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)
How organisms develop from inanimate matter is one of the biggest questions in science. Although many possible explanations have been proposed, there are no definitive answers. That’s no surprise: these processes took place three to four billion years ago, when the conditions on Earth were completely different from today.
Justifying hypotheses with experimental data
“Over this vast period of time, evolution has thoroughly obliterated the traces that lead back to the origins of life,” says Roland Riek, Professor of Physical Chemistry and Associate Director of ETH Zurich’s new interdisciplinary Centre for Origin and Prevalence of Life. Science has no choice but to formulate hypotheses – and to substantiate them as thoroughly as possible with experimental data.
For years, Riek and his team have been pursuing the idea that protein-like aggregates, known as amyloids, might have played an important role in the transition between chemistry and biology. Riek’s research group’s first step was to demonstrate that such amyloids can be formed relatively easily under the conditions that probably prevailed on the early Earth: in the laboratory, all it takes is a little volcanic gas (as well as experimental skill and a lot of patience) for simple amino acids to combine into short peptide chains, which then spontaneously assemble into fibres.
Precursor molecules of life
Later, Riek’s team demonstrated that amyloids can replicate themselves – which means that the molecules fulfil another decisive criterion for being considered precursor molecules of life. And now the researchers have taken the same line for a third time with their latest study, in which they show that amyloids are able to bind with molecules of both RNA and DNA.
These interactions are partly based on electrostatic attraction, since some amyloids are – at least in places – positively charged, while the genetic material carries a negative charge, at least in a neutral to acidic environment. However, Riek and his team have also noticed that the interactions also depend on the sequence of the RNA and DNA nucleotides in the genetic material. This means they might represent a kind of precursor to the universal genetic code that unites all living beings.
Increased stability as a major advantage
And yet: “Although we see differences in how the RNA and DNA molecules bind with the amyloids, we don’t yet understand what these differences mean,” Riek says. “Our model is probably still too simple.” That’s why he sees another aspect of the results as particularly important: when the genetic material attaches itself to amyloids, both molecules gain stability. In ancient times, this increased stability may have proved to be a great advantage.
This is because back then, in the so-called primordial soup, biochemical molecules were very dilute. Contrast this with today’s biological cells, within which these molecules are tightly packed together. “Amyloids have the proven potential to increase the local concentration and order of nucleotides in an otherwise dilute disordered system,” write Riek’s researchers in their recently published article.
Riek points out that although competition is central to Darwin’s theory of evolution, cooperation has also played a major evolutionary role. Both classes of molecules benefit from the stabilising interaction between amyloids and RNA or DNA molecules because long-lived molecules accumulate more strongly over time than unstable substances. It may even be that molecular cooperation, rather than competition, was the decisive factor in the emergence of life. “After all, there was likely no shortage of space or resources back then,” Riek says.
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Reference
Rout SK, Cadalbert R, Schröder N, Wang J, Zehnder J, Gampp O, Wiegand T, Güntert P, Klingler D, Kreutz C, Knörlein A, Hall J, Greenwald J, and Riek R. An Analysis of Nucleotide-Amyloid Interactions Reveals Selective Binding to Codon-Sized RNA. Journal of the American Chemical Society 2023, 145: 21915, doi: 10.1021/jacs.3c06287
Lithuanian scientists discovered a way to reduce the cost of biodiesel production by adding the by-product of cigarette waste recycling.
Stricter environmental norms and fossil fuel pollution call for cleaner fuels such as biodiesel. This vegetable oil- or animal fat-based diesel is biodegradable – up to 4 times faster than petroleum diesel – and nontoxic.
However, the high production cost of biodiesel remains a major barrier to its wider applicability, and, depending on the biomass source, using it may cause pollution. Adding a blender such as a triacetin compound, can solve both of these issues, according to research. Unfortunately, triacetin is usually produced chemically, consuming a lot of chemicals, and resulting in waste and toxic residues.
“Triacetin is used as a plasticiser in cigarettes’ filter, so, naturally, cigarette butts are rich in it,” says Samy Yousef, a chief researcher at Kaunas University of Technology, Lithuania.
Together with his colleagues from the Lithuanian Energy Institute (LEI), he conducted a series of experiments where they used pyrolysis to thermally decompose cigarette waste. The experiments were carried out in a 200 g reactor at different reaction temperatures (650, 700, and 750°C). The biggest quantity of triacetin (43 per cent) was synthesised at 750°C.
