Association between cognitive phenotype in unaffected siblings and prospective 3- and 6-year clinical outcome in their proband affected by psychosis

Abstract Background Cognitive alterations are a central and heterogeneous trait in psychotic disorders, driven by environmental, familial and illness-related factors. In this study, we aimed to prospectively investigate the impact of high familial risk for cognitive alterations, unconfounded by illness-related factors, on symptomatic outcomes in patients. Methods In total, 629 probands with non-affective psychosis and their sibling not affected by psychosis were assessed at baseline, 3- and 6-year follow-up. Familial cognitive risk was modeled by three cognitive subtypes (‘normal’, ‘mixed’ and ‘impaired’) in the unaffected siblings. Generalized linear mixed models assessed multi-cross-sectional associations between the sibling cognitive subtype and repeated measures of proband symptoms across all assessments. Between-group differences over time were assessed by adding an interaction effect of time and sibling cognitive subtype. Results Probands affected by psychosis with a sibling of the impaired cognitive subtype were less likely to be in symptomatic remission and showed more disorganization across all time points. When assessing differences over time, probands of siblings with the impaired cognitive subtype showed less remission and less improvement of disorganization after 3 and 6 years relative to the other subtypes. They also showed less reduction of positive, negative and excitement symptoms at 6-year follow-up compared to probands with a sibling of the normal cognitive subtype. Conclusions Cross-sibling pathways from higher levels of familial cognitive vulnerability to worse long-term outcomes may be informative in identifying cognition-related environmental and genetic risks that impact psychotic illness heterogeneity over time.

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QOLP-22. THE PSYCHO-ONCOLOGICAL BURDEN OF PATIENTS WITH AGGRESSIVE MENINGIOMA – RESULTS FROM A RETROSPECTIVE CROSS-SECTIONAL STUDY

Neuro-Oncology ◽

10.1093/neuonc/noab196.742 ◽

2021 ◽

Vol 23 (Supplement_6) ◽

pp. vi187-vi187

Author(s):

Christine Jungk ◽

Madlen Raedel ◽

Julia Mattern-Tremper ◽

Rolf Warta ◽

Christel Herold-Mende ◽

...

Keyword(s):

Internal Control ◽

Multivariate Regression Analysis ◽

Extent Of Resection ◽

Cross Sectional Study ◽

Related Factors ◽

Cross Sectional ◽

Who Grade ◽

Eortc Qlq ◽

The Impact

Abstract Despite the perception of meningioma as a benign disease, up to 35% of patients experience a clinically aggressive course with debilitating treatment and poor outcome. In contrast to the growing interest in novel therapies, the impact on health-related quality of life (HRQoL) is still understudied. Here, we analysed the psycho-oncological burden of patients with aggressive meningioma. Our institutional cohort was searched for meningioma patients with surgery as first intervention and HRQoL was assessed retrospectively at one time point with standardized self-assessment questionnaires (HADS-D, EORTC-QLQ-C30). Aggressive meningioma was defined as WHO grade 2 or 3 or recurrence of a WHO grade 1 meningioma within 5 years after index surgery. Results were correlated with demographic, tumor- and treatment-related factors by multivariate linear regression and compared to internal control patients (WHO grade 1 meningioma, no recurrence within the first 5 years). 400 out of 653 patients returned the questionnaires (62%). Of those, 95 patients (24%) were classified as aggressive meningioma while 305 patients served as internal control. Patients with and without aggressive meningioma differed with regard to sex (p=0.019), age (p=0.015), extent of resection (p< 0.0001) and adjuvant radiotherapy (p< 0.0001) at index surgery and KPS at 1st follow-up (p=0.037). 34% and 24% of aggressive meningioma patients were screened positive on the anxiety and depression subscales of HADS-D as opposed to 33% and 23% of internal controls (not significant). Aggressive meningioma patients fared significantly worse on most of the function scales of QLQ-C30 (QL: p=0.004; PF: p=0.049; RF: p=0.003; CF: p=0.01; SF: p=0.018) and reported more financial difficulties (FI: p=0.015). In multivariate regression analysis, female sex, KPS at 1st follow-up < 70 and aggressive meningioma were independent factors of impaired HRQoL. This cross-sectional analysis demonstrates that HRQoL is impaired in aggressive meningioma patients who should be screened and treated for their psycho-oncological needs.

