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

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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

Primarily obstructive sleep apnea, also known as sleep disordered breathing, during pregnancy and in the years after delivery may be associated with an increased risk for hypertension and metabolic syndrome, according to the results of a new study.

The findings were published online in the 

American Journal of Respiratory and Critical Care Medicine

, the journal of the American Thoracic Society.

In the study, investigators conducted sleep apnea tests on 1965 women who were part of the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be Heart Health Study and experiencing their first pregnancy. Additionally, they also tested 1222 women of the same study who were examined 2 to 7 years after delivery.

Investigators determined whether individuals were at increased risk for hypertension or metabolic syndrome.

“While epidemiologic data from cohorts of middle-aged and older adults indicate that sleep disordered breathing is associated with adverse cardiometabolic outcomes, less is known about how sleep-disordered breathing in pregnancy and in the post-delivery period impacts maternal health,” investigators from the UPMC Magee Womens Hospital said in a statement.

Sleep disordered breathing during pregnancy has been associated with a 2- to 3-fold increased risk for preeclampsia, which is persistent high blood pressure during pregnancy that can lead to serious health consequences, such as gestational diabetes.

Other adverse pregnancy outcomes are risk factors for later development of hypertension and metabolic disease for the mother.

Additionally, individuals with sleep apnea that persisted during pregnancy and during follow-up visits between 2 and 7 years after delivery had more than a 3-fold increased risk for incident hypertension and more than a 2-fold increased risk for metabolic syndrome compared with those who never participated in an abnormal sleep study.

Incident hypertension was defined as the first occurrence at any follow-up visit of diastolic blood pressure 90 mm HG or higher or systolic blood pressure 140 mm HG or higher.

“Our data also demonstrated a higher risk of developing metabolic syndrome and hypertension using a simple measurement of oxygen dips per hour of sleep,” Susan Redline, MD, MPH, who directs the Sleep Medicine Epidemiology program at Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, said in the statement. “These results suggest that use of simple oxygen monitoring devices may be useful for identifying women in pregnancy and in the post-delivery period at risk for adverse health outcomes and identifying women who may potentially benefit from treating sleep apnea.”.

Individuals in the study were tested both during pregnancy and 2 to 7 years later, each using the same model home sleep apnea test. Among other factors, sleep apnea tests measure the number of times an individual experiences breathing pauses and associated drops in oxygen levels.

The individuals were considered to have sleep apnea if they experienced 5 or more breathing pauses or drops in oxygen during their estimated sleep period.

“These data underscore the need to rigorously evaluate the role of screening and treating sleep apnea during pregnancy and in the post-delivery period as new strategies for early interventions aimed at improving long-term maternal health,” investigators said.

Sleep apnea in pregnancy associated with increased post-delivery risk of metabolic syndrome, hypertension. EurekAlert. News release. February 11, 2022. Accessed February 15, 2022. https://www.eurekalert.org/news-releases/942602

Obstructive sleep apnea during pregnancy and in the years after delivery may be associated with an increased risk for hypertension and metabolic syndrome.

Sleep Apnea During Pregnancy Associated with Risk of Hypertension, Metabolic Syndrome

The World Health Organization Guideline Development Group of International Experts has recommended molnupiravir, an antiviral drug, for patients with non-severe COVID-19 who have a high risk of hospitalization.

Although patients with the highest risk of hospitalization typically include those who are unvaccinated, older people, and those with weak immune systems or chronic diseases, the panel recommends that young and healthy patients, including children and pregnant/breastfeeding women, should not be given the drug due to potential harms.

Molnupiravir is an antiviral medicine that works by stopping COVID-19 from spreading, and it can help prevent more severe symptoms developing if it is used as early as possible after infection.

The recommendation is based on new data from 6 randomized controlled trials involving 4796 patients, which is the largest dataset on this drug so far, according to the panel.

Evidence from existing trials suggests that molnupiravir reduces the risk of hospital admission (43 fewer admissions per 1000 patients at highest risk) and time to symptom resolution (which was on average 3.4 fewer days), whereas low certainty evidence suggests a small effect on mortality, which was 6 fewer deaths per 1000 patients.

