It’s possible that I shall make an ass of myself. But in that case one can always get out of it with a little dialectic. I have, of course, so worded my proposition as to be right either way (K.Marx, Letter to F.Engels on the Indian Mutiny)
Monday, August 09, 2021
How to increase vaccination rates among Black people in Canada
To increase vaccination rates among Black people who are at high risk of COVID-19, employing an Afrocentric health-promotion approach that is centred on respecting patients' values and perspectives can help, argue authors in a commentary published in CMAJ (Canadian Medical Association Journal) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.210949.
"An Afrocentric approach, which acknowledges that health care experiences of Black people are affected by historical and present-day anti-Black racism, can be combined with communication frameworks to counsel vaccine-hesitant patients," writes Dr. Onye Nnorom, a family physician and assistant professor, Department of Family and Community Medicine and the Dalla Lana School of Public Health, University of Toronto, and President of the Black Physicians' Association of Ontario, with coauthors.
The authors are a team of Black female clinicians, researchers, nurses and community health leaders who have led COVID-19 vaccination efforts in Black communities.
Despite the higher risks of infection and serious complications, only 56.6% of Black Canadians reported willingness to receive the SARS-CoV-2 vaccine, compared with 76.9% of the overall population.
To combat vaccine hesitancy, which has roots in medical distrust and structural racism, the authors discuss how Afrocentric approaches and the LEAPS of care counselling framework have been successful in increasing influenza and COVID-19 vaccination rates in Black communities.
The LEAPS of care framework encourages providers to Listen and Learn more about the patients' lived experiences; Empower and Engage patients by respecting their own self-determination and perspectives; Ask and Acknowledge patients' concerns and previous health care encounters where they may have experienced racism; Paraphrase and Provide vaccine recommendations; Support and Spark community partnerships to respectfully overcome barriers to vaccination and support patients navigating a complex system.
"Black patients experience disrespectful discourse with providers because of anti-Black racism and biases in health care. Our position is that in every encounter, patients should feel respected. Please respect Black patients' values, views and concerns when it comes to the vaccine. That's how we can rebuild trust, and that is the key message from this framework," says Dr. Nnorom.
Black-led community partnerships can be very effective at helping increase vaccination rates: vaccine clinics held in a hard-hit hotspot part of Toronto from April to May 2021 increased vaccine uptake from 5.5% to 56.3%.
"Confidence in the vaccines will not improve if Black communities are told that they are at high risk and should continue to socially distance, while they are also excluded from vaccine priority lists or are not provided greater access to vaccines," write the authors. "Providers should offer accurate, current information to high-risk Black patients about how to access vaccines, given the difficulties in keeping up with changing preregistration criteria at different sites."
"Increasing SARS-CoV-2 vaccination rates among Black people in Canada" is published August 9, 2021.
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JOURNAL
Canadian Medical Association Journal
DOI
10.1503/cmaj.210949
ARTICLE TITLE
Increasing SARS-CoV-2 vaccination rates among Black people in Canada
Inequities intensify effect of COVID-19 on ethnocultural communities
A new study published in the Canadian Medical Association Journal (CMAJ) sheds light on the impact of COVID-19 on ethnocultural community members living in vulnerable circumstances https://www.cmaj.ca/lookup/doi/10.1503/cmaj.210131.
Researchers from the University of Alberta and the Multicultural Health Brokers Cooperative (MHBC) — community health workers of immigrant and refugee backgrounds serving diverse ethnocultural communities in Edmonton, Alberta — collaborated during the fall of 2020 to collect 773 stories of the impacts of COVID-19 and the efforts to mitigate it.
"We sought to understand how the challenges of COVID-19 are entangled with contextual factors at multiple levels, how families and communities are leveraging strengths and social capital to adapt, and the role of cultural brokers in managing the crisis," write co-leads Yvonne Chiu, co-executive director of MHBC, and Denise Campbell-Scherer, University of Alberta professor of family medicine, with coauthors.
The team found that COVID-19 destabilized family units and made it more time-consuming and resource-intensive for people to support their families. For many, finding appropriate information and support to help manage the impacts of the pandemic was also a major challenge. Financial, food and housing insecurity; precarious employment; job loss; lack of sick leave to allow self-isolation; low English literacy and other factors intensified the negative effects of COVID-19.
"The surge of COVID-19 in ethnocultural communities across North America, and the pandemic's destabilizing effect on health care systems, has highlighted the systemic structures that result in poorer health in ethnocultural communities," write the authors.
The study also shows how families and communities have leveraged strengths and social capital to adapt and highlight the important role of community health workers in helping people navigate health and social care systems.
