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Probiotics can support the effect of antidepressants and help alleviate depression, the results of a study from the University of Basel and the University of Psychiatric Clinics Basel (UPK) showed.

Investigators have been researching ways to improve existing therapies and develop new ones for individuals with depression. Medication and psychotherapy can help. However, symptoms persist for some individuals.

It is known from the results of previous studies that individuals with depression show an above-average prevalence of digestive and intestinal problems.

If the intestinal flora of individuals with depression is implanted in mice raised in sterile conditions, then the animals also developed depressive-like behavior, including less energy and a decreased level of interest in their surroundings compared with their peers, investigators said.

The microbiome-gut-brain axis is a promising approach.

The investigators suspected that the composition of the bacterial community in the gut plays an important role in depressive symptoms. They systemically investigated the effects of probiotics on individuals with depression.

All the individuals included in the study were inpatients at UPK and were given a probiotic or a placebo, for 21 and 26individuals, respectively, for 31 days, in addition to antidepressants. The participants nor the study staff members knew which preparation the individuals were taking throughout the study period.

Investigators carried out a series of tests on the individuals immediately before treatment, at the end of the 31 days, and again 4 weeks later.

They found that the composition of their intestinal flora changed, at least temporarily. In the probiotic group, an analysis of stool samples showed an increase in lactic acid bacteria at the end of the treatment, an effect that was accompanied by a reduction in depressive symptoms.

However, they found that the levels of these health-promoting gut bacteria decreased over the following 4 weeks.

“It may be that 4 weeks of treatment is not long enough and that it takes longer for the new composition of the intestinal flora to stabilize,” Anna-Chiara Schaub, MSc, 1 of the lead authors of the study from UPK, said in a statement.

Additionally, the investigators found that the effect of taking probiotics was seen in relation to brain activity using magnetic resonance imaging when viewing fearful or neutral faces. In individuals with depression, certain brain regions for emotional processing behave differently than in individuals who have good mental health.

After 4 weeks of probiotics, they found that the brain activity normalized in the probiotic group but not in the placebo group.

:With additional knowledge of the specific effect of certain bacteria, it may be possible to optimize the selection of bacteria and to use the best mix in order to support treatment for depression,” Schaub said.

The investigators think that it is important to use a wide range of bacteria in the form of probiotics. They also emphasized that probiotics are not suitable as sole treatment for depression.

'Good' bacteria to tackle depression. Science Daily. News release. June 9, 2022. Accessed June 23, 2022. https://www.sciencedaily.com/releases/2022/06/220609155718.htm

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Results of analysis confirm that intestinal flora play an important role in health, including mental health.

Study: Probiotics Can Support Effects of Antidepressants and Help Alleviate Depression

 interviewed April Kapu, RN, a professor at Vanderbilt University; acute care nurse practitioner based in Nashville, TN; and president of the American Association of Nurse Practitioners (AANP), on the future of the nurse practitioner workforce amid growth in the field and simultaneous extreme fatigue and stress among health care workers.

. Joining me is April Kapu, RN, a Vanderbilt professor; acute care nurse practitioner based in Nashville, TN; and president of the American Association of Nurse Practitioners, or AANP, which represents over 350,000 nurse practitioner, who is here to discuss the future of the nurse practitioner workforce amid simultaneous growth in the field and extreme fatigue and stress among health care workers following the COVID-19 pandemic.

So what is the future of the nurse practitioner workforce amid ongoing challenges relating to burnout and extreme fatigue and stress?

 I think that's an excellent question. We know that we are growing at a rate of 9% to 10% per year, and that our growth rate in the upcoming years will continue because nurse practitioners are in high demand.

We've shown that we provide very high quality, very valuable, and vital health care services to everyone everywhere, [and] we've increased access to care. Especially in those states that I had mentioned that have full practice authority, we've seen in those states the workforce increase, we've seen more access, more NPs moving to rural areas. Nebraska alone—when they moved to full practice authority, 25 of their counties that had historically been known as provider shortage areas, 25 of those counties saw an increase in nurse practitioners moving to rural areas. So this is substantial.

In order to keep our workforce supported and growing and meeting those needs, we need states to update their laws so nurse practitioners can practice to the full extent of their education and training. We mentioned mental health and the health and wellbeing of nurse practitioners, we can fall to the ‘Future of Nursing’ report 2020 to 2030—recommendation number 3 [is] we need to support the health and wellbeing of our nursing workforce, so that they can achieve all that is important to providing health care for healthy lives for everyone everywhere. Health equity is huge, understanding social determinants of health, access to care—these are very important matters in the future in the direction of nursing and all of health care, and to do that we need to support the health and wellbeing of our caregivers and surround them with infrastructures and support that destigmatize mental health services that support mental health and all those things that we had talked about earlier.

 Kind of looking beyond that to the nurse practitioner workforce more broadly speaking, what is your outlook on the future based on your work supporting nurse practitioners at AANP?