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Early and Mid-Term Implications of the COVID-19 Pandemic on the Physical, Behavioral and Mental Health of Healthcare Professionals: The CoPE-HCP Study Protocol

Frontiers in Psychology ◽

10.3389/fpsyg.2021.616280 ◽

2021 ◽

Vol 12 ◽

Author(s):

Mohammed Y. Khanji ◽

Carmela Maniero ◽

Sher NG ◽

Imrana Siddiqui ◽

Jaya Gupta ◽

...

Keyword(s):

Mental Health ◽

Healthcare Professionals ◽

Physical Symptoms ◽

Screening Tools ◽

Cross Sectional Survey ◽

Related Factors ◽

Cross Sectional ◽

Physical Wellbeing ◽

The Impact

IntroductionThe COVID-19 pandemic has led to unprecedented strain to healthcare systems worldwide and posed unique challenges to the healthcare professionals (HCPs) and the general public.ObjectivesThe aim of this study is to evaluate the impact of COVID-19 on the mental health, behavioral, and physical wellbeing of HCPs in the early and mid-term periods of the pandemic in comparison to non-HCPs. Thus, facilitating and guiding optimum planning and delivery of support to HCPs.Methods and AnalysisAn observational cross-sectional survey and cohort study aiming to enroll over 1050 participants (minimum, 800 HCPs and 250 controls). Study questionnaires will be completed at baseline and after 6-weeks and 4-months. Recruitment initiated July 2020. The study was designed in London, United Kingdom, but open to participants worldwide. Baseline: Questionnaires comprising of validated self-administered screening tools for depression, anxiety, sleep-related issues, wellbeing, and burnout. The questionnaires also explore changes in behavior and physical wellbeing of the participants. In addition, associations of these mental health and behavioral factors with work-related factors and support will be explored. Six-weeks and 4-months follow-up: Follow-up questionnaires will assess change in symptoms of anxiety and depression, sleep disorders, use of alcohol and other substances, behavioral or interpersonal relationship changes. Physical wellbeing will be assessed through the presence of suspected or confirmed COVID-19 infection and absence from work. We will also evaluate the impact of variable provision of personal protection equipment (supply and training), extended working hours, and concern for the wellbeing of family members, anxiety levels, and evidence of burnout.Statistical ConsiderationsThe study has 80% power to detect a 10% difference of combined depression and/or anxiety symptoms between the groups using two-sided type 1 error at 0.05 at baseline. Assuming that only 50% of these HCPs agree to be a part of a cohort survey, we will have 80% power to detect around 12% difference in the two groups in reported physical symptoms (20% vs. 32.3%), or prevalence of depression and/or anxiety at the end of the study.EthicsThe study was approved by the Cambridge East, Research Ethics Committee (20/EE/0166).Trial Registration NumberClinicalTrials.gov, NCT04433260.

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Longitudinal evidence of the impact of dog ownership and dog walking on mental health

Journal of Public Health ◽

10.1093/pubmed/fdz094 ◽

2019 ◽

Author(s):

Y Cui ◽

M Russell ◽

M Davern ◽

H Christian

Keyword(s):

Mental Health ◽

Self Report ◽

Related Factors ◽

Logistic Regression Models ◽

Dog Walking ◽

Dog Ownership ◽

The Impact ◽

Longitudinal Relationships ◽

Over Time

Abstract Background Emerging evidence supports the physical health and social benefits of dog ownership. This study examined the longitudinal effect of dog ownership and dog walking on mental health. Methods Data from a cohort of 1023 participants taking part in the RESIDential Environments project, in Perth, Western Australia were collected over a 2 year period (baseline and follow-up). Self-report survey items measured mental health (stress and depression), dog ownership status and weekly minutes of dog walking. Logistic regression models accounted for potential confounding factors including socio–demographic, self-rated health and baseline mental health. Results Overall, no statistically significant effects were observed over time between dog ownership and stress (adjusted OR: 1.20; 95% CI: 0.79, 1.81) or depression (adjusted OR: 1.51; 95% CI: 0.72, 3.16). There was a small inverse but non-significant association between weekly minutes of dog walking and stress over time (adjusted OR: 0.85; 95% CI: 0.60, 1.22). Conclusion There was little evidence of prospective associations between dog ownership or dog walking and mental health. Further research is required to confirm longitudinal relationships between dog ownership and dog walking and mental health and investigate dog-related factors, such as a person’s attachment to their dog.