"Cultural brokering and community social capital were key supports for people in [the COVID-19] crisis, and our findings can support policy and interventions that may reduce harm and support community resiliency," the authors conclude.
"Illuminating and mitigating the evolving impacts of COVID-19 on ethnocultural communities: a participatory action mixed-methods study"is published August 9, 2021.
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JOURNAL
Canadian Medical Association Journal
DOI
10.1503/cmaj.210131
ARTICLE TITLE
Illuminating and mitigating the evolving impacts of COVID-19 on ethnocultural communities: a participatory action mixed-methods study
ARTICLE PUBLICATION DATE
9-Aug-202
SYSTEMIC RACIST MEDICAL PRACTISE
Study links economic mobility to racial mortality gaps
A new study suggests structural racism measured by the racial economic mobility gap between Black and White persons with a similar parental income (as an indicator of similar childhood socioeconomic status) is strongly associated with Black-White disparities in mortality in the United States, both in a recent birth cohort and in all ages combined. These findings, appearing in Cancer Epidemiology, suggest that the effects of structural racism on mortality have persisted with a similar magnitude across generations in the past century.
Social inequalities and discriminatory policies by race/ethnicity, also collectively known as structural racism, is a major factor contributing to health disparities. Structural racism can adversely affect economic, social, service, and physical living environments leading to limited educational and job opportunities; lower income; poorer housing, transportation, and public safety; food insecurity; and limited health care.
This is one of the few studies to examine the association of structural racism to death from multiple specific causes. Investigators led by Farhad Islami, MD, PhD of the American Cancer Society, examined county-level data on economic mobility and death from all causes, heart diseases, cerebrovascular diseases, chronic obstructive pulmonary disease (COPD), injury/violence, all malignant cancers, and 14 cancer types in all ages combined and on all-cause mortality in ages 30-39 years. Data for ages 30-39 years covered 69% of individuals in that age group nationally and for all ages combined covered 82% to 90% of the U.S. population.
“Although more research is needed to identify factors mediating these associations and appropriate interventions to mitigate them, equitable and broad implementation of proven interventions to increase health equity, such as equitable access to care and preventive measures can help reduce health disparities,” said Dr. Islami.
Findings show that in the U.S., death rates are higher among non-Hispanic Black (Black) persons than among non-Hispanic White (White) persons. In ages 30-39 years, a one percentile increase in the economic mobility gap was associated with a 6.8% increase in the Black-White mortality gap among males and a 10.7% increase among females, based on data from 471 counties.
In all ages combined, the corresponding percentages based on data from 1,572 counties were 10.2% among males and 14.8% among females, equivalent to an increase of 18.4 and 14.0 deaths per 100,000 in the mortality gap, respectively. Similarly, strong associations between economic mobility gap and mortality gap in all ages were found for major causes of death, notably for potentially preventable conditions, including COPD, injury/violence, and cancers of the lung, liver, and cervix.
“Dismantling structural racism will require greater efforts to implement meaningful institutional changes, with broad societal engagement to create equitable local, state, and federal policies,” write the authors. “Results of this study could help advocate for and inform public policies to improve equity and establish a benchmark by which to evaluate progress in reducing structural racism and its adverse health effects.”
Article: Islami F, Fedewa SA, Thomson B, Nogueira L, Yabroff R, Jemal A. Association between disparities in intergenerational economic mobility and cause-specific mortality among Black and White persons in the United States. Cancer Epidemiology. doi: 10.1016/j.canep.2021.101998.
JOURNAL
Cancer Epidemiology
DOI
10.1016/j.canep.2021.101998
METHOD OF RESEARCH
Data/statistical analysis
SUBJECT OF RESEARCH
People
ARTICLE TITLE
Association between disparities in intergenerational economic mobility and cause-specific mortality among Black and White persons in the United States
ARTICLE PUBLICATION DATE
4-Aug-2021
Attachment style secures your love during lockdowns
What constitutes good relationship quality in times of crisis
Are there specific variables determining which relationships make it through times of crisis? Researchers led by Stephanie Eder from the University of Vienna set out to answer this question during the COVID-19 pandemic. 313 participants who were in a romantic relationship repeatedly completed questionnaires during the "first wave" of the COVID-19 pandemic. They filled in questionnaires assessing psychological characteristics, and answered questions with regards to their relationship and how the pandemic had affected their lives. Using machine-learning algorithms, the researchers identified predictors of having a high relationship quality during this time. So: What constitutes a "good" relationship during a lockdown?
