Academic stress has a greater negative impact on the mental well-being of college students who are female, nonbinary, or in the second year of a 4-year program than other students, according to the results of a study from Rutgers New Jersey Medical School.

Although investigators found correlations between perceived academic stress and poor mental well-being for all students, those specific groups felt the effects the most.

“This study shows that college students are not uniformly impacted by academic stress or pandemic-related stress and that certain groups should be offered additional resources and support,” Xue Ming, PhD, MD, a professor of neurology at Rutgers New Jersey Medical School, said in a statement. “The findings support prior studies that have shown that nonbinary adults face adverse mental health outcomes when compared to male- and female-identifying adults.”

, aimed to determine if a relationship exists between academic stress and mental well-being, as well as to identify groups that could experience these effects most. Additionally, investigators explored how the perception of the COVID-19 pandemic is affecting stress levels.

Investigators included 843 individuals in the study from aged 18 and 30 years old in different academic years.

They surveyed individuals using questions from the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS), which measured mental well-being and positive mental health, and from the Perception of Academic Stress Scale (PAS), which assessed sources of perceived academic stress and measured 3 main stressors: academic expectations; academic self-perceptions; and exams and workload.

Investigators found that students who are nonbinary reported the highest levels of stress and worst psychological well-being, followed by females. Both groups also reported higher COVID-19 related stress than males.

Additionally, sophomores reported higher academic stress levels and worse mental well-being than those in other academic years.

Further, students who were in their first year scored the best on the PAS, including stress resulting from COVID-19.

Investigators thought that sophomores were the most affected group, because they explore different majors, manage heavier workloads, and start taking more advanced courses,. Other factors could include increased studying, fewer coping mechanisms, and less established social support groups than students who are further into their academic careers.

“Colleges should consider offering tailored mental health resources to these groups to improve students' stress levels and psychological well-being,” Ming said. “To raise awareness and destigmatize mental health, colleges can distribute confidential validated assessments, such as the PAS and SWEMWBS, in class and teach students to self-score so they can monitor their stress and mental well-being.”

Investigators also recommended that colleges provide stress management and coping strategies, such as cognitive behavioral therapies, mindfulness meditation, and stress-reduction peer support groups, to help students build resilience.

How college students perceive academic stress affects their mental well-being. News release. Science Daily. August 9, 2022. Accessed August 15, 2022. https://www.sciencedaily.com/releases/2022/08/220809194856.htm

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Rutgers New Jersey Medical School analysis shows that not all groups are uniformly affected by the pressure, and those that are should be offered additional resources and support.

 Study: Academic Stress Hits Female, Nonbinary, or College Sophomore Students Hardest 

Racial and ethnic minorities bore a disproportionate mental health burden during the COVID-19 pandemic, according to the authors of a study published in 

During the heights of the pandemic, research established that minority groups were disproportionately impacted by COVID-19 when compared to non-Hispanic whites, including experiencing higher rates of infection, severe disease, hospitalization, and death. Following the pandemic, reports showing a 3-fold increase in the incidence of depression symptoms showed that the pandemic had a significant impact on mental health broadly, but the effects of COVID-19 on the mental health of minorities was not clear based on the data.

In the new study, investigators used data on 691,473 individuals in the United States and United Kingdom who responded to the smartphone-based COVID Symptom Study between January 23, 2021, and June 9, 2021. Recruited through social media, participants reported baseline information before logging daily information on their symptoms and COVID-19 testing results using an app called Zoe.

According to the study, after controlling for personal factors including prior mental health diagnoses and changes in leisure time activities, Black participants in the United States were 1.16 times more likely to screen positive for depression than White participants. Hispanic participants were also 1.23 times more likely to screen positive for depression and 1.23 times more likely to show signs of anxiety compared to White participants.

“The early phase of [the] COVID-19 pandemic was incredibly disruptive to everyday life,” wrote the authors in the study. “We found that racial and ethnic minorities in the US and UK were more likely to screen positive for depression and anxiety.”

Similar results were found for Black and Asian participants in the United Kingdom, as well as those within other participant subgroups, including Black health care workers, who had higher rates of depression and anxiety than White health care workers.

Based on these findings, the authors concluded that minority communities in both the United States and the United Kingdom experience a mental health burden that was disproportionate to other communities during the COVID-19 pandemic. These problems could also last well beyond any presumed conclusion of the pandemic.

“[The findings] suggest a disproportionate impact and mental health burden on persons of color, which need to be considered as we reshape health care systems to prioritize the long-term consequences of this disease,” the authors wrote in the study.

Minorities bore disproportionate mental health impact of pandemic. News release. Science Daily; August 10, 2022. Accessed August 17, 2022. 

https://www.sciencedaily.com/releases/2022/08/220810161148.htm

Research found that Black health care workers had higher odds of depression and anxiety than White health care workers.