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Dialysis initiation improves calcification propensity

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfz222 ◽

2019 ◽

Vol 35 (3) ◽

pp. 495-502 ◽

Cited By ~ 3

Author(s):

Belen Ponte ◽

Menno Pruijm ◽

Andreas Pasch ◽

Anne Dufey-Teso ◽

Pierre-Yves Martin ◽

...

Keyword(s):

Arterial Stiffness ◽

Repeated Measures ◽

Mineral Metabolism ◽

Dialysis Initiation ◽

University Hospitals ◽

Related Factors ◽

Fetuin A ◽

Cardiovascular Morbidity And Mortality ◽

The Impact ◽

Over Time

Abstract Background Cardiovascular morbidity and mortality is high in patients starting dialysis and could be related to modifications of calcification inducers and inhibitors by dialysis, promoting cardiovascular events. The impact of dialysis initiation on serum calcification propensity evolution and arterial stiffness is unknown. We therefore prospectively determined the evolution of the one-half maximal transition time (T50) value and its main determinants as well as pulse wave velocity over the first 3 months of dialysis initiation. Methods We analysed the evolution of T50, fetuin-A and mineral metabolism parameters before dialysis initiation (M0) and monthly until Month 3 (M3) in incident patients starting haemodialysis (HD) or peritoneal dialysis (PD) in two tertiary Swiss university hospitals. Arterial stiffness was assessed by pulse tonometry at M0 and M3 and biological parameters were compared between M0 and M3 and before/after HD. Linear mixed models were used to assess parameter evolution over time, taking into account repeated measures and other influencing variables. Results Forty-six patients on HD and 12 on PD were followed. Among them, 45 were male (78%) with a median age of 67 years (25th–75th quartile range 54–77). T50 significantly increased between M0 and M3 from 183 (120–266) to 246 min (175–330) (P < 0.001). Fetuin-A, calcium and magnesium also increased while phosphate decreased. Factors associated with T50 changes over time were fetuin-A, phosphate and magnesium (P < 0.001). Fetuin-A changes were associated with inflammation-related factors (albumin, C-reactive protein) but not calcium and phosphate levels. Arterial stiffness was not significantly modified over 3 months. PD and HD initiation showed similar trends. Conclusions Dialysis initiation significantly improves calcification propensity and fetuin-A levels. These modifications do not explain the high mortality related to dialysis initiation. The clinical relevance of using T50 values to initiate dialysis awaits further studies.

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Are neighborhood restaurants related to frequency of restaurant meals and dietary quality?: Prevalence and changes over time in the Multi-Ethnic Study of Atherosclerosis

Public Health Nutrition ◽

10.1017/s1368980021002196 ◽

2021 ◽

pp. 1-29

Author(s):

Amy H. Auchincloss ◽

Jingjing Li ◽

Kari A. B. Moore ◽

Manuel Franco ◽

Mahasin S. Mujahid ◽

...

Keyword(s):

Healthy Eating Index ◽

Dietary Quality ◽

Longitudinal Analyses ◽

Cross Sectional ◽

Cross Sectional Analysis ◽

Eating Out ◽

Restaurant Meals ◽

Sectional Analysis ◽

Over Time

Abstract Objective: To examine whether the density of neighbourhood restaurants affected the frequency of eating restaurant meals and subsequently affected diet quality. Design: Cross-sectional and longitudinal designs. Structural equation models assessed the indirect relationship between restaurant density (≤3 miles (4.8 km) of participant addresses) and dietary quality (Healthy Eating Index 2010 (HEI)) via the frequency of eating restaurant meals, after adjustment for sociodemographics, select health conditions, region, residence duration and area-level income. Setting: Urbanised areas in multiple regions of the USA, years 2000–2002 and 2010–2012. Participants: Participants aged 45–84 years were followed for 10 years (n 3567). Results: Median HEI (out of 100) was 59 at baseline and 62 at follow-up. Cross-sectional analysis found residing in areas with a high density of restaurants (highest ranked quartile) was associated with 52% higher odds of frequently eating restaurant meals (≥3 times/week, odds ratio [OR]:1.52, 95% confidence interval [CI] 1.18-1.98) and 3% higher odds of having lower dietary quality (HEI lowest quartile<54, OR:1.03,CI:1.01-1.06); associations were not sustained in longitudinal analyses. Cross-sectional analysis found 34% higher odds of having lower dietary quality for those who frequently ate at restaurants (OR:1.34,CI:1.12-1.61); and more restaurant meals (over time increase ≥1 times/week) was associated with higher odds of having worse dietary quality at follow-up (OR:1.21,CI:1.00-1.46). Conclusions: Restaurant density was associated with frequently eating out in cross-sectional and longitudinal analyses but was associated with the lower dietary quality only in cross-sectional analyses. Frequent restaurant meals were negatively related to dietary quality. Interventions that encourage less frequent eating out may improve population dietary quality.