 So the American Association of Nurse Practitioners—we are the largest nurse practitioner organization in the world. It's a member-driven organization, so it's members speaking up and voicing what their needs are for their practice. So we have lots of practice tools to support voicing their needs in terms of education. We have workshops, online courses, continuing education, conferences, journals—so many different ways for nurse practitioners to immediately access education—podcasts—lots, and lots of ways to immediately have access to education and advocacy—we have an amazing state and federal advocacy team.

For research—not often do we mention how engaged AANP is in research to better patient care outcomes, but also to continually demonstrate our impact to health care and continually demonstrate the quality outcomes of NP practice.

Then leadership—we have so many opportunities for NPs to take different paths to lead. They want to be more of an executive leader, if they want to lead in health policy, if they want to lead more in the educational realm. We have lots and lots of resources to help develop those relationship skills. So a lot of resources for support and much of this is just really driven by the voice of our members.

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April Kapu, RN, president of the American Association of Nurse Practitioners (AANP), discusses the future of the nurse practitioner workforce amid ongoing challenges relating to burnout and extreme fatigue and stress.

Future of Nurse Practitioner Workforce During Ongoing Burnout, Extreme Fatigue, Stress

New research has found strong evidence that dispatching mental health professionals instead of police officers to some nonviolent 911 emergencies could have significant benefits.

Researchers at Stanford studied a pilot 911 response program in Denver, Colorado, in which mental health specialists responded to calls involving trespassing and other nonviolent events. According to the study results, researchers found a 34% decrease in reported crimes during the 6-month trial. The study also found that direct costs of the alternative 911 approach were 4 times lower than police-only responses.

“We provide strong, credible evidence that providing mental health support in targeted, nonviolent emergencies can result in a huge reduction in less serious crimes without increasing violent crimes,” said researcher Thomas Dee, PhD, in the press release. “In our politically divisive times, this first-responder innovation provides a rare opportunity for consensus on meaningfully improving public safety and health.”

National discussions around police reform and first responders have become highly controversial, including growing awareness of the need for experts in situations involving mental health or substance abuse. Currently, a small but growing number of cities around the country are exploring programs that embed mental health care and other social services in first responder procedures. Despite the controversy, Dee said the study’s findings suggest that there are sensible ways to reinvent first responder services in approaches that could have universal appeal.

Several cities—including New York City; Austin, Texas; San Francisco and San Mateo, California; and Washington, DC—are experimenting with new approaches to responding to mental health emergencies through little or no law enforcement involvement. According to the study, cities have been motivated by not only high-profile cases of police brutality, but also by data suggesting that police spend more time responding to “low-priority” calls than any other type of emergency. According to the study authors, as many as two-thirds of these types of 911 calls could be directed to mental health experts.

Cities are generally exploring 3 alternative responses. In one model, police officers are trained to direct people in crisis situations to appropriate services. A second approach involves partnering law enforcement with mental health professionals. Finally, a third reform approach removes police altogether from some 911 calls.

Descriptive evidence from other studies suggests that these models may be effective, but until now, no studies have tied the cause-and-effect of these alternative approaches with empirical evidence that they work. However, a pilot program in Denver could offer this much-needed empirical evidence.

For 6 months in 2020, officials in Denver tested the third, more radical approach by removing police officers from specific 911 calls. In emergencies involving low-risk infractions, such as public intoxication, welfare checks, trespassing, and public disorder, the dispatchers would send a mobile team with 1 mental health specialist and 1 paramedic. The program was called the Support Team Assistance Response (STAR).

The initiative covered 8 precincts in Denver’s downtown neighborhoods, where 911 calls involving low-income, at-risk individuals in nonviolent situations were expected to be high. The team of responders handled nearly 750 incidents involving mental health, homelessness, and/or substance abuse issues during the pilot period.

Interestingly, not all incidence started with a 911 call. In some cases, STAR teams were contacted directly by police officers or they responded to situations that they encountered on their own. In each case, the STAR team would direct individuals to substance abuse treatment centers or other support services as needed.

Using granular crime data publicly released by the city, researchers were able to track all of the adult criminal offenses reported across the 36 police precincts from the period before STAR operations began as well as the time in which the program was active.

The investigators found that dispatching mental health workers made a dramatic difference. Over the span of the pilot program, reports of less serious crimes in STAR-patrolled neighborhoods fell by 34% relative to crime levels observed in neighborhoods where STAR was unavailable. This drop in crime is attributed to fewer citations for public intoxication and other low-level infractions, as well as the likelihood that potential repeat offenders were now getting necessary help.

“The community-response program has 2 benefits,” Dee explained in the press release. “One, it directs people in crisis to appropriate mental health care instead of directing them to the criminal justice system. Two, it prevents future criminal activity because the people who are now receiving mental health care are not committing more offenses.”

In a quality check of their data, the researchers also examined reports of more serious crimes that police, not STAR teams, responded to in the precincts covered. They found no detectable increase in those crime rates, which suggests that the STAR program drove the decrease in low-level criminal activity, according to the researchers.