The most important predictor was the so-called "Attachment style": Participants with a “secure” attachment tend to have a higher relationship quality than those with "anxious" or "avoidant" attachment styles. This psychological predictor by far trumps external factors. However, predicting changes in relationship quality over the course of the lockdowns is harder, where the researchers could not identify predictive variables.
The results of this study highlight the role of attachment style even in adult relationships. The study is the first to show the role of attachment style for romantic relationship quality during the COVID-19 pandemic.
Publication in "Frontiers in Psychology": Eder, S. J., Nicholson, A., Stefanczyk M., Pieniak, M., Martínez-Molina, J., Pešout Ondra, Binter, J., Smela, P., Scharnowski, F., Steyrl, D. (2021). Securing Your Relationship: Quality of Intimate Relationships During the COVID-19 Pandemic Can Be Predicted by Attachment Style. In: Frontiers in Psychology (12); DOI: 10.3389/fpsyg.2021.647956
Related studies on psychological aspects of the pandemic via the "Open Science Framework": Eder, S. J., Stefańczyk, M., Pieniak, M., Molina, J. M., Pešout, O., Binter, J., … Nicholson, A. (2021). Predicting interpersonal dynamics during the COVID-19 pandemic using machine learning: A cross-national longitudinal study. Verfügbar unter: osf.io/db4px
JOURNAL
Frontiers in Psychology
DOI
10.3389/fpsyg.2021.647956
METHOD OF RESEARCH
Survey
SUBJECT OF RESEARCH
People
ARTICLE TITLE
Securing Your Relationship: Quality of Intimate Relationships During the COVID-19 Pandemic Can Be Predicted by Attachment Style
ARTICLE PUBLICATION DATE
20-Jul-2021
Disclaimer: AAAS a
Tick tock in the brain: Chinese scientists provide molecular insights into primate hippocampal aging
IMAGE: DANGEROUS PROTEIN AGGREGATES (AMYLOID-BETA) ACCUMULATE IN THE AGED MONKEY HIPPOCAMPUS.view more
CREDIT: GUANGHUI LIU, INSTITUTE OF ZOOLOGY, CHINESE ACADEMY OF SCIENCE
Deep inside our brain is a region called the hippocampus. It plays a crucial role in learning and memory, and its progressive deterioration with age is functionally linked to a variety of human neurodegenerative diseases. But what drives it down the path of aging?
The hippocampus is a complex structure with a highly heterogeneous cell composition, so it is difficult to accurately reveal the molecular regulatory networks of various cell types contributing to the aging process with traditional techniques. In addition, due to the ethical restrictions, it is difficult to obtain disease-free human brain tissues of both young and old ages. All these factors limited our understanding of the aging mechanism in the human hippocampus, let alone the development of therapeutic interventions.
Using brain tissues from non-human primates (NHPs), the ideal model to mimic human hippocampal aging, scientists from the Institute of Zoology of the Chinese Academy of Sciences and Xuanwu Hospital Capital Medical University have worked jointly and established the first single-nucleus transcriptomic landscape of primate hippocampal aging, revealed the molecular mechanism of its functional deterioration with age, and provided a valuable resource for the identification of new diagnostic biomarkers and potential therapeutic targets for interventions against hippocampal aging and related human neurodegenerative disorders. This study entitled “Single-nucleus transcriptomic landscape of primate hippocampal aging” is published online in Protein & Cell on 2021.
In this study, the aged NHP hippocampus was found to demonstrate an array of aging-associated damages, including genomic and epigenomic instability, loss of proteostasis, as well as increased inflammation. To explore unique cellular and molecular characteristics underlying these age-related phenotypes, scientists generated a high-resolution single-nucleus transcriptomic landscape of hippocampal aging in NHPs. This landscape is composed of the gene expression profiles of 12 major hippocampal cell types, including neural stem cells, transient amplified progenitor cells (TAPC), immature neurons, excitatory/inhibitory neurons, oligodendrocytes, and microglia. Among them, TAPC and microglia were most affected by aging, as they manifested the most aging-related differentially expressed genes and those annotated as high-risk genes for neurodegenerative diseases. In-depth analysis of the dynamic gene-expression signatures of the stepwise neurogenesis trajectory revealed the impaired TAPC division and compromised neuronal function, underlying the early onset and later stage of dysregulation in adult hippocampal neurogenesis, respectively. This landscape also enabled us to to unveil contributing factors to a hostile microenvironment for neurogenesis in the aged hippocampus, namely the elevated pro-inflammatory responses in the aged microglia and oligodendrocyte, as well as dysregulated coagulation pathways in the aged endothelial cells. This may aggravate the loss of neurogenesis in the aged hippocampus, and may lead to the further decline of cognitive function and the occurrence of neurodegenerative diseases.