Study: COVID-19 Pandemic Disproportionately Impacted the Mental Health of Minority Populations

New research has found that tendencies toward impulsivity in early adolescence are connected to a variety of poor outcomes in later adolescence, including antisocial personality disorder (APD) and alcohol use disorder (AUD), according to data from hundreds of Philadelphia youth tracked for more than 6 years.

In past studies, the link between impulsivity and disorders such as APD and AUD were analyzed, but the value of intervention during adolescence was not evaluated. The new findings suggest that targeted support during early adolescence once individuals start to exhibit higher levels of impulsivity may help to stop a cascading chain of events that could lead to APD and AUD in late-adolescence.

“Kids with impulse control problems are at risk for a variety of adverse outcomes, such as drug use, acting-out behavior, and antisocial behavior,” said study co-author Dan Romer, PhD, research director of the Annenberg Public Policy Center of the University of Pennsylvania, in a press release. “What we’ve found is that you’ve got to start mitigating impulsivity before it starts influencing behaviors that lead to substance use and antisocial behavior disorders. Once adolescents are on a trajectory of engaging in those behaviors, it may become more difficult to prevent disorders later in adolescence than it is to treat impulsivity itself.”

The study is based on data from the Philadelphia Trajectory Study, which included 364 adolescents of diverse ethnic backgrounds. The study was conducted over 6 waves, during which participants between the ages of 10 and 12 years were interviewed annually starting from 2004 to 2010, with a final 2-year follow-up in 2012. The current study relies on 5 years of self-reported data pulled from waves 3 through 6; by the final wave, the participants were between the ages of 18 and 21 years.

During the study, the team found that from early to mid-adolescence, changes in impulsivity predicted changes in antisocial behavior and alcohol use. However, by the time the participants have reached mid- to late-adolescence, changes in impulsivity were no longer predicting those behaviors.

“It is also important to target antisocial behavior to interrupt the cascade that predicts both [AUD] and [APD],” lead study author Ivy Defoe, an assistant professor of social and behavioural sciences at the University of Amsterdam, said in the press release. “In fact, the study showed that increases in antisocial behavior in mid- to late-adolescence further predicted increases in impulsivity as well. This is consistent with labeling theory that suggests that individuals who show antisocial behavior are subsequently labeled as ‘antisocial’ or ‘rule-breakers,’ which causes them to further exhibit attributes that are associated with such behavior.”

The investigators noted that potential interventions for individuals exhibiting high levels of impulsivity in early adolescence is by alerting parents about the potential risks and ways of referring their children for treatment.

“Intervening early is critical to further avoid the consequences of impulsivity which are more difficult to reverse once psychopathology has developed,” said the research team in the press release. They added that such interventions could include mindfulness training and family-based interventions in which parents and caregivers work to help their child overcome harmful impulsive tendencies.

Significantly, the investigators also noted that the data showed that socioeconomic status was a significant predictor of impulsivity at each wave of the study.

“Future research could further investigate the mechanisms by which early exposure to socioeconomic disadvantage influences heightened impulsivity during adolescence, including impacts on child executive functioning and parenting behaviors,” the researchers said in the press release.

Targeting Impulsivity Early in Adolescence Could Prevent Later Behavioral Disorders. Annenberg Public Policy Center University of Pennsylvania. August 8, 2022. Accessed August 16, 2022. 

https://www.annenbergpublicpolicycenter.org/targeting-impulsivity-early-in-adolescence-could-prevent-later-behavioral-disorders/

Research showed that changes in impulsivity during early to mid-adolescence predicted changes in antisocial behavior and alcohol use. 

Study: Targeting Impulsivity Early in Adolescence Could Prevent Later Behavioral Disorders

Almost 30,000 people in the United States die from alcoholic liver diseases every year. Alcohol, especially in excess amounts, has a slew of negative adverse effects (AEs) on the liver, stomach, and the intestinal gut microbiome. The cause for the latter condition has not yet been identified, but new data suggest the liver may be the cause of the gut microbiome imbalance.

Investigators at the University of California San Diego (UCSD) recently proposed that alcohol negatively affects the gut microbiome because of acetate in particular. When drinking, acetate is produced by the liver then diffused into the intestines where it becomes a carbon source that supports growth of bacteria. However, not all of the resulting bacteria growth is beneficial.

"You can think of this a bit like dumping fertilizer on a garden," said co-corresponding author Karsten Zengler, PhD, professor in the departments of Pediatrics and Bioengineering at UCSD School of Medicine and Jacobs School of Engineering, in a press release. "The result is an explosion of imbalanced biological growth, benefitting some species but not others."

Known to regulate appetite, energy, and immune response, acetate can be health promoting by improving cardiac function, enhancing red blood cell production, and improving memory function. However, like many nutrients, an excess amount of acetate can create dysbiosis, which is associated with metabolic changes that can cause cancer.

To understand the issue further, Zengler and his colleagues conducted a study in mice. They fed the mice a molecule that the gut broke into 3 acetates, the third of which altered the rodents’ intestinal microbiome similarly to that of the effects of alcohol. However, it did not damage the rodents’ livers.

