dementia Later in Life

A recent study found that fitness apps that focus on illness- and death-related messaging are more likely to be effective in helping motivate participation than are social stigma, obesity, or financial cost messaging, according to a University of Waterloo press release.

In previous studies, messages that were related to mortality were seen as a barrier to acknowledging health risks; however, the new study found that this is the opposite for fitness apps.

This specific study queried 669 individuals to assess how persuasive specific types of messages are in motivating them to work out at home with a fitness app to determine their efficacy; how they connect with social-cognitive beliefs such as self-regulation, self-efficacy, and outcome expectation; and evaluating the role of gender in how effective the messages were.

“I did not expect only illness- and death-related messages to be significant and motivational,” said Kiemute Oyibo, a postdoctoral fellow at the University of Waterloo’s School of Public Health Sciences, in a press release. “Not only were illness- and death-related messages motivational, they had a significant relationship with self-regulatory belief and outcome expectation, and there was no significant difference between males and females.”

Oyibo added that he expected obesity-related messages to be motivational and have a prominent relationship with self-regulatory belief because obesity is a leading cause of global mortality.

“This study is important because it helps us—especially designers of health apps—understand the types of messages that individuals, regardless of gender, are likely to be motivated by in persuasive health communication, and that are likely to influence individuals’ social-cognitive beliefs about exercise,” Oyibo said in the press release.

Future studies should consider other demographic characteristics besides gender, such as age, culture, race, and education, to uncover the role they play in persuasive health communication.

Illness-and-death related messages found to be significant motivators for exercise. University of Waterloo. October 19, 2021. Accessed October 25, 2021. 

https://uwaterloo.ca/news/media/illness-and-death-related-messages-found-be-significant

Study: Illness-, Death-Related Messages Significant Motivators for Exercise

The FDA has approved a varenicline solution (Tyrvaya, Oyster Point Pharma) nasal spray 0.03 mg1 as the first and only nasal spray approved for the treatment of the signs and symptoms of dry eye disease, according to a press release.

Dry eye is a chronic disease of the ocular surface characterized by a loss of homeostasis of the tear film, which can result in a multitude of symptoms. The condition impacts more than 340 million adults globally.

Varenicline solution is the first pharmaceutical therapy approved by the FDA to treat the signs and symptoms of dry eye disease. Additionally, the Aptar Cartridge Pump System (CPS) will be the first and only FDA-approved treatment for dry eye disease via the nasal route, according to the press release.

CPS has been in the process of development for more than 15 years and is specifically designed to enable reliable, exact dosing and targeted medication delivery to the nasal mucosa.

“This approval further demonstrates the broad potential for Aptar’s drug delivery solutions and the continued market opportunities for nasal drug delivery,” said Stephan B. Tanda, Aptar President and CEO, in a press release. “We are pleased that our proven CPS nasal system is now a multidose delivery option for patients suffering from dry eye disease.”

First Nasally-Administered Pharmaceutical Treatment for Dry Eye Disease Approved by US FDA with Aptar’s Nasal Pump System. BusinessWire. October 25, 2021. Accessed October 26, 2021. https://www.businesswire.com/news/home/20211025005101/en

Varenicline solution is the first pharmaceutical therapy approved by the FDA to treat the signs and symptoms of dry eye disease. 

FDA Approves Aptar Nasal Pump System as First Nasally-Administered Pharmaceutical Treatment for Dry Eye Disease

Red blood cells function as immune sensors by binding cell-free DNA called nucleic acid, which is present in the body's circulation during sepsis and COVID-19, according to a study published by 

. The study found that this DNA-binding capability triggers removal of the cells from circulation, driving inflammation and anemia during severe illness, meaning that red blood cells play a larger role in the immune system than previously thought.

“Anemia is common, affecting about a quarter of the world's population. Acute inflammatory anemia is often seen early after an infection such as parasitic infections that cause malaria,” said Nilam Mangalmurti, MD, assistant professor of Medicine at the University of Pennsylvania, in a press release. "For a long time, we haven't known why people—when they are critically ill from sepsis, trauma, COVID-19, a bacterial infection, or parasite infection—develop an acute anemia. These findings explain one of the mechanisms for the development of acute inflammatory anemia for the first time.”

Toll-like receptors (TLRs) are a class of proteins that play a key role in the immune system, activating immune responses, such as cytokine production. According to the study, during sepsis and COVID-19, red blood cells express an increased amount of the TLR protein TLR9 on their surface. When these cells bind too much to inflammation-causing nucleic acid, they lose their normal structure, causing the body to cease recognizing them. Macrophages then remove these blood cells from circulation, causing the immune system to become activated in otherwise unaffected organs, resulting in inflammation, according to the study.

“Right now, when patients in the ICU become anemic, which is almost all of our critically ill patients, the standard is to give them blood transfusions, which has long been known to be accompanied by a host of issues including acute lung injury and increased risk of death,” Mangalmurti said in the release. “Now that we know more about the mechanism of anemia, it allows us to look at new therapies for treating acute inflammatory anemia without transfusions, such as blocking TLR9 on the red blood cells. Targeting this TLR9 may also be a way to dampen some of the innate immune activation without blocking this receptor in immune cells, which are very important for the host when fighting a pathogen or injury.”

According to Mangalmurti, this discovery could have implications for using red blood cells as diagnostic tools. As an example, a physician may be able to take red blood cells from a patient with pneumonia, sequence the nucleic acid that has been soaked up from the infection, and identify the specific kind of pathogen to better determine what kind of antibiotic to prescribe.

Red blood cells play much larger role in immune system through discovery of DNA-binding capability, study finds [news release]. ScienceDaily; October 20, 2021. Accessed October 25, 2021. 

https://www.sciencedaily.com/releases/2021/10/211020150401.htm

The study found that this DNA-binding capability triggers removal of the cells from circulation, driving inflammation and anemia during severe illness, meaning that red blood cells play a larger role in the immune system than previously thought.

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