This study established, for the first time, a comprehensive single-nucleus transcriptomic atlas of primate hippocampal aging, which provides extensive resources for the illustration of age-related molecular signatures at the single-cell level, including changes of internal factors and external microenvironment that contribute collectively to the impaired ability for neuronal regeneration in the old hippocampus. It has deepened our understanding of age-related changes in hippocampal structure and function, and identified cell types and molecules that are most susceptible in the aging process of hippocampus, thus enabling the identification of potential diagnostic biomarkers and therapeutic targets for neurodegenerative diseases associated with hippocampal aging.
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All relevant data can be accessed via an interactive user-friendly webtool at Aging Atlas.
Reference: Hui Zhang et al (2021). Single-nucleus transcriptomic landscape of primate hippocampal aging, Protein & Cell DOI: 10.1007/s13238-021-00852-9
About Higher Education Press
Founded in May 1954, Higher Education Press Limited Company (HEP), affiliated with the Ministry of Education, is one of the earliest institutions committed to educational publishing after the establishment of P. R. China in 1949. After striving for six decades, HEP has developed into a major comprehensive publisher, with products in various forms and at different levels. Both for import and export, HEP has been striving to fill in the gap of domestic and foreign markets and meet the demand of global customers by collaborating with more than 200 partners throughout the world and selling products and services in 32 languages globally. Now, HEP ranks among China's top publishers in terms of copyright export volume and the world's top 50 largest publishing enterprises in terms of comprehensive strength.
The Frontiers Journals series published by HEP includes 28 English academic journals, covering the largest academic fields in China at present. Among the series, 13 have been indexed by SCI, 6 by EI, 2 by MEDLINE, 1 by A&HCI. HEP's academic monographs have won about 300 different kinds of publishing funds and awards both at home and abroad.
About Protein & Cell
Protein & Cell is a peer-reviewed international journal that publishes original research articles, reviews, and commentaries concerning latest development in multidisciplinary areas in biology and biomedicine, with an emphasis on protein and cell research. The subject areas include, but are not limited to biochemistry, biophysics, cell biology, oncology, genetics, immunology, microbiology, molecular biology, neuroscience, stem cell, plant science, protein science, structural biology and translational medicine. In addition, we also address the up-to- date research highlights, news and views, and commentaries covering research policies and funding trends in China. The recent impact factor of Protein & Cell is 10.164.
DOI
10.1007/s13238-021-00852-9
METHOD OF RESEARCH
Experimental study
SUBJECT OF RESEARCH
Animal tissue samples
ARTICLE TITLE
Single-nucleus transcriptomic landscape of primate hippocampal aging
ARTICLE PUBLICATION DATE
29-May-2021
Antibodies dovetail with protection, study in non-human primates shows
AMERICAN ASSOCIATION FOR THE ADVANCEMENT OF SCIENCE (AAAS)
A study by Kizzmekia Corbett et al. reports that antibody responses induced by the mRNA-1273 (Moderna) vaccine are a correlate of protection against SARS-CoV-2 infection in non-human primates. Defining immune correlates of protection is a critical aspect of vaccine development for extending the use of approved vaccines and facilitating the development of new candidate vaccines. Although immune responses associated with protection after primary infection have been assessed in non-human primates (NHPs), there are no studies to date that have specifically defined immune correlates of protection in upper and lower airways after vaccination with any COVID-19 vaccine approved for use in humans. To investigate the correlates of protection for such a vaccine, Kizzmekia Corbett et al. studied NHP immune responses to various doses of the mRNA-1273 vaccine. Using bronchoalveolar lavages and nasal washes, they determined that mRNA-1273 vaccination elicited spike protein-specific antibodies in the airways, which correlated with protection against SARS-CoV-2 replication in the lungs. Lower antibody levels were needed for reduction of viral replication in the lower airway than in the upper airway, the authors found, which may explain why the current crop of vaccines is more effective against severe lower tract disease. To determine if the antibodies generated from the vaccine are not only a correlate of protection but also the mechanism of protection, the researchers transferred NHP antibodies to Syrian hamsters and found they offered protection against SARS-CoV-2 challenge. The authors note that ongoing NHP studies will assess the durability of mRNA-1273-elicited protection against global SARS-CoV-2 variants.
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JOURNAL
Science
DOI
10.1126/science.abj0299
ARTICLE TITLE
Immune Correlates of Protection by mRNA-1273 against SARS-CoV-2 in Nonhuman Primates
ARTICLE PUBLICATION DATE
29-Jul-2021
LEGALIZE ALL DRUGS
Research Snapshot: Discovery points to ketamine’s long-term antidepressant effects
Building on recent research confirming how ketamine induces rapid antidepressant action, Professor of Pharmacology Lisa Monteggia and her collaborators show how the molecular mechanism of the gene MeCP2 and associated synaptic adaptability are critical to the long-term antidepressant effects of ketamine.