Certain mitigation strategies were described by the panel that are needed at population level, such as pharmacovigilance and antiviral resistance monitoring, given concerns about genotoxicity, emergence of resistance, and new variants. 

However, there were no recommendations for patients with severe or critical illness since there are no trial data on molnupiravir for this population. Cost and availability issues associated with molnupiravir were also highlighted by the panel, which may make access to low- and middle- income countries challenging and exacerbate health inequity.

Further, in the same guidance update, the panel recommended a treatment combining 2 antibodies, casirivimab and imdevimab, to be used in people who are confirmed not to have the omicron variant.

The new guidance adds to previous recommendations for the use of baricitinib, interleukin-6 receptor blockers and systemic corticosteroids for patients with severe or critical COVID-19.

WHO recommends antiviral drug for patients with non-severe COVID-19 at highest risk of hospital admission. EurekAlert! March 2, 2022. Accessed March 10, 2022. 

https://www.eurekalert.org/news-releases/944989

Molnupiravir can help prevent more severe COVID-19 symptoms developing if it is used as early as possible after infection. 

Molnupiravir Recommended for Patients with Non-Severe COVID-19 at Highest Risk of Hospital Admission

Individuals with congenital heart defects who were hospitalized with COVID-19 infections were at higher risk for severe illness or death than those without heart defects, according to study results published by 

, the American heart Association’s journal.

Individuals with congenital heart defects who contracted COVID-19 infections were also more likely to need ventilators or require treatment in the intensive care unit (ICU), study results showed.

Those at the highest risk of the most severe COVID-19 infections were individuals who had heart defects in addition to another heart condition, being aged 50 years or older, or being men, the study showed.

Investigators examined data on individuals who were hospitalized with COVID-19 between March 2020 and January 2021, which was collected by the Premier Healthcare Database Special COVID-19 Release, a database representing approximately 20% of all United States hospitalizations.

Individuals with and without heart defects received care in the same hospitals, and investigators accounted for differences in age, ethnicity, health insurance type, race, and sex, as well as other high-risk conditions, including diabetes, Down syndrome, heart failure, obesity, and pulmonary hypertension.

During the study period, 235,638 individuals between aged 1 and 64years were hospitalized for COVID-19 and included in the study. Investigators divided the individuals into those who had congenital heart defects and those who did not.

In the 2 groups, investigators then determined how many individuals required admission to the ICU, needed a ventilator to help with breathing, or died. They also reviewed other characteristics, including other health conditions.

Of the individuals in the study, 421 had congenital heart defects.

Investigators found that among those with heart defects, approximately 73% were older than age 30 years, 61% were male, 55% were non-Hispanic white, 19% were Hispanic, and 16% were non-Hispanic Black.

Overall, approximately 68% of individuals with heart defects had at least 1 other health condition, compared with approximately 59% of those without congenital heart defects.

Additionally, approximately 54% of individuals with congenital heart defects were admitted to ICUs compared with 43% without.

Investigators also found that approximately 24% of individuals with congenital heart defects required ventilators compared with 15% without.

Approximately 11% of individuals with congenital heart defects died during hospitalization compared with 7% of those without.

Furthermore, investigators noted that individuals with congenital heart defects consistently remained at high risk for severe COVID-19 infection, even when divided into categories by age or other health conditions in the study.

“People with heart defects should be encouraged to receive the COVID-19 vaccines and boosters and to continue to practice additional preventive measures for COVID-19, such as mask-wearing and physical distancing. People with heart defects should also consult with their health care teams about additional steps to manage personal risks related to COVID-19, given the significantly increased risk of severe infection and serious complications,” Karrie Downing, MPH, an epidemiologist at the National Center on Birth Defects and Developmental Disabilities and the COVID-19 Response Team at the CDC, said in a statement.

A limitation of the study was that only individuals who were hospitalized with COVID-19 were included in the study, so clinical details about the underlying heart defects were not available.

Laboratory testing of COVID-19 also varied by hospital, and vaccination status was not considered in the study.

People with heart defects may be at greater risk for severe COVID-19 illness. EurekAlert. News release. March 7, 2022. Accessed March 7, 2022. https://www.eurekalert.org/news-releases/945163

These individuals, who were also more likely to require treatment in the intensive care unit, should get their vaccines and booster shots, investigators say.