Original approach to toxic waste
Smokers around the world buy roughly 6.5 trillion cigarettes each year. The average weight of a cigarette butt is 0.2 g; more than 1.1 million tons of them are produced annually. Cigarette waste contains extensive amounts of toxic chemicals, carcinogens, microplastic fibres, and radioactive elements that need special attention.
“In our research group, we are working on the topics of recycling and waste management, therefore we are always looking for the waste, which is present in huge amounts and has a unique structure. Cigarettes are made of three components – tobacco, paper and a filter made of cellulose acetate fibres – and are a good source of raw materials and energy. Plus, cigarette butts are easy to collect as there are many systems and companies for collecting this waste in place,” explains Yousef.
Although there have been attempts to recycle cigarette waste for the extraction of raw materials, the majority of studies focused on the investigation of thermal degradation of the individual components. Lithuanian scientists in their experiments were treating cigarette butts as a mixture, and, according to them, it is an original approach.
“There are studies which, similarly to us, are using pyrolysis as a method but they are applying it to filter components only. In this case, the pre-treatment of the material is needed to separate all components. Since tobacco is a toxic waste, the disposal of it requires special care, and due to the technologically complicated process to separate the components of the cigarette waste, this is not economically feasible,” says Yousef, a chief researcher at KTU Faculty of Mechanical Engineering and Design.
All products have real applications
After a series of pyrolysis at different temperatures experiments, the researchers were able to extract oil (38–39.5 wt%), char (25.7–27.7 wt%) and gas (33–36.4 wt%) from cigarette waste. The char product with a porous structure was very rich in calcium (up to 32 wt%).
“All the products have real applications. Char, which, in our case is porous and very rich in calcium can be used for fertilisers, or wastewater treatment as an absorbent, and energy storage. Gas can be used for energy purposes. Last, but not least is oil, rich in triacetin, which can be used as an additive to biodiesel to reduce the cost,” says Yousef, who believes that the technology has great upscaling possibilities.
For any emerging waste treatment technology to be integrated into a circular economy system, there must be a waste collection system and recycling strategy, as well as infrastructure present.
Cigarette butts’ collection systems, e.g. metal wastebasket and ashtrays are used widely to collect them separately from solid waste. As for the recycling strategy, the researchers propose using pyrolysis treatment at 750°C, which thermally converts cigarette butts into char, gas, and oil. Gaseous products can be used to generate electricity and to power the conversion plant, char can be used as absorbents, while oil can be added to biofuels at a rate of up to 25 per cent since the allowable triacetin rate is 10 per cent.
Meanwhile, KTU researcher Yousef says that the group is researching other possibilities for using cigarette waste.
PHOTOGRAPH (A) ANDLINE DRAWING (B) OF THE SKULL IN RIGHT LATERAL VIEW. A WELL-PRESERVED EMBRYO (C) AND ITS 3D (D) RECONSTRUCTION SHOWING THE PREHATCHING POSTURE.
Dinosaur reproductive biology is a well-attended but highly debated area. In the past 30 years, the discovery of several exceptionally well-preserved fossils related to reproduction has greatly improved our knowledge in this field. However, due to the scarcity of fossil evidence and the lack of quantitative analysis within a broad phylogenetic scale, much of this area remains unknown, especially the pre-Cretaceous evolutionary history.
The current study reported a new Early Jurassic sauropodomorph dinosaur discovered in Guizhou, northwestern China. The specimens contain three skeletons from adult individuals and five egg clutches (Figs. 1, 2). The genus name is the combination of the Mandarin Chinese “Qian” (an alternative name for Guizhou Province) and “long” (dragon), and the species name “shouhu” means “guarding” in Chinese, referring to the associated preservation of adult skeletal fossil and embryo-containing egg fossils. Qianlong is a medium-sized basal sauropodomorph dinosaur, which is about six meters long and one ton in weight. The embryos display some differences from the adults, like a proportionally longer postdentary bone, a more vertical anterior margin of the snout, and fewer teeth. Allometric analyses of limb ratios among adult and embryonic specimens indicate that adult Qianlong was bipedal, but the babies were likely to be quadrupedal. The general taphonomical and sedimentary features indicate that Qianlong might possess reproductive behavior such as colonial nesting, similar to other basal sauropodomorphs including Massospondylus and Mussaurus.
