Tag: Mental health

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Preferences for Telehealth Physical Activity Participation Among a Cohort of Children and Youth With Disabling Conditions: Cross-Sectional Survey Study

Background: Children with disabling conditions encounter numerous challenges in participating in physical activity within their community. Telehealth has emerged as an ideal method for promoting physical health and wellness, but there is a need to identify optimal implementation strategies. Objective: This study aimed to describe the telehealth physical activity preferences of active children and youth with disabling conditions to rapidly inform the development of a pilot telehealth program that could be delivered nationally. Methods: A cross-sectional survey was conducted among a convenience sample of pediatric members of a community-based wellness program. Questions probed preferences for delivery method; programming frequency, intensity, duration, and type; desired outcomes; technology access and proficiency; and additional needed supports. Of the initial 56 respondents, 4 (7.1%) over the age of 18 years were excluded, leaving 52 (92.9%) for analysis. Outcomes were summarized descriptively. Results: Of 392 wellness program members, 56 (14.3%) responses were gathered. The mean age of the 52 analyzed respondents was 10 (SD 3; range 5-16) years. The sample predominantly comprised male (32/52, 61.5%) and White (34/52, 65.4%) individuals, with autism spectrum disorder and developmental disorder as the most common disability types (22/52, 42.3% each). Social and psychological barriers were the most frequently reported challenges to physical activity participation (36/52, 69.2% and 27/52, 51.9%, respectively). Most respondents reported an ideal exercise dose of 1 to 2 sessions per week of 30 to 45 minutes at a novice or beginner difficulty level. Winter was the preferred season for participation. The 2 most desired delivery formats were live videoconferencing and prerecorded videos. Desired program outcomes included strength improvement, mental health, developing new hobbies and activities, and social connection. Over 90% of respondents (47/52, 90.4%) reported having adequate technology at home to support virtual participation. Conclusions: Optimal telehealth programs for this cohort should be brief and low intensity and offered seasonally, with both live and prerecorded delivery options. Although this preferred dose does not meet US physical activity guidelines, it may represent an appropriate starting point for many inactive children with disabilities. Future research should examine behavior change strategies that motivate children to enroll in these programs and support gradual increases in physical activity over time.
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Influenza Drugs Could Prevent Cognitive Decline in Chronic Viral Infections 

Researchers at Northwestern University have found that a combination of influenza drugs could reduce cognitive impairment and premature aging in people living with chronic infections. In a study published today in the journal Med, the team uncovered a previously unknown mechanism by which viruses like HIV drive cognitive decline over time even when effectively treated. 

“We are not saying yet that people should take flu drugs to prevent cognitive decline,” explains Mohamed Abdel-Mohsen, PhD, associate professor of medicine in the division of infectious diseases at Northwestern University’s Feinberg School of Medicine. “We are saying that our findings open the door to testing whether this drug class, or better next-generation versions, could be repurposed for brain and aging-related complications.”

At least 25% of people living with HIV develop symptoms affecting their memory and thinking, even when the infection is effectively managed using antiretroviral therapy.  Until now, the reason for it remained unclear. 

Abdel-Mohsen’s team analyzed blood samples from more than 100 people in the AIDS Clinical Trials Group, all of which were infected with HIV and taking antiretroviral therapy. Based on clinical testing, the patients were separated in two groups, one having normal cognition and another cognitive impairment. 

Results showed that those who developed cognitive impairment had reduced levels of glycans in their blood. These protective sugar molecules normally keep inflammation under control, but when they are degraded, inflammation becomes chronic and accelerates aging processes. 

The researchers also found that glycan degradation was more pronounced among women in the study. While men saw changes in glycan levels evolve gradually and steadily over time, women experienced an acceleration around menopause. 

“Before menopause, women show a slower loss of anti-inflammatory glycans and slower accumulation of pro-inflammatory glycans compared with men, but around menopause there is a rapid shift toward a more inflammatory glycan profile,” says Abdel-Mohsen.

In human immune cells and mouse models, a combination of two influenza drugs successfully preserved glycans and reduced inflammation, slowing down aging and protecting memory. The treatment was composed of oseltamivir, sold as Tamiflu, and an experimental drug. Both are glycan-based drugs belonging to the sialidase inhibitor drug class, which block an enzyme that the influenza virus relies on to replicate itself. 

In future studies, the researchers will investigate whether glycans can serve as biomarkers of future cognitive decline, which could eventually lead to the development of predictive blood tests The team is also planning to further study and optimize potential treatment strategies based on the influenza drugs to prevent cognitive impairment.