Heart Defects Linked to Higher Risk of Severe COVID-19 Illness, Study Results Show

Researchers from Queen Mary University of London found that common symptoms linked with Parkinson’s, such as tremor and memory problems, can appear up to 10 and 5 years before diagnosis, respectively. During their investigation, the researchers additionally uncovered 2 new early features of Parkinson’s, epilepsy, and hearing loss, and were able to replicate these findings using additional data from the UK Biobank.

Using electronic primary health care records, the team looked at over a million people living in East London between 1990 and 2018 to explore early symptoms and risk factors for Parkinson’s.

Previous studies about Parkinson’s have focused on affluent white populations, with patients from minority ethnic groups and those who live in areas of high social deprivation largely under-represented in Parkinson’s research to date. This recent study provides more evidence of risk factors and early signs of Parkinson’s, using data from urban populations.

Hypertension and type 2 diabetes were associated with increased odds of developing Parkinson’s, in addition to an observation of stronger connections between memory complaints within this population than previously described in East London.

“This is the first study focusing on the pre-diagnostic phase of Parkinson’s in such a diverse population with high socioeconomic deprivation but universal access to health care,” said lead study author Cristina Simonet, PhD, in a press release. “People from minority ethnic groups and deprived areas have largely been under-represented in Parkinson’s research up till now, but to allow us to get a full picture of the condition we need to ensure research is inclusive and represents all those affected.”

Study co-author Alastair Noyce, PhD, added that people see their GPs with symptoms but often don’t get a diagnosis until 5 to 10 years after, and diagnosing Parkinson’s earlier can provide a real opportunity to intervene early and offer treatments that could improve quality of life for patients.

“This study confirms that many of the symptoms and early features of Parkinson’s can occur long before a diagnosis,” Noyce said in a press release. “Through our ongoing PREDICT-PD research, we’re hoping to identify people at high risk of Parkinson’s even before obvious symptoms appear – which means that we could do more than just improve quality of life for patients, and perhaps be in the position to slow down or cure Parkinson’s in the future.”

New early signs of Parkinson’s uncovered in most diverse UK study to date. Queen Mary University of London. March 7, 2022. Accessed March 9, 2022. 

https://www.qmul.ac.uk/media/news/2022/smd/new-early-signs-of-parkinsons-uncovered-in-most-diverse-uk-study-to-date--.html#

Early Signs of Parkinson's Disease Can Appear 5 to 10 Years Before Diagnosis

 interviewed April Kapu, DNP, a professor at the Vanderbilt School of Nursing, an acute care nurse practitioner based in Nashville, TN, and president of the American Association of Nurse Practitioners, on the future of the nurse practitioner workforce amid health care staffing burnout and the extreme fatigue and stress of the pandemic.

 With current strains on staffing numbers, have you seen more nurse practitioners need to step in and fill the roles of physicians who may be focusing on treating patients with COVID-19?

 So, nurse practitioners, like other health care workers, have been under sustained crisis mode for the last 2 years, going into the third year. We're kind of moving past our fifth wave, and it has been sustained adrenaline, sustained taxing on your physical being, your emotional wellbeing, and your mental wellbeing throughout.

I think that's for all health care workers but certainly NPs—they work right alongside physicians, so our NPs are seeing COVID-19 positive patients 24/7 in our ICUs. We opened additional ICUs to specifically treat COVID-19 positive patients, and those NPs are right there taking care of patients.

I think we've spent a lot of time talking about the physical exhaustion because of the staffing shortage because staff are out because of COVID-19 reasons, families with COVID-19, or we've just seen a lot of professionals leave the health care workforce because of burnout. We were in a staffing shortage before we even went into the pandemic because of all those things you're seeing people having to stay 12, 14, 16, 24, or more hours on the job caring for patients, working shift after shift. You may think you're going to take off for the weekend, but you're called in to come back and work, so multiple days in a row—so you see that physical exhaustion.