Extant reptiles and birds lay eggs and are protected by eggshells. Eggshells can be divided into three types: soft-shelled eggs, hard-shell eggs, and leathery eggs. Soft-shelled eggs possess a soft shell membrane that lacks or has a very thin calcareous layer (generally less than 60 μm), and modern lizards (except some geckos) and snake eggs are soft-shelled eggs. Hard-shelled eggs bear a thick calcareous layer, such as bird eggs, crocodile eggs, and some turtle eggs. The eggshell thickness of leathery eggs is between the soft shell and the hard shell, but it shows flexible properties, such as the eggshell of Chelydra serpentina. The researchers employed multiple techniques to examine the eggshell microstructure of Qianlong (Fig. 2), including histological thin-section, electron backscatter diffraction, energy-dispersive spectroscopy, and scanning electron microscope. The results show that Qianlong possesses eggshell microstructures similar to other Cretaceous dinosaur egg fossils, consisting of the mammillary layer and continuous layer with well-developed eggshell units. The calcareous layer of Qianlong is about 160 μm, which is much thicker than that in most soft-shelled eggs (usually less than 60 μm), but thinner than that in hard-shelled eggs (usually more than 200 μm). A comparison of eggshell fragmentation among different eggshell types suggests that the eggshell surface of Qianlong bears extremely small fragments, similar to those found in leathery eggshells but distinct from the folded surface in soft-shelled eggs and surface with large fragments in hard-shelled eggs. These observations indicate that Qianlong laid leathery eggs.
To test the macroevolutionary patterns of selected reproductive traits across the dinosaur-bird transition, the researchers assembled a dataset that includes the data from 210 fossil and extant species among all major reptilian clades. The dataset was then used to test the evolutionary trends with multiple time-scaled phylogenies. “Our ancestral state reconstruction with different time-scaled phylogenies supported that the first dinosaur egg was leathery.” Yu said. This differs from the previous hypophysis that the earliest dinosaur eggs are soft or hard-shelled. Archosaurs, the most recent common ancestor of dinosaurs, pterosaurs, and crocodiles, also originated from leathery eggs, whereas pterosaur eggs originated from soft-shelled eggs (Fig. 3). Quantitative analysis of the relative egg size showed that crocodiles, dinosaurs and pterosaurs had an increasing trend in the process of evolution, with the most significant change occurring during the origin stage of theropods (Fig. 4). For egg morphology, the earliest dinosaurs were subcircular or oval, and ornithischian and sauropods were more rounded. Theropods tended to be elongated, especially oviraptorosaurs. In addition, through the analysis of the relative (egg size) thickness of the eggshell (only calcareous layer), it was found that most reptiles tended to thicken eggshells during the process of evolution except for pterosaurs and lepidosaurs. Finally, the morphological changes of the eggshell units in archosaurs were analyzed, and it was found that most groups of dinosaurs exhibited an elongated overall evolutionary trend, especially in theropod dinosaurs. The bird eggshell unit became longer and then shorter, unlike other reptiles such as crocodiles and turtles, which became shorter and broader.
“These results provide important information for understanding the productive biology of early dinosaurs and the evolution of dinosaur egg size, egg shape, and eggshell type.” Xu said.
The comprehensive study has spanned over eight years. Xing Xu and Fenglu Han (associate professor at China University of Geosciences) initiated their research on these materials in 2016. However, the embryonic eggs were not fully prepared until 2019, when Shukang Zhang joined the team to study the eggshell microstructure. Xing Xu, Yilun Yu and Fenglu Han began to do Quantitative analyses of dinosaur egg fossils from 2020. “The dataset was collected and checked carefully to ensure its accuracy. Study of these materials was hard and time-consuming, but fortunately, we persevered with the research and obtained some convincing results!.” Han said.
Egg clutch, eggs and eggshell microstructure of Qianlong shouhu.
A. an
Eggshell type ancestral state reconstruction under hierarchal Bayes framework.egg clutch preserving 16 eggs and a fragmentary bone. B. A complete egg. C. Close-up of eggshell fragments showing cracked eggshell. Radial thin section under normal light showing the entire eggshell microstructure (D) and its line drawing (E).
Simplified time-calibrated diapsid tree showing the egg size evolution (A). egg elongation index (B), eggshell thickness evolution (C) and eggshell unit (D) based on our ASR analyses.
Restoration of life-scene of the sauropodomorph Qianlong from the Early Jurassic of southwestern China.
CREDIT
Image credit: Minghui Ren.