While MeCP2 has been shown to be important for typical antidepressants, this research indicates that, in cooperation with ketamine’s initial target, the gene is important for long-term antidepressant action, Monteggia said. The researchers discovered that MeCP2 influences ketamine’s behavioral effect as well as potentiation—the strengthening of synapses—improving its antidepressant effects over time. This work also shows that the long-term effects of ketamine involve synaptic adaptability, or plasticity—not simply structural changes. Monteggia and her team went on to show that repeated exposure to ketamine further strengthened synaptic plasticity—eliciting more plasticity of plasticity—which the team termed “metaplasticity.” This may explain why repeated doses of ketamine produce a cumulative and prolonged effect.
WHY IT MATTERS
“We think we have the pathway in the brain to engage these long-term effects,” said Monteggia, also director of the Vanderbilt Brain Institute. “To have an impact on treatment or clinical drug development, you must know the processes in the brain that are involved. This is the first research that gives us an explanation for how ketamine produces long-term effects involving synaptic plasticity in the brain and why ketamine has cumulative antidepressant effects—a huge step forward.”
This discovery will allow researchers to target the neural pathway that prolongs ketamine’s antidepressant effects without the drug itself. While ketamine has significant promise, it also carries abuse liabilities, as the drug can trigger psychomedical effects. At low doses the drug is not harmful, but no one knows the outcome of sustained use of ketamine to date. This discovery may be a way to circumvent the unintended and still unknown negative effects of ketamine exposure.
WHAT’S NEXT
With the knowledge that MeCP2 can regulate gene expression, researchers are now looking to understand the neural pathway of the gene more fully, and to find commonalities with common antidepressants to extend their effects.
FUNDING
This work was supported by National Institutes of Health grants MH070727, MH081060 and MH066198, the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education grant 2016R1A6A3A03008533, and the Swedish Pharmaceutical Society and the Swedish Society for Medical Research.
Collaborators on this research include Ege Kavalali, professor of pharmacology and William Stokes Chair in Experimental Therapeutics, and Vanderbilt postdoctoral researcher Ji-Woon Kim, as well as Anita Autry of Albert Einstein College of Medicine, Elisa Na of Texas Woman’s University, Megumi Adachi of Astellas Pharma, and Carl Bjorkholm of University of Texas Southwestern Medical Center.
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JOURNAL
Nature Neuroscience
DOI
10.1038
ARTICLE TITLE
Sustained effects of rapidly acting antidepressants require BDNF-dependent MeCP2 phosphorylation
ARTICLE PUBLICATION DATE
28-Jun-2021
How to make up your mind when the glass seems half empty?
Review highlights recent advances in understanding how anxiety can drive ‘pessimistic’ decision making
IMAGE: NEUROSCIENTISTS AT KYOTO UNIVERSITY’S INSTITUTE FOR ADVANCED STUDY OF HUMAN BIOLOGY (WPI-ASHBI) HAVE CONNECTED SOME OF THE DOTS TO REVEAL THE BRAIN NETWORKS THAT GIVE ANXIETY INFLUENCE OVER DECISIONS. WRITING IN THE JOURNAL FRONTIERS IN NEUROSCIENCE, THE GROUP HAS PUBLISHED A REVIEW THAT SYNTHESIZES RESULTS FROM YEARS OF BRAIN MEASUREMENTS IN RATS AND PRIMATES AND RELATES THESE FINDINGS TO THE HUMAN BRAIN.view more
CREDIT: KYOTO UNIVERSITY
KYOTO—Is a new high-income job offer worth accepting if it means commuting an extra hour to work? People often have to make tough choices regarding whether to endure some level of discomfort to take advantage of an opportunity or otherwise walk away from the reward. In making such choices, it turns out that the brain weighs our desire to go for the reward against our desire to avoid the related hardship.
In previous research, negative mental states have been shown to upset this balance between payoff and hardship toward more ‘pessimistic’ decision making and avoidance. For example, scientists know that people experiencing anxiety have a stronger-than-normal desire to avoid negative consequences. And people with depression have a weaker desire to approach the reward in the first place. But there is still much we do not know about how the brain incorporates feelings into decision making.
Neuroscientists at Kyoto University’s Institute for Advanced Study of Human Biology (WPI-ASHBi) have connected some of the dots to reveal the brain networks that give anxiety influence over decisions. Writing in the journal Frontiers in Neuroscience, the group has published a review that synthesizes results from years of brain measurements in rats and primates and relates these findings to the human brain.