What we don't talk about as much is the mental and emotional exhaustion because these patients are sick and you're caring for these patients and you get to know the patients and the family, and as they get sicker and sicker, and they pass away, maybe you're coordinating final conversations with the family via Zoom—this is all new territory and it's very emotional. It takes a lot out of you because you're grieving just like the patient and the family and oftentimes you must work with those final conversations and the patient passes away and then you must just immediately move on to the next patient without having time to debrief or grieve.

So, this has been tough on everyone in the health care workforce. I don't know that people outside the hospital doors know that until they're in the hospital with their family and they see what's happening and just the tremendous stress that COVID-19 has brought to the inpatient environment.

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April Kapu, DNP, a professor at the Vanderbilt School of Nursing and president of the American Association of Nurse Practitioners, discusses the shifting roles and responsibilities of nurse practitioners during the COVID-19 pandemic.

The Expanding Role of the Nurse Practitioner Shifts to Meet the Needs of the Pandemic

Individuals with a combination of high lipoprotein(a) (Lp(a)) and high coronary artery calcium scores (CAC) face more than a 20% risk of a heart attack or stroke over the subsequent 10 years, according to the results of a study by preventive cardiologists at the University of Texas (UT) Southwestern Medical Center.

"We are hopeful that by making the connection between Lp(a) and CAC as dual risk drivers, we can raise awareness in the medical community and improve earlier heart attack prevention for these patients," Parag Joshi, MD, associate professor of Internal Medicine at UT Southwestern, said in a statement.

 "Our data may also expedite the development of treatments designed specifically for this high-risk population.”

Investigators, which also included some from Emory University, found that individuals with combined high Lp(a) and high CAC had about a 22% 10-year risk of heart attack or stroke compared with a 10% to 15% 10-year risk in individuals who had just 1 of the risk factors.

Individuals who had high Lp(a) and no CAC had the lowest 10-year risk of heart attack or stroke, while those who had low Lp(a) and high CAC had a higher-than-average 10-year risk of heart attack or stroke but lower than high Lp(a) CAC combined.

Journal of American College of Cardiology

 and will appear in the March print edition of the journal.

"Establishing the connection between Lp(a) and CAC means we can move to the important next phase of research, which will be defining and personalizing early screening protocols to identify patients at high risk of heart attack," Joshi said.

 "With further research, this could mean selectively scanning patients with high Lp(a) for their CAC score and studying therapies specifically designed to reduce Lp(a) among patients with high CAC."

The investigators confirmed the connection between Lp(a) and CAC by comparing data from 2 landmark cardiovascular trials.

The first trial was the Dallas Heart Study, which is a comprehensive, ongoing study of more than 6000 heart-healthy individuals. UT Southwestern conducted the study starting in 2000.

The second study was the multi-ethnic study of atherosclerosis, which included 6000 individuals, and investigated early stages of hardening of the arteries.

Approximately 1 in 6 individuals in the United States have high Lp(a), a type of bad cholesterol whose levels are driven primarily by genes, according to the statement.

CAC is a marker of plaque deposited around the heart.

Coronary artery disease (CAD) is the most common type of heart disease, and approximately 18.2 million individuals over aged 20 years have the condition, according to the CDC.

Approximately 2 in 10 deaths from CAD happen in adults who are younger than aged 65 years, according to the CDC.

1. High CAC, high cholesterol increase heart attack/stroke risk, cardiologists find. ScienceDaily. News release. February 23, 2022. Accessed March 3, 2022. https://www.sciencedaily.com/releases/2022/02/220223153349.htm

2.Heart disease facts. CDC. Updated February 7, 2022. Accessed March 3, 2022. https://www.cdc.gov/heartdisease/facts.htm

Patients with elevated high lipoprotein(a) and coronary artery calcium scores are at risk over the subsequent 10 years, findings from an analysis by cardiologists indicate.

High CAC, Cholesterol Increase Risk of Heart Attacks and Strokes, Study Results Show

New research has demonstrated that almost 1 in 5 people with ADHD experience clinically significant levels of hoarding, which could be linked to a hidden population of adults struggling with hoarding and its consequences. Clinically significant hoarding involves excessive accumulation, difficulties discarding and excessive clutter, and can lead to daily distress, depression, and anxiety,.

The study recruited 88 participants from an adult ADHD clinic operated by the Cambridge and Peterborough NHS Foundation Trust; the study focused on differentiating from prior research that focused on older females who self-identify as hoarders and have looked for help later in life.