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See the article:
Exceptional Early Jurassic fossils with leathery eggs shed light on dinosaur reproductive biology
RESEARCH INSTITUTE FOR SUSTAINABILITY (RIFS) – HELMHOLTZ CENTRE POTSDAM
The Green Climate Fund (GCF) is the world’s largest dedicated multilateral climate fund, and aims to support climate mitigation and adaptation efforts in developing countries. Mobilizing financial resources from the private sector is an important priority for the donor countries backing the GCF. However, so far the GCF has underperformed in this respect. According to a new study by Thomas Kalinowski (Ewha Womans University, Seoul, and Research Institute for Sustainability - Helmholtz Centre Potsdam) this is due to numerous shortcomings in the GCF’s strategy.
The Green Climate Fund was established in 2010 under the UN Framework Convention on Climate Change (UNFCCC). It currently administers some 200 projects with a total value of USD 40 billion, of which the private sector accounts for only a small share. This is due to a number of reasons, as Thomas Kalinowski explains: "This shortfall in private sector engagement is largely driven by the perception that investments are unlikely to be profitable. There is a lack of attractive business models, especially when it comes to climate adaptation, and investments in particularly vulnerable countries in the Global South are considered excessively risky."
An exception to this is the renewable energy sector, where private sector engagement with the GCF is concentrated. According to Kalinowski, this suggests that private climate financing from the Global North is unlikely to play a decisive role in enabling the paradigm shift towards sustainable development in the Global South. In light of this, public funding for development cooperation should not be reduced.
Private sector projects are financed from public funds
In September 2022, the Green Climate Fund had 47 approved private sector projects (out of a total of 207 projects). Five of these 47 projects had lapsed and were no longer under implementation, which is a much higher rate of failure compared to the public sector, where only two of 160 projects failed. This leaves 42 private sector projects, with a volume of USD 16.9 billion, out of a total of USD 40.2 billion in GCF funds. This means that 21 per cent of all projects and 42 per cent of all project funds are allocated to private sector projects.
This is not the full picture, however, as Kalinowski's analysis shows. In fact, 22 per cent of the total volume of USD 16.9 billion invested in private sector projects are funds provided by the Green Climate Fund itself. The remainder comes from other, largely public institutions, such as the European Bank for Reconstruction and Development (EBRD) and other regional or national development banks. "In other words, a large proportion of the Green Climate Fund's project financing for the private sector does not come from the private sector, but from public sources," explains the political scientist.
Short-term profit interests vs. long-term transformation
More important than the quantity of private projects, however, is their quality. Kalinowski highlights the urgent need to ensure that private sector projects are compatible with the principles of the GCF and of good development cooperation in general. "It is critical that climate projects in the Global South are embedded in national development and climate strategies. Efforts to strengthen the involvement of private sector actors and civil society in the Global South, and to improve the broader business environment in recipient countries, are more important than maximizing private capital flows."
If these aspects are not properly considered, the GCF and private climate finance risk adding to the already high external debt burden of countries in the Global South, further destabilizing financial markets and exacerbating economic dependency. Kalinowski concludes that although renewable energy generation is preferable to the continued exploitation of natural resources, this alone will not provide a pathway to sustainable development in the Global South.
For successful non-profit impact on business governance, it is essential to advocacy non-profit organisations to engage key business stakeholders, a new study from the University of Eastern Finland shows. These stakeholders, such as employees, investors, politicians and the media, can be influenced by non-profit organisations in various ways.
“With a Strategic Confrontation and Collaboration Interaction Model (SCCIM), non-profit organisations can plan their strategy and figure out how to engage these important business partners effectively,” Doctoral Researcher Maike A. Diepeveen of the University of Eastern Finland says.
Advocacy non-profit organisations aim to protect, promote and support interests, often recommending new practices. They focus on issues like climate change, ecosystems and biodiversity. Additionally, they assist vulnerable or marginalised groups who may struggle to voice their concerns. The study examined how resource-strapped non-profit organisations can effectively promote their interests or causes by influencing the practices of multinational businesses.
As global issues like climate change become more urgent, everyone is expected to contribute by adopting more sustainable practices. Certain forward-thinking companies, driven by their stakeholders, quickly establish new guidelines to lead the way in adopting sustainable practices.
“When non-profit organisations work closely with these responsible businesses, it creates a chance to create excellent best practice examples,” Diepeveen concludes.
With the help of the SCCIM, these best practices can then be applied to other companies either through collaboration or influence, and they can also inform improved government policies.