“We are facing a new epidemic of anxiety, and it is important that we understand how our anxiety influences our decision making,” says Ken-ichi Amemori, associate professor in neuroscience at Kyoto University, ASHBi. “There is a real need for a better understanding of what is happening in the brain here. It is very difficult for us to see exactly where and how anxiety manifests in humans, but studies in primate brains have pointed to neurons in the ACC [anterior cingulate cortex] as being important in these decision-making processes.”
Thinking of the brain as an onion, the ACC lies in a middle layer, wrapping around the tough ‘heart’, or corpus callosum, which joins the two hemispheres. The ACC is also well-connected with many other parts of the brain controlling higher and lower functions with a role in integrating feelings with rational thinking.
The team started by measuring brain activity in rhesus macaques while they performed a task to select or reject a reward in the form of food combined with different levels of ‘punishment’ in the form of an annoying blast of air in the face. The potential choices were visually represented on a screen, and the monkeys used a joystick to make their selection, revealing how much discomfort they were willing to consider acceptable.
When the team probed the ACC of the monkeys, they identified groups of neurons that activated or deactivated in line with the sizes of the reward or punishment on offer. The neurons associated with avoidance and pessimistic decision-making were particularly concentrated in a part of the ACC called the pregenual ACC (pACC). This region has been previously linked to major depressive disorder and generalized anxiety disorder in humans.
Microstimulation of the pACC with a low-level electrical pulse caused the monkeys to avoid the reward, simulating the effects of anxiety. Remarkably, this artificially induced pessimism could be reversed by treatment with the antianxiety drug diazepam.
With knowledge of the pACC’s involvement in anxiety-related decision-making, the team next searched for its connections to other parts of the brain. They injected viruses at the specific sites that instructed nerve cells to start making fluorescent proteins that would light up under microscope observation. The virus then spread to other connected nerve cells, revealing the pathways other areas of the brain linked to this center of ‘pessimistic’ thought.
The team found interconnections with many parts of the prefrontal cortex at the front of the human brain, which is associated with higher cogitative function and reasoning. They also noted a strong connection with labyrinth-like structures known as striosomes.
Amemori explains, “The function of the striosome structure has been something of a mystery for a long time, but our experiments point to these being an important node linking pessimistic decision-making to the brain’s reward system and dopamine regulation.”
The team noted a further connection, namely that between these striosomes and another more distant region, the caudal region of the orbitofrontal cortex (cOFC) at the front of the brain. This part is also known to be involved in cognition and decision-making.
When the team repeated their brain monitoring, microstimulation, and virus tracing studies in cOFC, they found a very similar influence on the monkey’s tendency toward pessimistic decision making. Curiously, the pACC and the cOFC also shared many of the same connections to other parts of the brain.
The team was able to generalize these findings in primates to humans by drawing comparisons with the body of knowledge in human brains studies based on magnetic resonance imaging or MRI.
Amemori says, “The many parallels in brain activation point to a common mechanism for both humans and monkeys. It’s important that we have associated striosomes and their extended network with decision making under an anxious condition, and we hope that this study will be useful toward developing brain pathway-specific treatments for neurological and psychiatric disorders in humans.”
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JOURNAL
Frontiers in Neuroscience
DOI
10.3389/fnins.2021.649167
METHOD OF RESEARCH
Experimental study
SUBJECT OF RESEARCH
Animals
ARTICLE TITLE
Causal evidence for induction of pessimistic decision-making in primates by the network of frontal cortex and striosomes
ARTICLE PUBLICATION DATE
29-Jun-2021
Transgender adults more likely to experience subjective cognitive decline, depression
IMAGE: ALZHEIMER'S ASSOCIATION INTERNATIONAL CONFERENCE 2021view more
CREDIT: ALZHEIMER'S ASSOCIATION
DENVER, JULY 28, 2021 -- Transgender and gender nonbinary adults in the U.S. are more likely to report worsening memory and thinking, functional limitations and depression compared to cisgender (non-transgender) adults, according to two studies reported at the Alzheimer's Association International Conference® (AAIC®) 2021 in Denver and virtually.
Little is known about Alzheimer's disease, dementia and cognitive impairment among transgender adults. However, it is known that transgender adults experience a greater number of health disparities considered risk factors for dementia -- including higher cardiovascular disease, depression, diabetes, tobacco/alcohol use and obesity -- and the social inequities experienced by transgender adults are also linked to an increased risk of cognitive impairment.