The results showed that 19% of this ADHD group displayed clinically significant hoarding symptoms and were on average 30 years of age, with an equal split between male and female genders. Among the 81% of the remaining study group participants, the researchers found a larger hoarding severity, but not to a point that significantly impaired their lives versus the control group.

Following the analysis of these findings, the researchers asked a closely-matched group of 90 adults without an ADHD diagnosis from the general population about ADHD symptoms and impulsivity, levels of hoarding and clutter, obsessive compulsive severity, perfectionism, depression and anxiety, and everyday functioning. These results showed only 2% of the control group exhibited clinically significant hoarding symptoms.

In a larger online sample of 220 UK adults, researchers replicated this analysis to see if similar patterns were found, and only 3% of adults from the general population without an ADHD diagnosis group exhibited hoarding symptoms.

"Hoarding disorder is much more than simply collecting too many possessions. People with diagnosed Hoarding Disorder have filled their living areas with so many items and clutter that it impacts their day-to-day functioning leading to a poorer quality of life, anxiety, and depression,” said Sharon Morein, PhD, associate professor in Psychology at Anglia Ruskin University (ARU), in a press release.

Morein added that the findings also indicate that hoarding disorder should be routinely assessed in individuals with ADHD, as they do not typically disclose associated difficulties, despite these symptoms potentially impairing their everyday lives.

"Greater awareness amongst clinicians and people with ADHD about the link between ADHD and hoarding could also lead to more effective long-term management, as hoarding often gradually worsens with time,” Morein said in the press release.

ADHD linked to hoarding behavior. Science Daily. February 25, 2022. Accessed March 2, 2022. 

https://www.sciencedaily.com/releases/2022/02/220225135652.htm

Among the 81% of the remaining study group participants, the researchers found a larger hoarding severity, but not to a point that significantly impaired their lives versus the control group.

Study: People With ADHD More Likely to Exhibit Hoarding Behaviors 

 How has the role of nurse practitioner changed as a result of the shifting needs of the pandemic?

 This has just been so amazing to be part of—to be able to be a nurse practitioner during this time and to be able to work with so many amazing nurse practitioners during this time.

I started early in March of 2020 working with nurse practitioners to really make sure that we were meeting all of the needs that were kind of coming on strong because of the pandemic, and I can say that nurse practitioners have been there, ready to go from the very beginning. They've been on the front line, they were setting up testing centers in the community, we were setting up emergency departments like literally in a parking garage outside of an emergency department, setting up new standards of care for ed care, for ICU care, for acute, in hospital care.

We began to see patients in the home who were COVID-19 positive. I remember putting together the car kits—what all the different supplies we needed in the trunk of our car so we could see patients in the home. Telehealth—it just went off the charts in terms of being able to see patients via telehealth because a lot of patients did not feel comfortable coming in or they were very high risk, and so we had to see them for their health care needs. So, telehealth really boomed throughout the pandemic.

So, we saw a lot of changes, and we broke a lot of barriers. Telehealth is one. Seeing patients more in the home—a lot more—moving towards hospital to home, so what can we do to care for you in your environment, and then a lot in terms of nurse practitioners moving to communities as I had mentioned earlier to make sure that those health care services are readily available.

April Kapu, DNP, a professor at the Vanderbilt School of Nursing and president of the American Association of Nurse Practitioners, discusses the role of the nurse practitioner during the shifting needs of the pandemic.

Addressing How the Role of the Nurse Practitioner Has Changed During the Pandemic

Introducing nature into large hospitals can humanize the institutional environment and help reduce the stress of health care providers, patients, and visitors, according to the results of a study conducted by investigators at West Virginia University (WVU).

Shan Jiang, an associate professor at the Davis College of Agriculture, Natural Resources and Design at WVU, digitally created environments that could be used as a controlled experiment to see if participants could complete various wayfinding tasks.

Study participants saw the same hospital layout and room arrangement. However, 1 group also saw large windows with nature views along the walls. The other group were shown only solid walls without nature views or any daylight.

Jiang found that individuals in the greenspace group walked a shorter distance and took less time to complete wayfinding tasks.