CHICAGO – Black patients underwent medical imaging for cognitive impairment years later than white and Hispanic patients and were less frequently tested with MRI, according to research being presented this week at the annual meeting of the Radiological Society of North America (RSNA).
Previous studies have shown that Black patients are at increased risk of Alzheimer’s disease and other types of dementia. They are less likely to have a diagnosis and are diagnosed at a more advanced stage of disease compared to white patients.
Medical imaging—ideally with MRI—plays an increasingly important role in the diagnostic work-up of cognitive impairment. However, it is unknown how disparities in imaging access may lead to these delays in cognitive impairment diagnoses.
“If disparity in obtaining access to neuroimaging is one possible barrier that delays diagnosis, it is important to identify this and figure out possible solutions to benefit these patients and prevent a delayed diagnosis,” said study lead author Joshua Wibecan, M.D., radiology resident at Boston Medical Center in Boston, Massachusetts.
Drawing from four years of data, Dr. Wibecan and colleagues studied imaging disparities at their safety net academic medical center. A safety net medical center provides health care for people regardless of their insurance status or ability to pay.
The researchers identified all outpatient CTs of the head, CT angiographies of the head and MRI brain examinations performed for cognitive impairment. They obtained patient self-identified race from the Boston Medical Center Clinical Data Warehouse for Research.
Self-identified Black/African American patients were imaged for cognitive impairment at an older age and were less frequently imaged for cognitive impairment with MRI. While CT and MRI can both be useful in detection of cognitive impairment and dementia diagnoses, MRI provides much more detail about brain abnormalities.
The average age at imaging for cognitive impairment among the groups with Black patients was 72.5 years, compared with 67.8 years for white patients, 66.5 years for Hispanics and 66.7 years for the Other group. Only 50.9% of Black patients underwent MRI testing for cognitive impairment, compared to 60% of white patients, 67% of Hispanics and 68.2% in the Other group.
“Our study demonstrates two main findings,” Dr. Wibecan said. “First, Black patients who received MRI or CT for cognitive impairment were significantly older than patients from other races. Second, Black patients were significantly less likely to be imaged with MRI, the optimal type of imaging for cognitive impairment, as opposed to CT.”
Early imaging evaluation is important to identify treatable causes of cognitive impairment, such as tumors, bleeding or swelling within the brain. Additionally, new treatments have recently become available for Alzheimer’s disease that can potentially slow the rate of decline. Earlier diagnosis may, therefore, lead to early treatment and a longer period of better cognitive function.
“As treatment for Alzheimer’s Disease improves, it will be even more important to identify patients at early stages of disease for optimal treatment,” Dr. Wibecan said.
Further research is needed, Dr. Wibecan said, to understand why there was a significant difference in the types of imaging exams ordered for the workup of cognitive impairment across racial groups.
Chad W. Farris, M.D., Ph.D., neuroradiologist from Boston Medical Center and assistant professor of radiology at Boston University Chobanian & Avedisian School of Medicine, co-authored the study.
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Note: Copies of RSNA 2023 news releases and electronic images will be available online at RSNA.org/press23.
RSNA is an association of radiologists, radiation oncologists, medical physicists and related scientists promoting excellence in patient care and health care delivery through education, research and technologic innovation. The Society is based in Oak Brook, Illinois. (RSNA.org)
Editor’s note: The data in these releases may differ from those in the published abstract and those actually presented at the meeting, as researchers continue to update their data right up until the meeting. To ensure you are using the most up-to-date information, please call the RSNA Newsroom at 1-312-791-6610.
For patient-friendly information on brain MRI and CT, visit RadiologyInfo.org
Adding a few servings of whole grains linked to slower memory decline in Black people
MINNEAPOLIS – Black people who eat more foods with whole grains, including some breads and cereals, quinoa, and popcorn, may have a slower rate of memory decline compared to Black people who eat fewer whole grain foods, according to a study published in the November 22, 2023, online issue of Neurology®, the medical journal of the American Academy of Neurology.The researchers did not see a similar trend in white participants.
The study does not prove that eating more whole grains slows memory decline; it only shows an association.
The study found that among Black people, those who ate the most whole grains had lower levels of memory decline—equivalent to being 8.5 years younger than those who ate small amounts of whole grains.
“With Alzheimer’s disease and dementia affecting millions of Americans, finding ways to prevent the disease is a high public health priority,” said study author Xiaoran Liu, PhD, MSc, of Rush University in Chicago. “It’s exciting to see that people could potentially lower their risk of dementia by increasing their diet of whole grains by a couple of servings a day.”