One of the first clinical manifestations of Alzheimer's disease may be subjective cognitive decline (SCD), a self-reported experience of confusion or memory loss that is happening more often or is getting worse.
These new data at AAIC 2021 are among the first ever looking at cognition specifically in transgender and gender nonbinary individuals. Key findings include: - Transgender adults -- individuals who identify with a gender different than the one assigned to them at birth -- were nearly twice as likely to report SCD and more than twice as likely to report SCD-related functional limitations, such as reduced ability to work, volunteer or be social. - Prevalence of depression was significantly higher for transgender and gender nonbinary adults (individuals who identify outside the male/female binary) (37%) compared to cisgender adults (19.2%). Additionally, reports of cognitive disability, a surrogate for SCD, were significantly higher in transgender and nonbinary adults (24.7%) compared to cisgender adults (10.5%).
"We know far too little about Alzheimer's, dementia and cognitive well-being among transgender and gender nonbinary individuals," said Carl V. Hill, Ph.D., MPH, Alzheimer's Association chief diversity, equity and inclusion officer. "As we learn more about dementia within this population, there is a great need for health care that is culturally competent and delivered with humility to address the needs of aging transgender individuals and their loved ones."
The first dementia prevalence data for U.S. lesbian, gay and bisexual individuals were reported at AAIC 2018, followed by the first data report suggesting higher rates of SCD among lesbian, gay, bisexual and/or transgender Americans at AAIC 2019. Also that year, the Alzheimer's Association partnered with SAGE (Advocacy & Services for LGBT Elders) to develop an issues brief and infographic that offers recommendations for working with LGBT people living with Alzheimer's or other dementias, as well as supporting LGBT-identified caregivers for people living with dementia. Among those recommendations is using gender-affirming language. The Association also maintains a list of resources for the LGBT community and caregivers on its website.
Transgender Adults Report More Subjective Cognitive Decline Than Cisgender Adults
Using data from the 2015-2019 Behavioral Risk Factor Surveillance System (BRFSS), a large annual health behavior survey led by the Centers for Disease Control and Prevention (CDC), Ethan Cicero, Ph.D., RN, Assistant Professor at Emory University's Nell Hodgson Woodruff School of Nursing, and colleagues examined data on SCD and associated functional limitations -- including giving up day-to-day activities or interferences with ability to work, volunteer or engage in social activities -- among transgender and cisgender adults.
Approximately 17% of transgender adults (1 in 6) reported SCD, which is significantly higher than the 10.6% rate for cisgender adults (roughly 1 in 10). Among those reporting SCD, transgender adults were 2.3 times more likely to report associated social and self-care limitations when compared to cisgender adults. Among those reporting SCD, transgender adults were about three years younger and more likely to be a racial/ethnic minority, to be uninsured, and to have depression.
Barriers to health care were a concern among transgender adults -- 1 in 3 transgender adults who experienced worsening memory problems and 1 in 2 transgender adults with related social and self-care limitations were unable to see a doctor because of cost.
"We are not certain what may be causing the elevated subjective cognitive decline rates among transgender adults. We postulate that it may be in part due to anti-transgender stigma and prejudice that expose transgender people to high rates of mistreatment and discrimination where they live, work, learn, seek health care and age," Cicero said. "More research is needed to identify and target preventive intervention strategies, develop culturally relevant screenings, and shape policies to improve the health and well-being of the transgender population."
Depression, Cognitive Disability Higher Among Transgender and Gender Nonbinary Adults
Using data from the 2019 BRFSS, Nickolas H. Lambrou, Ph.D., assistant scientist, Gleason Lab at the Division of Geriatrics and Gerontology at the University of Wisconsin School of Medicine & Public Health, and colleagues examined associations between health conditions, cognitive disability and gender identity. Of respondents providing a gender identity (n=231,414), 955 identified as transgender or gender nonbinary (TNB).
The researchers found prevalence of depression was significantly higher for transgender and nonbinary adults (37%) compared to cisgender adults (19.2%). Additionally, reports of cognitive disability were significantly higher in TNB respondents (24.7%) compared to cisgender respondents (10.5%). Nonbinary respondents reported the highest proportion of depression (49.6%) and cognitive disability (30.5%) compared to all other gender groups. The analysis also suggested that men, whether transgender or cisgender, were more likely to report cognitive disability associated with depression compared to other groups. However, it is important to note that cisgender men also reported the lowest proportions of depression (14%) and cognitive disability (9.4%) compared to all other gender identity groups.
"This research demonstrates that the cognitive health of transgender or gender nonbinary adults is different than cisgender adults, and that there are health differences within the TNB population. Notably, TNB respondents reported depression and cognitive disability at more than twice the rate of cisgender adults," Lambrou said.