“On the treatment side, we want to do more preclinical work to optimize the approach,” says Abdel-Mohsen. “Although some sialidase inhibitors are already used safely in people for influenza, they have not been tested for this purpose, dose or duration.”

The post Influenza Drugs Could Prevent Cognitive Decline in Chronic Viral Infections  appeared first on Inside Precision Medicine.

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Metabolic syndrome and perioperative neurocognitive disorders: epidemiology, mechanisms, and interventions

Perioperative neurocognitive disorders, an umbrella term encompassing preoperative cognitive impairment, acute postoperative delirium, and longer term postoperative neurocognitive disorders, represent significant complications for the growing population of older surgical patients. The rising prevalence of metabolic syndrome, defined by the clustering of abdominal obesity, insulin resistance, hypertension, and dyslipidemia, necessitates a deeper understanding of its impact on the perioperative brain. This comprehensive review elucidates the intricate epidemiological and mechanistic links between metabolic syndrome and the spectrum of cognitive decline. Epidemiologically, we disaggregate the risk profiles of individual components, demonstrating that distinct metabolic phenotypes serve as specific predictors for different phases of impairment. Mechanistically, we propose a sequential pathophysiological cascade where chronic systemic inflammation primes the brain for injury. Surgical stress triggers the failure of a compromised blood brain barrier, leading to the activation of the TLR4/NLRP3 inflammasome and the induction of central insulin resistance. These processes ultimately culminate in mitochondrial energy crises and synaptic degradation. To address these vulnerabilities, we evaluate an integrated perioperative strategy spanning preoperative metabolic optimization, intraoperative management, and emerging pharmacological interventions such as SGLT2 inhibitors and mitochondria targeted antioxidants. Critically, this review identifies a major knowledge gap regarding the absence of dedicated randomized controlled trials targeting the surgical metabolic syndrome population. Ultimately, our findings advocate for a clinical paradigm shift toward phenotype specific metabolic optimization to improve neurocognitive outcomes in these high risk patients.
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A novel fixel-based approach for resolving neonatal white matter microstructure from clinical diffusion MRI

IntroductionPreterm birth is a major risk factor for disrupted brain development and subsequent neurodevelopmental disorders, yet the underlying mechanisms remain poorly understood. Further, typical neuroimaging analyses are particularly challenging in the neonatal brain: data is frequently low quality, and a lack of cellular development violates the assumptions relied on by many commonly-used techniques. In this study, we develop and present an advanced diffusion magnetic resonance imaging method to examine the microstructural organization of white matter in a clinically-acquired cohort of premature neonates.MethodsUsing a novel approach that resolves multiple tissue compartments within the brain, we provide highly detailed orientation and quantification of white matter fibers and tissue signal fraction. We also utilize a series of automated segmentation algorithms to identify and measure these metrics across key tracts and subcortical regions. We investigate how these measures relate to postmenstrual age, as well as to clinical factors reflecting neonatal illness severity.ResultsWe report successful segmentation and reconstruction of numerous white matter tracts throughout the neonatal brain. We further demonstrate the utility and functionality of microstructural analysis in a variety of pathologies commonly encountered in the neonatal clinical environment. Our results demonstrate tract-specific developmental trajectories, with early-maturing pathways showing higher microstructural organization. Exploratory analyses suggest that neonatal illness severity has modest, tissue-specific associations with microstructural properties.DiscussionThis work demonstrates that advanced microstructural imaging methods can extract meaningful white matter measurements from clinically-acquired scans, providing a practical framework for studying neonatal brain development in real-world hospital settings. These metrics are able to be calculated at extremely young ages, potentially allowing non-invasive study of vulnerable populations before detailed behavioral or neurological assessments are feasible.
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Teachers’ Well-Being and Health in Germany: Representative Cross-Sectional Study