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The Impact of Intervention-Related Risk Factors on the Risk of Ventilator-Associated Pneumonia Is High in a Neurosurgical Intensive Care Unit

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.1059 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s407-s409

Author(s):

Ksenia Ershova ◽

Oleg Khomenko ◽

Olga Ershova ◽

Ivan Savin ◽

Natalia Kurdumova ◽

...

Keyword(s):

Risk Factors ◽

Mechanical Ventilation ◽

Negative Slope ◽

Infection Prevention And Control ◽

Ventilator Associated Pneumonia ◽

Related Factors ◽

Icu Patients ◽

The Impact ◽

Adf Test ◽

Over Time

Background: Ventilator-associated pneumonia (VAP) represents the highest burden among all healthcare-associated infections (HAIs), with a particularly high rate in patients in neurosurgical ICUs. Numerous VAP risk factors have been identified to provide a basis for preventive measures. However, the impact of individual factors on the risk of VAP is unclear. The goal of this study was to evaluate the dynamics of various VAP risk factors given the continuously declining prevalence of VAP in our neurosurgical ICU. Methods: This prospective cohort unit-based study included neurosurgical patients who stayed in the ICU >48 consecutive hours in 2011 through 2018. The infection prevention and control (IPC) program was implemented in 2010 and underwent changes to adopt best practices over time. We used a 2008 CDC definition for VAP. The dynamics of VAP risk factors was considered a time series and was checked for stationarity using theAugmented Dickey-Fuller test (ADF) test. The data were censored when a risk factor was present during and after VAP episodes. Results: In total, 2,957 ICU patients were included in the study, 476 of whom had VAP. Average annual prevalence of VAP decreased from 15.8 per 100 ICU patients in 2011 to 9.5 per 100 ICU patients in 2018 (Welch t test P value = 7.7e-16). The fitted linear model showed negative slope (Fig. 1). During a study period we observed substantial changes in some risk factors and no changes in others. Namely, we detected a decrease in the use of anxiolytics and antibiotics, decreased days on mechanical ventilation, and a lower rate of intestinal dysfunction, all of which were nonstationary processes with a declining trend (ADF testP > .05) (Fig. 2). However, there were no changes over time in such factors as average age, comorbidity index, level of consciousness, gender, and proportion of patients with brain trauma (Fig. 2). Conclusions: Our evidence-based IPC program was effective in lowering the prevalence of VAP and demonstrated which individual measures contributed to this improvement. By following the dynamics of known VAP risk factors over time, we found that their association with declining VAP prevalence varies significantly. Intervention-related factors (ie, use of antibiotics, anxiolytics and mechanical ventilation, and a rate of intestinal dysfunction) demonstrated significant reduction, and patient-related factors (ie, age, sex, comorbidity, etc) remained unchanged. Thus, according to the discriminative model, the intervention-related factors contributed more to the overall risk of VAP than did patient-related factors, and their reduction was associated with a decrease in VAP prevalence in our neurosurgical ICU.Funding: NoneDisclosures: None

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T3 Are Burns a Chronic Condition: Examining Physical and Mental Functioning up to 20 Years After Injury

Journal of Burn Care & Research ◽

10.1093/jbcr/irab032.002 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

pp. S2-S3

Author(s):

Callie Abouzeid ◽

Audrey E Wolfe ◽

Gretchen J Carrougher ◽

Nicole S Gibran ◽

Radha K Holavanahalli ◽

...

Keyword(s):