"These rates are concerning because cognitive disability may be a risk factor or early indicator of Alzheimer's or other dementia. Further research is needed; it is critical that researchers include measures to identify TNB participants so we have an accurate representation of their health and health behaviors," Lambrou added.
AMERICAN GUN CULTURE POST SHOOTING PTSD
Nonfatal firearm injuries lead to increased chance of mental health disorder in youth
Researchers at MUSC Health find those under 18 years of age are more likely to suffer a mental health disorder in the year following a nonfatal firearm injury
THIS RESEARCH TEAM FOUND THAT CHILDREN WITH AN UNDERLYING MENTAL ILLNESS ALREADY HAVE A HIGHER BASELINE RISK FOR INJURY FROM A FIREARM. AND ONCE INJURED, THE SAME CHILDREN HAVE A GREATER RISK OF DEVELOPING ADDITIONAL MENTAL DISORDERS.view more
CREDIT: BRENNAN WESLEY, MUSC HEALTH
For every youth who dies with injury from a firearm, at least four survive. These survivors led researchers at MUSC Health to look at new mental health diagnoses that may stem from nonfatal gunshot wounds in adolescents.
Betsy Oddo, M.D., a pediatric hospital medicine fellow at MUSC Shawn Jenkins Children’s Hospital, says firearm injury is the leading cause of death for youth in the United States. In a recent paper in Academic Pediatrics, Oddo and her team looked at pediatric patients in the year before they suffered their firearm-related injury and the year following.
“What we ultimately found is that in the time before their injury, a large proportion of these patients already had an underlying mental health diagnosis,” she said. “And then in the year after their injuries, another proportion went on to have a new mental health diagnosis.”
This research team found that children with an underlying mental illness already have a higher baseline risk for injury from a firearm. And once injured, the same children have a greater risk of developing additional mental disorders. Any physical disability they may experience from the injury adds to any mental stress they may also be feeling.
The level of risk depends on the type of mental health disorder prior to injury. Children diagnosed with depression are at a higher risk for suicide, and according to the Centers for Disease Control and Prevention, 3.2% of children between the ages of 3 and 17 have diagnosed depression — which equates to 1.9 million people in the United States. Rates of depression in children have only increased over time.
Oddo points to conduct disorder as another risk factor, as children with conduct disorders or substance-related disorders are more likely to be involved in community violence. While more common in boys than in girls, the lifetime prevalence of conduct disorder is 12% for boys and 7% for girls according to American Family Medicine.
Patients in South Carolina have access to the MUSC Health Trauma Survivors Network, which provides a community of patients, families, health care providers and volunteers who can help people connect after a serious injury such as a gunshot wound. In addition to connecting trauma victims with mental health services when they are first admitted to the hospital, Oddo is also part of a hospital-based violence intervention program that will soon start to see children.
Physicians at MUSC also screen children who enter the hospital or emergency room with mental health concerns as well as asking about any firearms at home. If there are firearms in the home, Oddo can offer free gun locks to the family and free counseling on safe gun storage as an injury prevention method. She thinks discussing access to firearms should be a regular part of any pediatrician visit.
“This paper just goes to show that the mental health epidemic in this country and the firearm violence epidemic in this country are intertwined,” said Oddo. “It’s important for us to address mental health needs in the population of children who have suffered a firearm injury.”
Oddo and her team plan to look at the ways these children are utilizing the mental health care system in an effort to understand if they are getting adequate attention in the timeframe needed following a firearm-related injury. She advises any parents who are concerned about mental health disorders in their children to be mindful of guns in their homes, urging parents to keep weapons locked away and to keep firearms separate from ammunition to reduce the odds of the physical injury and mental health damage that a firearm injury can inflict.
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As the clinical health system of the Medical University of South Carolina, MUSC Health is dedicated to delivering the highest quality patient care available while training generations of competent, compassionate health care providers to serve the people of South Carolina and beyond. Comprising some 1,600 beds, more than 100 outreach sites, the MUSC College of Medicine, the physicians’ practice plan and nearly 275 telehealth locations, MUSC Health owns and operates eight hospitals situated in Charleston, Chester, Florence, Lancaster and Marion counties. In 2020, for the sixthconsecutive year, U.S. News & World Report named MUSC Health the No. 1 hospital in South Carolina. To learn more about clinical patient services, visit muschealth.org.
JOURNAL
Academic Pediatrics
DOI
10.1016/j.acap.2021.06.003
ARTICLE TITLE
Increase in Mental Health Diagnoses Among Youth With Nonfatal Firearm Injuries