The STAR program also saved money, with the direct cost of responding to each offense at $151 on average, which is 4 times less than the estimated average of $646 direct cost per minor criminal offense, according to the study.

“These results are extraordinarily promising,” Dee said in the press release, although he noted that more pilots and studies are needed to make sure that any permanent reforms are correctly implemented. “This is not something that every 911 system should be implemented tomorrow. This reform requires thoughtful and detailed implementation—from training people who field 911 calls to hiring the right kind of mental health interventionists and coordinating carefully with law enforcement agencies.”

A new Stanford study shows benefits to dispatching mental health specialists in nonviolent 911 emergencies. News release. Stanford News; June 8, 2022. Accessed June 23, 2022. 

https://news.stanford.edu/2022/06/08/stanford-study-shows-benefits-reinventing-911-responses/

Reports of less serious crimes in neighborhoods with the pilot program fell by 34% relative to crime levels observed in neighborhoods where the program was unavailable.



Dispatching Mental Health Specialists to Nonviolent 911 Emergencies Shows Benefits

New research has found that a person’s mood will decrease over the course of a conversation the more they look at themselves while taking part in an online chat, according to a press release from Illinois News Bureau.

These findings strengthen the challenges of online meeting platforms and raise the issue of the psychological problems that may be occurring in people participating in online activities, such as anxiety and depression.

“We used eye-tracking technology to examine the relationship between mood, alcohol and attentional focus during virtual social interaction,” said Talia Ariss, a University of Illinois (U of I) Urbana-Champaign doctoral candidate who led the research with U of I psychology professor Catharine Fairbairn, in the press release. “We found that participants who spent more time looking at themselves during the conversation felt worse after the call, even after controlling for pre-interaction negative mood. And those who were under the influence of alcohol spent more time looking at themselves.”

Additionally, the new study adds to previous studies that suggest that people who focus more on themselves than on external realities may be susceptible to mood disorders, according to the study authors.

“The more self-focused a person is, the more likely they are to report feeling emotions that are consistent with things like anxiety and even depression,” Ariss said in the press release. “Users of the online video call platform Zoom increased 30-fold during the pandemic—burgeoning from 10 million in December 2019 to 300 million by April 2020,” the researchers wrote. “The pandemic has yielded a surge in levels of depression and anxiety and, given reports of heightened self-awareness and ‘fatigue’ during virtual exchange, some have posited a role for virtual interaction in exacerbating such trends.”

The participants in the study answered questions about their emotional status before and after the online conversations, and they were instructed to discuss what they like and dislike about the local community during the chats as well as their musical preferences. Further, each participant was able to see themselves and their conversation partners on a split-screen monitor, and some consumed an alcoholic beverage before talking while others drank nonalcoholic beverages.

Although the participants stared at their conversation partners on the monitor more than themselves, there was a significant difference in the amount of time that the individual participants spent gazing at themselves.

“The cool thing about virtual social interactions, especially in platforms like Zoom, is that you can simulate the experience of looking in a mirror,” Ariss said in the press release.

The addition of alcohol in the research and using eye-tracking technology also allowed the researchers to explore how mild inebriation affected where a person focused their attention.

“In the context of in-person social interactions, there is strong evidence that alcohol acts as a social lubricant among drinkers and has these mood-enhancing properties,” Ariss said in the press release. “This did not hold true, however, in the online conversations, where alcohol consumption corresponded to more self-focus and had none of its typical mood-boosting effects.”

Fairbarn added that at this point in the pandemic, many people have come to the realization that virtual interactions are not the same as face-to-face.

“A lot of folks are struggling with fatigue and melancholy after a full day of Zoom meetings,” Fairbarn said in the press release. “Our work suggests the self-view offered in many online video platforms might make those interactions more of a slog than they need to be.”

Staring at yourself during virtual chats may worsen your mood, research finds. Illinois News Bureau. June 13, 2022. Accessed June 21, 2022. 

https://news.illinois.edu/view/6367/117509126

Low Moods May Arise From Staring at Yourself During Online Meetings, Calls

 interviewed April Kapu, RN, a professor at Vanderbilt University; acute care nurse practitioner based in Nashville, TN; and president of the American Association of Nurse Practitioners (AANP), on the future of the nurse practitioner workforce amidst simultaneous growth in the field and extreme fatigue and stress among health care workers.

So although COVID-19 remains still a part of our daily lives, would you say COVID-19 has become more like the flu now or is it still a greater threat?

 Well, COVID-19 and the flu are 2 very different viruses, they have 2 different mechanisms of actions, and we address those very differently. We have seen across the world tremendous devastation as a result of COVID-19. We cannot underestimate the potential devastation from this particular virus. So everything that we learned, we need to keep that at the forefront of our minds: That we follow those communities that have high rates of transmission, that we put in those communities that we as collectively as the public that we put into place social distancing masking, that we are vaccinating, that—if you are found to have signs and symptoms of COVID-19—that you're testing, that you are quarantining, especially away from immunocompromised individuals, so that you don't propel that rate of transmission.