Following the experiment, Zengler explained that the intestines express fewer antimicrobial molecules by consuming alcohol frequently.

“Persons with alcohol-related liver disease commonly have bacterial overgrowth in their guts. These findings suggest that microbial ethanol metabolism does not contribute significantly to gut microbiome dysbiosis (imbalance) and that the microbiome altered by acetate does not play a major role in liver damage," Zengler said in the press release. "The situation is more complicated than previously assumed. It's not as simple as more ethanol equals microbiome changes and thus, microbiome dysbiosis equals more liver disease.”

The study authors noted that the findings do not provide a direction for new treatments for alcoholic liver disease. However, the authors explained that the results can guide future research toward the investigation of the effects of acetate on gut microbiota.

Zengler also noted that in future research that will be conducted among his colleagues at UCSD, the investigation of how ethanal consumption changes the gut microbiome is no longer necessary. Instead, Zengler and colleagues will begin to look to identify the bacteria that are causal for deleterious effects of alcohol consumption, rather than the AEs of consumption or disease.

University of California – San Diego. Alcohol use can alter gut microbes, but not in the way you might think. Science Daily. Aug 11, 2022. Accessed on Aug 15, 2022. https://www.sciencedaily.com/releases/2022/08/220811135321.htm

Although alcohol is not absorbed by the intestines, research has demonstrated that excessive drinking causes the liver to produce too much acetate which may lead to intestinal bacterial overgrowth.

Study: Excessive Alcohol Consumption Causes Gut Microbiome Imbalance 

When children get a sense of comfort from spending time with a parent or a caregiver, their experiencing a type of attachment termed a “secure attachment” with that individual. This secure attachment with a parental figure has been shown to play a significant part in socio-emotional development and mental health during an individual’s youth.

On the other end of the spectrum, a child’s insecure attachment with a parent or caregiver has been found to be associated with depression and anxiety, delinquency and substance use problems, and poorer social competence.

"When mothers struggle in their own interpersonal relationships, the passing on of secure attachment and healthy relationship functioning to adolescent offspring seem to be impeded," said Carla Sharp, PhD, professor of psychology and director of the University of Houston Developmental Psychopathology Lab, in the journal 

Borderline Personality Disorder and Emotion Dysregulation

. "Maternal interpersonal problems were associated with higher levels of insecure attachment in adolescent offspring such that adolescents would either dismiss the need for attachment with their moms or show angry preoccupation with the relationship with their moms."

Although there has been an accumulation of data showing the presence of an association between a mothers' mental health issues and their child’s maladaptive attachment in close or romantic relationships in adulthood, the study published in 

 is the first to investigate adolescent relationships and their association with offspring attachment.

The study authors noted that after infancy and early childhood, the parent-child attachment during adolescence is considered to be the second most critical developmental window. Due to the importance of this period, the investigators wanted to assess this period in an individual’s development further to shed light on the impact of the parent-child attachment in adolescence to inform potential interventions that may prevent or reduce youth psychopathology and other adverse outcomes.

During the study, the investigators interviewed 351 adolescents who were inpatient at a psychiatric program or facility and those adolescents’ biological mothers. The adolescents interviewed had an average age of 15 years and 64% of them were female.

During the interviews, the adolescent participants were asked about distressing interpersonal behaviors that they find "hard to do," such as feeling close to other people, or behaviors that they "do too much," such as trying to please other people. Following the interviews, the participants were then assessed on their ability to describe their attachment experiences in a manner that was coherent and collaborative, as well as to reflect on these attachment experiences and how they have impacted the participants personally.

Additionally, the investigators interviewed the biological mothers of the adolescents and asked them to recall experiences from their relationships with their mothers. During these interviews, the investigators looked at whether the relationship dynamic that the mothers recalled having with their mothers helped to explain their present relationship with their children. The results showed a strong correlation between the two.

"The way that parents recalled their experiences with their caregivers is likely impacted by their own interpersonal functioning and may impact the relationship that they build with their children," first study author Sophie Kerr, a graduate student working with Sharp at the University of Houston Developmental Psychopathology Lab, said in a press release.

The authors further noted that these study results will help to drive research to examine the mechanisms of intergenerational risk to tailor interventions that can help to improve parent-child relationships and attachment.

"Findings highlight the mediating role of the mothers' recalled experiences with caregivers in the impact of their interpersonal problems on adolescents, suggesting interventions that enhance interpersonal function such as mentalization-based interventions may be helpful for mothers with interpersonal problems and personality pathology," said Sharp in the press release.

Moms' problems linked to adolescent attachment issues. Houston, TX: University of Houston; August 9, 2022. Accessed August 15, 2022. https://www.sciencedaily.com/releases/2022/08/220809141259.htm

Research found a strong correlation between a mother’s dynamic with their mother and whether or not their child is able to form secure attachments with others in adolescence.

Maternal Personality Disorder Symptoms May Lead to a Child’s Insecure Attachment in Adolescence

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

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.

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