The study involved 3,326 people with an average age of 75 without dementia. Of all participants, 1,999 people, or 60%, were Black. They were followed for an average of six years.
They filled out a questionnaire every three years on how often they ate whole grains. They also completed cognitive and memory tests every three years, including recalling lists of words, remembering numbers and putting them in the correct order.
Participants were then divided into five groups based on the amount of whole grains they had in their diet. The lowest group consumed less than half a serving per day, and the highest group consumed 2.7 servings per day. The Dietary Guidelines for Americans recommend at least three servings of whole grain foods daily. One serving of whole grains is equivalent to an ounce of food, such as one slice of bread, a half cup of cooked pasta or rice, an ounce of crackers or a cup of dry cereal.
Researchers found that a higher proportion of Black participants had more than one serving per day of whole grains than white participants, with 67% and 38%, respectively.
To determine rates of cognitive decline, researchers used an overall global cognition score summarizing four cognitive tests and examined their change over time.
After adjusting for factors that could affect the rate of cognitive decline, such as age, sex, education and smoking, researchers found that the global cognitive score of Black people who had the highest intake of whole grains, or more than three servings a day, declined at a rate of 0.2 standard deviation units per decade more slowly than Black people who had the lowest intake, or less than one serving per day.
“These results could help medical professionals make tailored diet recommendations,” Liu added. “More large studies are needed to validate our findings and to further investigate the effect of whole grains on cognition in different racial groups.”
A limitation of the study is that the food frequency questionnaire was self-reported, so people may not accurately remember what they ate.
The study was supported by the Alzheimer's Association and the National Institutes of Health.
Learn more about dementia at BrainandLife.org, home of the American Academy of Neurology’s free patient and caregiver magazine focused on the intersection of neurologic disease and brain health. Follow Brain & Life® on Facebook, Twitter and Instagram.
When posting to social media channels about this research, we encourage you to use the hashtags #Neurology and #AANscience.
The American Academy of Neurology is the world’s largest association of neurologists and neuroscience professionals, with over 40,000 members. The AAN is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, concussion, Parkinson’s disease and epilepsy.
"Prenatal interventions for Black people should aim to address mental health distress and treat high depression, anxiety, and stress," the research group recommends.
Depression, anxiety, and stress are common in Black pregnant people and commonly co-occur
At three U.S. urban clinics, the researchers were involved in determining whether pregnant Black patients were eligible for a trial of cognitive–behavioral therapy tailored to racial/ethnic minority people. At less than 19 weeks of gestation, 452 patients ages 18 to 40 completed the Edinburgh Postnatal Depression Scale, the General Anxiety Disorders–7 Scale, and the Perceived Stress Scale.
In total, 194 patients (43%) screened positive for depression, anxiety, and/or stress:
19% were only depressed
1.5% were only anxious
10% were only stressed
3.6% were depressed and anxious
25% were depressed and stressed
8% were anxious and stressed
33% were depressed, anxious, and stressed
All told, then:
81% reported depression alone or with anxiety or stress
46% reported anxiety alone or with depression or stress
76% reported stress alone or with depression or anxiety
The findings support changes in prenatal mental health screening
National prenatal care guidelines call for screening for depression and anxiety, Dr. Gennaro and her colleagues note, but screening is far from universal. "Screening occurs more frequently in the postpartum period than during pregnancy, and, when screened, pregnant people are less likely to receive evidence-based care than when they are postpartum. In fact, over a third of pregnant people have never received screening and these numbers are higher in minorities."
Moreover, the results of this study indicate the necessity of adding screening for stress to prenatal care, the authors say. "While all pregnant people need to be screened, attending school and being younger were additional risk factors and may warrant further consideration for people who have borderline screening scores."
On average, screening for depression, anxiety, and stress in this study added only 10 minutes to the prenatal visit. "Screening using validated tools . . . allows focused attention to the full scope of symptomatology, which is particularly important given the overlap of some mental health symptoms, such as appetite and sleep changes, with normal physiologic adaptations to pregnancy," the researchers explain.
They add that individuals who acknowledge self-harm on question 10 of the Edinburgh Postnatal Depression Scale should immediately be assessed further so they can be referred to the appropriate care, potentially including emergency psychiatric evaluation or social work.
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JOURNAL
The Nurse Practitioner
ARTICLE TITLE
Depression, anxiety, and stress in pregnant Black people: A case for screening and evidence-based intervention