We've learned a lot. We know the effectiveness of our vaccinations, we know the effectiveness now of boosters as they're rolling out, and so we know that is our number one tool in preventing certainly transmission, but also severity and illness and ultimately hospitalization and death. So even though we're dealing with mostly Omicron variants right now, and they have been found to be less severe in terms of symptoms, it's still a very fast rate of transmission, and we still know that we have to hold high regard for the potential devastation of these variants as well as any future mutations of variants of COVID-19.

So they're 2 very different viruses, and still flu has very deadly potential impacts as well, but we've learned a lot already throughout the decades around flu. We know about getting our flu shots and what treatments are out there, [such as] antivirals and things like that around flu, but they're 2 different viruses and we have 2 different ways of approaching, as well as treatments out there for those 2 different types of viruses that are out there.

Absolutely, yeah. What is the latest guidance from the CDC on recommending a fourth booster for seniors and immunocompromised individuals?

 Well, they are recommending a fourth booster if you are 18 and above. That can be Moderna if you're 12 and above [and] in immunocompromised [individuals] that would be Pfizer. But to get that fourth booster, it's recommended for 50 years and over. I got my fourth booster a couple of weeks, so if you’re 50 and over, and if it's been 4 months since your last booster, you can get the fourth booster.

If you're immunocompromised and greater then 12 years old, you could have a discussion with your nurse practitioner—the fourth booster may be a good idea for that individual as well. The nurse practitioner is going to talk to you about the different types of vaccinations because there's some parameters around the ages, the boosters, and the types and when to get them.

So if you have any question about whether or not the fourth booster is right for you, I would just say have a conversation with your nurse practitioner. They'll go through all of these details so you can make that informed decision.

April Kapu, RN, president of the American Association of Nurse Practitioners (AANP), discusses the latest guidance from the CDC on recommending a fourth booster for seniors and immunocompromised individuals.

Expert: COVID-19 ‘Has Not Become the Flu,’ They Are Two Very Different Viruses

So April, how has the role of the nurse expanded in recent years in terms of filling gaps in care that may have been caused by the pandemic?

I think that's really interesting to note. Again, it’s been 2 plus years that we've been through the pandemic and what we saw in the pandemic is—so just for the for the sake of the listeners, nurse practitioners are trained and educated through national standards, so we have national standards for accredited education training and national board certification; however, our licensure authority to practice is really state-specific, and why that's important is that there are many states that still have laws that are very outdated that need to be updated so that nurse practitioners in those states can practice to the full extent of their education and training. So this concept is this licensure authority to practice to the full extent of your education and training.

We are now at 26 states and DC that have updated their laws where nurse practitioners can practice to that full extent of education and training during the pandemic. We had 4 states move to what we know as full practice authority, and that was Massachusetts, Delaware, [and] more recently New York and Kansas. These states, like many states, had put into place executive orders which really relieved some of these outdated restrictions barriers, allowing more patients to have full and direct access to NP care—and we needed it. We had so much going on throughout the pandemic. We needed to have as much access to care as possible, and we knew that nurse practitioners were qualified and able to provide that. So in these 4 states, they actually were able to see the care that nurse practitioners provided as well as the increased access to care that the residents in their states would have, so they updated their laws to full practice authority.

So now we're at 26 and DC and hoping that now we have the momentum that all states will move to updating their laws to where we can help with the overall need to increase access to care.

Absolutely. So, following the pandemic, would you say trauma and burnout are continuing to impact the lives of frontline providers and health care workers, including nurse practitioners, and are these professionals still feeling the effects of the pandemic?

Yes, so without a question yes. The physical impact of the physical exhaustion, the mental, the emotional toll that the pandemic took on all health care workers, certainly. But nurse practitioners, as to what I’m speaking about today, still are really looking and evaluating and saying is this something that I want to continue to do. We love what we do, we find great joy in what we do, but there needs to be some infrastructure and system-wide change to really support the health and wellbeing of the caregivers, just as we want to make sure we have plenty of mental health services out there readily available for everyone.

So a lot of discussion and thought certainly on behalf of the American Association of Nurse Practitioners and on national level that we need more mental health resources for nurse practitioners, as well as all health care providers. We need to certainly address the workforce challenges because numbers-wise, you need health care workers all working, and we need plenty of them in order to take care of all of the many individuals that need care.

But on a more local level, we need policies and programs supporting healthy work environments that we really do prioritize the health and wellbeing of our workforce and in specific, our nurse practitioner workforce so that they will continue to feel supported [and] recognized for the work they do that they'll have that staffing support that they have readily accessible and available mental health services and supports there for them. So these are the things that we need to see moving forward in order to continue to show to our workforce our health care workforce that we do support them that we do support mental health as well as overall health and wellbeing.

April Kapu, RN, president of the American Association of Nurse Practitioners (AANP), discusses how trauma and burnout are continuing to impact the lives of frontline providers and health care workers, including nurse practitioners.