<strong>Background:</strong> Teachers play a fundamental role in the educational system and carry significant responsibilities. However, various occupational demands may compromise their health and well-being. At present, empirical data on the specific correlates of health and well-being among teachers in Germany remain limited, for example, regarding the relevance of health literacy. <strong>Objective:</strong> The primary aim of this study was to conduct a comprehensive assessment of the current health and well-being status among teachers. Specifically, the study aimed to quantify these factors according to the Positive Emotions, Engagement, Relationships, Meaning, and Accomplishments (PERMA) model as well as their general and mental health literacy. Secondary aims were to explore how health and well-being are associated with general and mental health literacy, as well as other personal and professional factors. <strong>Methods:</strong> This cross-sectional web-based survey was conducted in 2022 among teachers currently working in Germany. Participants were randomly sampled from all teachers in a general population panel (&gt;100,000 panelists recruited exclusively offline). In total, 61.6% (1005/1631) of the invited teachers participated (mean 49.99, SD 9.74 years). The final sample was weighted by gender, age, school type, and federal state. Health and well-being (PERMA Profiler questionnaire), general health literacy (European Health Literacy Survey Questionnaire, 16 items), mental health literacy (Mental Health Literacy Tool for the Workplace), sociodemographic (eg, gender and age), and professional information (school type, experience, and teaching load) were assessed. Bivariate (ANOVAs, <i>t</i> tests, and Pearson correlations) and multivariate (multiple regression) analyses were computed to analyze the associations between the health and well-being outcomes and the other factors. <strong>Results:</strong> The teachers reported intermediate to high well-being and health according to the PERMA model. In addition to significant bivariate associations, regression analysis for the well-being outcome (<i>F</i><sub>13, 977</sub>=10.66; <i>P</i>&lt;.001) revealed general (β=.23; <i>P</i>&lt;.001) and mental health literacy (β=.15; <i>P</i>&lt;.001) as significant positive predictors. In addition, teachers aged 40-49 years (β=–.12; <i>P</i>=.002) and 50-59 years (β=–.10; <i>P</i>=.03), as well as those with 10-19 years of experience (β=–.08; <i>P</i>=.04), reported significantly lower well-being than their younger/early-career peers. The regression model for the health outcome (<i>F</i><sub>13, 980</sub>=8.34; <i>P</i>&lt;.001) showed that general health literacy (β=.25; <i>P</i>&lt;.001), teaching at nonprimary schools (β=.10; <i>P</i>=.002), and a high teaching load (≥28 hours: β=.10; <i>P</i>=.02) were positively associated with the health outcome. Teaching experience of 10-19 years (β=–.09; <i>P</i>=.02) and older age (50-59 years: β=–.12; <i>P</i>=.02; ≥60 years: β=–.09; <i>P</i>=.046) predicted lower health scores. Other factors were not significant in the well-being and health regression models (all <i>P</i>&gt;.05). <strong>Conclusions:</strong> This study highlights the potential of health literacy as an intervention target for improving teachers’ health and well-being. To build on these findings, longitudinal and interventional studies are needed. <strong>Trial Registration:</strong>
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Differences in brain functional connectivity between autonomous sensory meridian response and classical music

Autonomous sensory meridian response (ASMR) is a tingling sensation that originates in the occipital region and spreads along the neck and spine, elicited by specific audiovisual stimuli known as ASMR triggers. The characteristics of ASMR-related changes in brain activity relative to other external stimuli, and whether these changes are specific to ASMR, remain unclear. The aim of this study is to compare changes in functional connectivity during exposure to ASMR triggers and classical music, and to clarify the changes in connectivity that are more strongly associated with ASMR trigger listening. Forty-eight healthy adults without a history of psychiatric disorders underwent functional MRI under three conditions: resting state without auditory stimulation, listening to ASMR triggers, and listening to classical music. Functional connectivity during the ASMR and classical-music conditions was assessed relative to the resting state. As a result, functional connectivity between the medial prefrontal cortex and the right lateral parietal cortex increased during ASMR trigger listening compared to rest. Relative to classical music listening, ASMR trigger listening increased functional connectivity between the medial prefrontal cortex and the right lateral parietal cortex, between the left anterior insula and left supramarginal gyrus, and between the right rostral prefrontal cortex and the anterior cingulate cortex. No significant changes in functional connectivity were observed during classical music listening alone. These findings suggest that, compared with classical music listening, ASMR trigger listening is associated with stronger functional connectivity between specific ROI pairs involved in self-referential/internal evaluative processing and sensory integration.
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Expressive writing combined with digital cognitive therapy in patients with schizophrenia: a narrative review of efficacy, linguistic phenotypes, and adherence modulators

Schizophrenia involves emotional and cognitive deficits that are often unresponsive to medication, emphasizing the need for effective psychosocial rehabilitation. This narrative review and conceptual perspective explores the potential integration of expressive writing (EW) and digital cognitive therapy (DCT) as a proposed dual approach to support emotional regulation and cognitive recovery. EW can facilitate emotional processing and motivation, while digital therapy may improve attention, memory, and executive function through structured and interactive training. Their proposed combination could promote engagement, strengthen self-efficacy, and support long-term rehabilitation. Linguistic analysis using natural language processing (NLP) could offer objective indicators of emotional and cognitive change, potentially enabling personalized and adaptive intervention. Overall, the proposed integration model may provide a practical and broadly implementable framework for improving functional prognosis and promoting recovery in schizophrenia, but empirical research is needed to determine its effectiveness, scalability, or clinical applicability, among other aspects.