"In terms of spatial orientation and wayfinding, window views of nature and small gardens can effectively break down the tedious interiors of large hospital blocks and serve as landmarks to aid people's wayfinding and improve their spatial experience," she said in a statement.

The study results also showed that individuals in the greenspace group demonstrated less anger and confusion.

The findings of this study were published in the 

Health Environment Research and Design Journal

Based on the findings of previous research, it is estimated that individuals must go through at least 7 steps before arriving at their final designation, which could be an environmental stressor for individuals.

"Large hospitals can be visually welcoming but the functionality and internal circulation are indeed complex and confusing," Jiang said.

Jiang said that the study was prompted by her own experiences, as well as the experiences of family members and others

The study results also showed that greenspaces that were strategically placed, such as the main corridor or junction of departmental units, could serve as landmarks that positively attract attention, aiding in wayfinding and improving navigation.

Jiang, who has a background in landscape architecture, is interested in the immediate surroundings of individuals, particularly in the relationship between architecture and landscapes. She found that gardens, plants, and other flora have strong therapeutic effects on individuals.

"You may explain such therapeutic effects from multiple perspectives. People's color/hue preferences tend to range from blue to green, nature and plants are positive distractions that could restore people's attentional fatigue, and human beings could have developed genetic preference of greenery from evolutionary perspectives," Jiang said.

"All mechanisms together contribute to the positive experience when looking at gardens and nature views,” she said.

Many hospitals across Europe have successfully integrated parks within hospital settings, Jiang said.

In the United States, the Lucile Packard Children’s Hospital Stanford in California has patios and window nooks in every patient room, as well as a view in most rooms of a large healing garden.

Jiang said her work will continue to grow in this area, and she has released a book that emphasizes the importance of transparent spaces and windows and how they can strengthen human-nature interactions within health care environments.

Seeing 'green' can ease confusion, anger in navigating hospitals. Science Daily. News release. February 18, 2022. Accessed February 22, 2022. https://www.sciencedaily.com/releases/2022/02/220218172312.htm

Introducing nature can help humanize the institutional environment help improve individuals with spatial orientation and navigation, results of analysis show.

Study: Greenspaces in Hospitals Reduce Patient, Provider, Visitor Stress

New findings from NIH found that women who have experienced sexual violence in their lifetime, including sexual assault and workplace sexual harassment, were more prone to developing high blood pressure over a 7-year follow-up period, according to a press release.

“Our results showed that women who reported experiencing both sexual assault and workplace sexual harassment had the highest risk of hypertension, suggesting potential compounding effects of multiple sexual violence exposures on women’s cardiovascular health,” said the study lead author Rebecca B. Lawn, PhD, from the Harvard T H Chan School of Public Health, Boston, in the press release.

Lawn and her team analyzed the connections between lifetime exposure to sexual violence and blood pressure in comparison to the possible impacts of exposure to other types of trauma. The team used data from the Nurses’ Health Study II (NHS II), which is a longitudinal study of adult women in the United States from 1989, enrolling 115,000 nurses in total.

In addition, a NHS II sub-study assessed a group of participants who reported whether they had ever experienced sexual harassment at work, either physical or verbal, and whether they had ever experienced unwanted sexual contact. Exposure to other traumas, such as an accident or a disaster, were also reported.

Specific participants were excluded, including those who were already diagnosed with high blood pressure or were taking medication for high blood pressure from their analyses and women with a history of cardiovascular or cerebrovascular disease. The final sample had 33,127 women who were between the age of 43 to 64 in 2008.

As indicated in the NHS II data, approximately 23% of the women included in the study had experienced sexual assault at some point in their life and 12% had experienced workplace sexual harassment, whereas 6% had experienced both. Meanwhile, about 21% of the women reported developing high blood pressure over the follow-up period from 2008 to 2015.

Women who had experienced sexual assault at any point in their lifetime and those who had experienced workplace sexual harassment were more likely to develop high blood pressure compared with women who had never experienced any type of trauma. The women who had experienced both sexual assault and harassment had the highest risk of developing high blood pressure.

A new study from NIH highlights why health research into women’s experiences of sexual assault and workplace sexual harassment is critical.

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