Assessing the Ways the Role of the Nurse Has Expanded to Fill Gaps in Care Caused by the Pandemic

A new study has discovered that life circumstances during childhood, including having fewer friends and siblings, low-quality relationships with parents, bad health, and growing up in a poorer household, are all associated with a higher rate of loneliness in older age.

Sophie Guthmuller of Vienna University of Economics and Business, Austria, used data from the large cross-national Survey on Health, Ageing, and Retirement in Europe (SHARE), which collects information from individuals across Europe 50 years of age and older on health, socioeconomic status, and social and family networks, and loneliness was measured with the R-UCLA Loneliness Scale.

Based on the data, Guthmuller observed that ill health was the primary factor correlated with loneliness in older age (43.32%). Additionally, social support in older age accounts for 27.05%, whereas personality traits (10.42%) and life circumstances during childhood (7.50%) also were found to play a role.

For people who rarely or never had close friends in childhood, the odds of loneliness at the age of 50 years or older were 1.24 times higher compared to those who had close friends in childhood. Additionally, the odds were 1.34 times higher in those who had a fair or poor relationship with their mother as a child compared to those with an excellent maternal relationship, while they were 1.21 times higher for those who grew up in a low income household versus a high income household.

Additionally, the data showed that people with neurotic personalities experienced more loneliness traits, whereas those who scored higher for conscientiousness, extraversion, agreeableness, and openness less frequently experienced loneliness in older age.

Furthermore, Guthmuller pointed out that the findings of the study confirm the importance of social networks and support in older age, in addition with the role of personality traits and childhood circumstances. In conclusion, she noted that early interventions are key to targeting later loneliness, and specifically interventions aimed at increasing social support in later life should be modified to support all personality types.

"The study finds, as expected, that health status and social support at older ages are the 2 main factors correlated with loneliness at age 50+. Interestingly, the study reveals that personality traits and life circumstances during childhood are significantly associated with loneliness later in life, after controlling for a large set of later life conditions,” Guthmuller said in the press release. “In light of the trend of increasing childhood loneliness, and the impact of the COVID-19 pandemic on children's life, the findings of this study confirm the importance of early life interventions to tackle long term effects on loneliness."

Childhood circumstances and personality traits are associated with loneliness in older age. EurekAlert! May 18, 2022. Accessed May 31, 2022.

https://www.sciencedaily.com/releases/2022/05/220518140714.htm

Based on the data, Guthmuller observed that ill health was the primary factor correlated with loneliness in older age.

Loneliness in Older Age Associated With Childhood Circumstances, Personality Traits

Contemporary Clinic spoke with Sandee Lombardi, Clinical Nurse Coordinator at the University of California San Diego Medical Center, and Howard Reid, Vice President of Marketing, Pulmonary Hypertension at Janssen, about PHrontline Conversations, the new educational series for nurses treating patients with pulmonary hypertension (PH) and pulmonary arterial hypertension (PAH). 

The new educational content series for nurses treating patients with pulmonary hypertension and pulmonary arterial hypertension is set to be more unique than other programs. 

PHrontline Conversations Continue to Support Pulmonary Hypertension, Pulmonary Arterial Hypertension Nurses

So April, AANP recently released data on the role of the nurse practitioner being ranked the number 1 health care job—what is the basis of AANP’s data presenting this ranking, and why do you think the profession is so highly ranked?

 Well AANP released the data really pointing to the 2022 US News and World Report's data on their top jobs. So among overall jobs, nurse practitioners were ranked number 2, but in health care jobs, they were ranked number one. And there's a lot that goes into that ranking. They review lots of different professions, as you know, but they look at things like median salary, growth projections, opportunities for jobs out there, opportunities for landing jobs, and satisfaction in those roles. So there are a lot of different factors that play into these rankings.

We were very pleased, and I am so happy that the American Association of Nurse Practitioners really jumped on that early because it really does say a lot about our growth as a profession, and what we're doing out there. We're certainly stepping up to meet a tremendous need in health care today.

 Absolutely. How has the nurse practitioner workforce numbers been impacted by the strains of the pandemic and have these numbers started to return to pre-pandemic levels yet?

 Well, actually Alana, before the pandemic, we were at about 270,000 nurse practitioners across the United States. We have been growing at a rate of 9% to 10% per year. So we're now at about 355,000 employees across the United States, and I think what's really happened is the pandemic has spotlighted what was already there—that we have a tremendous need in health care and that there are over 91 million Americans that lack access to primary care. Nurse practitioners are highly qualified professionals, and they're really increasing in number to meet that need. We are seeing more and more nurse practitioners moving into primary health care spaces and other settings to meet that need, and we see more and more consumers, more people across the United States choosing to see a nurse practitioner as their regular health care provider.

April Kapu, RN, president of the American Association of Nurse Practitioners, discusses recently released data showing the role of the nurse practitioner is ranked number one among health care jobs.

Data Shows the Role of Nurse Practitioner Ranked Number One Job in Health Care

Neuroscientists have found that a region of the forebrain known as the striatum was on average 10% larger in individuals with psychopathy compared to a control group of individuals who had low or no psychopathic traits, according to a study.

Psychopathic individuals are generally defined as those who have an egocentric and antisocial personality, marked by a lack of remorse for their actions, a lack of empathy for others, and often criminal tendencies. The striatum is the subcortical region of the brain that contains the entire cerebrum and coordinates multiple aspects of cognition, including motor and action planning, decision-making, motivation, reinforcement, and reward perception.

Notably, although not all individuals with psychopathic traits end up breaking the law and not all criminals meet the criteria for psychopathy, there is a correlation. Clear evidence has linked psychopathy to more violent behavior, according to the study. Understanding the role of biology in antisocial and criminal behavior may help improve existing theories of behavior, as well as inform policy and treatment options.

“Our study’s results help advance our knowledge about what underlies antisocial behavior such as psychopathy,” said Olivia Choy, PhD, an assistant professor at Nanyang Technological University, in the press release. “We find that in addition to social environmental influences, it is important to consider that there can be differences in biology—in this case, the size of brain structures—between antisocial and non-antisocial individuals.”

Earlier research has suggested that psychopaths may have an overly active striatum but have not conclusively determined the impact of its size on behaviors. The new study, conducted by researchers at Nanyang Technical University Singapore, the University of Pennsylvania, and California State University, reveals a significant biological difference between individuals who have psychopathic traits and those who do not.

In their study, the researchers scanned the brains of 120 participants in the United States and interviewed them using the Revised Psychopathy Checklist, which helps determine the presence of psychopathic traits in individuals. Through an analysis of the MRI scans and interviews, the researchers linked having a larger striatum to an increased need for stimulation through thrills and excitement, and a higher likelihood of impulsive behaviors.

As part of the basal ganglia, the researchers noted that this region of the brain receives signals from the cerebral cortex, which controls cognition, social behavior, and discerning which sensory information warrants attention. In the past 20 years, however, the understanding of the striatum has expanded, with hints that the region is linked to difficulties in social behavior.

However, earlier studies have not addressed whether striatal enlargement is observed in adult women with psychopathic traits. Within the study of 120 individuals, the researchers examined 12 women and observed, for the first time, that psychopathy was linked to an enlarged striatum in females, just as in males. In human development, the striatum typically becomes smaller as a child matures, suggesting that psychopathy could be related to differences in brain development.

“A better understanding of the striatum’s development is still needed,” Choy said in the press release. “Many factors are likely involved in why one individual is more likely to have psychopathic traits than another individual. Psychopathy can be linked to a structural abnormality in the brain that may be developmental in nature. At the same time, it is important to acknowledge that the environment can also have effects on the structure of the striatum.”

Study finds psychopathic individuals are more likely to have larger striatum region in the brain. News release. Nanyang Technological University; May 10, 2022. Accessed May 11, 2022. 

https://www.ntu.edu.sg/docs/default-source/corporate-ntu/hub-news/study-finds-psychopathic-individuals-are-more-likely-to-have-larger-striatum-region-in-the-brain.pdf?sfvrsn=fd7259b3_1

Earlier research has suggested that psychopaths may have an overly active striatum but have not conclusively determined the impact of its size on behaviors.

Research Finds Psychopathic Individuals Are More Likely to Have a Larger Striatum Region in the Brain

A new analysis found that the organizational performance during the COVID-19 pandemic may be reflected in the nursing workforce retention as the risk for workforce attrition appears high, according to a study published in 

The purpose of the study was to get a better glimpse of the perspective of nurses working in the United States on the frontlines during the COVID-19 pandemic’s first wave. The impact of the pandemic on nurses’ roles, professional relationships, and the organizational cultures of their employers were a focus as well.

The research team conducted an online qualitative study through social networking recruitment to find frontline nurses across the country to participate. The participants provided long form, text-based responses to 4 questions designed to capture their experiences between the first COVID-19 wave between May and July 2020.

In total, 318 nurses participated from 29 out of 50 states, with 242 nurses completing all of the questions. The findings from the study suggest that the place of work mattered significantly in terms of the frontline working experience. Role changes, risk assumption, interprofessional teamwork experiences, and likelihood to leave their jobs or the profession altogether were major influences.

Although it was known that the working conditions varied during the pandemic, nurses shared that they experienced high levels of occupational risk to their health and were observed to be seen as threats to patient outcomes.

The data emphasized that nurses showed several signals about the potential impact to the stability and sustainability of the United States nursing workforce that are now manifesting, including a massive loss to the frontline of the US nursing workforce stemming from high rates of burnout. 

A. Squires, M. Clark-Cutaia, M. Henderson, et al., "Should I stay or should I go?” Nurses’ Perspectives AboutWorking During the Covid-19 Pandemic in the United States: A Summative Content Analysis Combined with Topic Modelling (2022), 

https://doi.org/10.1016/j.ijnurstu.2022.104256

The purpose of the study was to get a better glimpse of the perspective of nurses working in the United States on the frontlines during the COVID-19 pandemic’s first wave. 

Study: Potential Threats to Stability, Sustainability for US Nursing Workforce

A small animal study found that female rats exposed to the sound of a scream may have diminished ovarian reserve and reduced fertility, according to research published in the Endocrine Society’s journal 

According to the study authors, ovarian reserve is the reproductive potential left within a woman’s 2 ovaries based on the number and quality of eggs. For each woman, they are born with a limited number of eggs and her body is not able to create more, although diminished ovarian reserve can also occur over time. However, the cause of the diminished quality and quantity of eggs in the ovaries has remained unknown for some time.

To assess one potential source of diminished ovarian reserve, the researchers looked to the potential role of stress in this process.

“We examined the effect of stress on ovarian reserve using a scream sound model in rats,” said Wenyan Xi, PhD, of the Second Affiliation Hospital of Xi’an Jiao Tong University in Xian, China, in a press release. “We found that female rats exposed to the scream sound had diminished ovarian reserve and decreased fertility.”

The research team used a scream sound model to investigate the effect of stress on ovarian reserve in female rats, and they exposed the female rats to a scream sound for 3 weeks and analyzed the effect on their sex hormones, the number and quality of their eggs, and their ability to get pregnant and have babies after mating.

The analysis found that the scream sound decreased the rats’ estrogen and Anti-Mullerian hormone levels. The Anti-Mullerian hormone is a hormone made by the ovaries which helps build reproductive organs, whereas estrogen is a group of hormones that play an important role in growth and reproductive development.

Furthermore, the investigators observed that the scream sound appeared to lower the number and quality of the rats’ eggs and resulted in smaller litters.

“Based on these findings, we suggest stress may be associated with diminished ovarian reserve,” Xi said in the press release. “It is important to determine an association between chronic stress and ovarian reserve because doing so may expand our appreciation of the limitations of current clinical interventions and provide valuable insight into the cause of diminished ovarian reserve.”

Stress may be associated with fertility issues in women. Endocrine Society. May 10, 2022. Accessed May 11, 2022. 

https://www.endocrine.org/news-and-advocacy/news-room/2022/stress-may-be-associated-with-fertility-issues-in-women#:~:text=Female%20rats%20exposed%20to%20a,the%20Endocrine%20Society's%20journal%2C%20Endocrinology

Study: Stress May Be Associated with Fertility Issues in Women

Adults who failed to pay down student debt or took on new educational debt between young adulthood and early mid-life faced an elevated risk of cardiovascular (CV) illness, results of a study published in the 

Additionally, individuals who repaid their student debt had better or equivalent health than individuals who never faced student debt, which suggests that relieving the burden of student debt could improve population health.

“As the cost of college has increased, students and their families have taken on more debt to get to and stay in college. Consequently, student debt is a massive financial burden to so many in the United States, and yet we know little about the potential long-term health consequences of this debt,” Adam Lippert, PhD, from the Department of Sociology at University of Colorado Denver, said in a statement.

“Previous research showed that, in the short term, student debt burdens were associated with self-reported health and mental health, so we were interested in understanding whether student debt was associated with cardiovascular illness among adults in early mid-life,” Lippert said.

The study included data from the National Longitudinal Study of Adolescent to Adult Health, which is a panel of 20,745 adolescents in grades 7 to 12 who were first interviewed during the 1994-1995 school year.

Four subsequent waves of data were collected, which included wave 3, where the respondents were aged 18 to 26 years, and wave 5, where the respondents were aged 22 to 44 years, and were invited to in-home medical exams.

Investigators assessed biological measures of CV health of 4193 qualifying individuals using the 30-year Framingham cardiovascular disease (CVD) risk score, which considers age, antihypertensive treatment, body mass index, blood pressure, diabetes diagnosis, sex, and smoking status, to measure the likelihood of CVD over the next 30 years.

Additionally, investigators looked at levels of C-reactive protein (CRP), a biomarker of chronic or systemic inflammation.

Student debt was classified into categories that included consistently in debt, never had student debt, paid off debt between waves 3 and 5, and took on debt between waves.

The models were adjusted for respondent family and household characteristics, including education, income, and other demographics.

Investigators found that more than one-third of respondents did not report student debt in either wave, while 24% consistently had debt, 12% had paid off their loans, and 28% took on student debt.

Individuals who consistently had debt or took on debt had higher CVD risk scores than those who had never been in debt and those who paid off their debt. Additionally, individuals who paid off debt had significantly lower CVD risk scores than those never in debt.

Investigators also found clinically significant CRP value estimates for those who took on new debt and those who were consistently in debt between young adulthood and early mid-life, which exceeded those who never had debt or paid off debt.

Ethnicity and results had no impact on the results, according to investigators.

Student debt can impair your cardiovascular health into middle age. EurekAlert. News release. May 3, 2022. Accessed May 3, 2022. https://www.eurekalert.org/news-releases/951393

Individuals with college debt have a higher risk of cardiovascular illness, undermining the typical benefits of a post-secondary education, data indicate.

Student Loans Can Impair Heart Health into Middle Age, Study Results Show

Several recent clinical trials demonstrated pre-exposure prophylaxis (PrEP) can effectively reduce the risk of HIV transmission and in Europe, which led the European Center for Disease and Prevention (ECDC) to recommend the integration of PrEP into national HIV prevention programs for those most at risk of HIV infection.

A survey conducted in 2018 and 2019 investigated testing frequencies and factors associated with intermittent testing among self-funded PrEP users in Germany. This stems from existing guidelines that found PrEP users are periodically tested for HIV, sexually transmitted infections (STIs), and renal function.

There were 4848 survey participants, and between 1 in 5 and 1 in 4 did not follow the recommended testing frequencies for HIV, STI, and renal function required in the German guidelines for PrEP use. Respondents who frequently tested for STI had higher proportions of self-reported STI diagnoses during PrEP use, overall and across levels of partner numbers and condom use.

According to the study authors, the strongest factors associated with less frequent testing were that respondents did not test before they started taking PrEP, they obtained PrEP from informal sources, and they used it on-demand or occasionally. Further, they concluded that infrequent testing such as this during PrEP use “can lead to missed diagnoses,” and barriers to testing should be addressed to enable proper medical supervision.

The study authors suggest that the most likely mode of transmission was sex with a person on antiretroviral treatment who was not virally suppressed at the time of HIV transmission. They added that further promotion of adherence to antiretroviral therapy among HIV-positive individuals is an important pillar in preventing onward transmission.

As for asymptomatic men who have sex with men (MSM) who use PrEP, regular STI screening and testing is just as important in this population because previous studies found a similar predominance of asymptomatic cohorts of MSM who would have been missed without testing.

HIV pre-exposure prophylaxis works but needs regular testing. EurekAlert! April 7, 2022. Accessed April 18, 2022. 

https://www.eurekalert.org/news-releases/949068

Pre-exposure prophylaxis can effectively reduce the risk of HIV transmission.

Regular Testing Needed for HIV PrEP, Study Shows

More than half of parents said that it is difficult to get their children to eat well-balanced diets, and half say their children regularly takes supplements, according to the University of Michigan Health CS Mott Children’s National Poll on Children’s Health.

“A balanced diet helps children get the nutrients they need for healthy growth and development,” Sarah Clark, MPH, co-director at Mott Poll, said in a statement. “Our poll finds that many turn to dietary supplements as a solution but may not always consult with a health provider.”

Additionally, approximately one-third of parents said that their children are picky, and one-third said they do not think their children eat enough fruits and vegetable.

Approximately 13% said that they worried that their children were not getting enough of certain minerals and vitamins, while 9% said that their children needed more fiber in their diets.

The survey was nationally representative and included 1251 parents each of whom had at least 1 child between age 1 and 10 years.

Another potential barrier is cost. About half of parents agreed that it is more expensive to provide their children with healthy diets.

“We know that fresh, healthy foods can be more expensive than processed or packaged items that are often higher in sodium and added sugars,” Clark said. “This can make it especially frustrating for parents when children waste or refuse to eat healthy foods.”

More than three-quarters of parents said that they gave their multivitamins.

Approximately half said they had also provided their children with probiotics, which are live bacteria and yeast that help digestion by providing good microbes in the gut.

More than one-fifth of parents said that they have given their children Omega-3 supplements, a fatty acid that supports brain development and cell growth..

Additionally, about one-third of parents said that their children have not taken them regularly.

Among those who have given their child supplements, 4 in 5 said that they chose products made specifically for children.

However, only approximately 2 in 5 of parents said that they discussed supplement use with their children’s health care providers.

“Dietary supplements are often intended to enhance the amount of vitamins children consume through a regular diet,” Clark said. “The use of dietary supplements in children is an important health decision to discuss with doctors, but less than half of parents who have given their child a supplement talked to their child’s health provider.”

Parents in lower-income households were also less likely to talk about supplement use with their children’s health care providers compared with higher-income parents, according to the survey results.

Because supplements are classified by the FDA as food, they do not receive the same premarketing evaluation and review as medications, which results in limited research on the efficacy and safety of vitamins, Clark said.

“To minimize the risks of supplement use, parents should share concerns about their child’s diet with a pediatrician who can help them identify the best strategies to improve the nutritional quality of their child’s diet and determine whether supplements are recommended,” she said.

Half of parents regularly give kids a dietary supplement. EurekAlert. News release. April 18, 2022. Accessed April 20, 2022. https://www.eurekalert.org/news-releases/949682

Three in 5 say it is hard to get kids to eat well-balanced diets, because of not eating enough fruits and vegetables, pickiness, and other reasons.

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