Mental Health ◽

Hospital Stay ◽

National Database ◽

Time Points ◽

Patient Reported ◽

Burn Survivors ◽

Population Demographic ◽

The Impact ◽

Over Time

Abstract Introduction Burn survivors often face many long-term physical and psychological symptoms associated with their injury. To date, however, few studies have examined the impact of burn injuries on quality of life beyond 2 years post-injury. The purpose of this study is to examine the physical and mental well-being of burn survivors up to 20 years after injury. Methods Data from the Burn Model System National Database (1997–2020) were analyzed. Patient-reported outcome measures were collected at discharge with a recall of preinjury status, and then at 5, 10, 15, and 20 years after injury. Outcomes examined were the Physical Component Summary (PCS) and Mental Component Summary (MCS) of the Short Form-12. Trajectories were developed using linear mixed methods model with repeated measures of PCS and MCS scores over time and controlling for demographic and clinical variables. The model fitted score trajectory was generated with 95% confidence intervals to demonstrate score changes over time and associations with covariates. Results The study population included 420 adult burn survivors with a mean age of 42.4 years. The population was mainly male (66%) and white (76.4%) with a mean burn size of 21.5% and length of hospital stay of 31.3 days. Higher PCS scores were associated with follow-up time points closer to injury, shorter hospital stay, and younger age. Similarly, higher MCS scores were associated with earlier follow-up time points, shorter hospital stay, female gender, and non-perineal burns. MCS trajectories are demonstrated in the Figure. Conclusions Burn survivors’ physical and mental health worsened over time. Such a trend is different from previous reported results for mental health in the general population. Demographic and clinical predictors of recovery over time are identified.

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Impact of sound levels and patient-related factors on sleep of patients in the intensive care unit: a cross-sectional cohort study

Scientific Reports ◽

10.1038/s41598-020-76314-9 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Piotr F. Czempik ◽

Agnieszka Jarosińska ◽

Krystyna Machlowska ◽

Michał P. Pluta

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Sleep Quality ◽

Sleep Duration ◽

Smartphone Application ◽

Sound Level ◽

Related Factors ◽

Cross Sectional ◽

Sound Levels ◽

The Impact

Abstract Sleep disruption is common in patients in the intensive care unit (ICU). The aim of the study was to measure sound levels during sleep-protected time in the ICU, determine sources of sound, assess the impact of sound levels and patient-related factors on duration and quality of patients' sleep. The study was performed between 2018 and 2019. A commercially available smartphone application was used to measure ambient sound levels. Sleep duration was measured using the Patient's Sleep Behaviour Observational Tool. Sleep quality was assessed using the Richards-Campbell Sleep Questionnaire (RCSQ). The study population comprised 18 (58%) men and 13 (42%) women. There were numerous sources of sound. The median duration of sleep was 5 (IQR 3.5–5.7) hours. The median score on the RCSQ was 49 (IQR 28–71) out of 100 points. Sound levels were negatively correlated with sleep duration. The cut-off peak sound level, above which sleep duration was shorter than mean sleep duration in the cohort, was 57.9 dB. Simple smartphone applications can be useful to estimate sound levels in the ICU. There are numerous sources of sound in the ICU. Individual units should identify and eliminate their own sources of sound. Sources of sound producing peak sound levels above 57.9 dB may lead to shorter sleep and should be eliminated from the ICU environment. The sound levels had no effect on sleep quality.

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Prevalence and family factors associated with loneliness during COVID-19: A cross-sectional study from South India

INDIAN JOURNAL OF MENTAL HEALTH AND NEUROSCIENCES ◽

10.32746/10.32746/ijmhns.2020.v3.i2.52 ◽

2020 ◽

Vol 3 (02) ◽

pp. 61-67

Author(s):

G. Sanjana ◽

Vijaya Raghavan

Keyword(s):

Online Survey ◽

South India ◽

Survey Design ◽

Southern India ◽

Related Factors ◽

Cross Sectional ◽

Health Crisis ◽

Factors Associated ◽

Family Discord ◽

The Impact

Background: Loneliness can affect anyone at any point in their life. It can be detrimental to the wellbeing and quality of life of individuals and communities. In the ongoing COVID-19 pandemic, loneliness is considered as a public health crisis. Hence, the objectives of the study were to estimate the prevalence of loneliness and family related factors associated with loneliness among general population in south India. Materials and Methods: The study employed a crosssectional online survey design. The data was collected in the first phase of the lockdown in 2020 from adults in Southern India. Socio-demographic profile and family related variables were collected using a semistructured proforma. Loneliness was assessed by UCLA loneliness scale. Results: Of 573 total respondents to the survey, aged between 18-65 years, 43% were male and 57% were female. The overall prevalence of loneliness was 63% (358/573). No significant gender differences were observed in the prevalence of loneliness. Family discord was associated with higher rates of loneliness (p less than 0.01). Other factors associated were younger age and being single. Conclusion: Rates of loneliness during the COVID-19 lockdown were high in Southern India. Findings suggest that interventions should prioritize younger people. Increasing social support and improving interpersonal skills, which in turn would help reduce family discord and may reduce the impact of COVID-19 on loneliness.

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Long-term trajectory of cognitive performance in people with bipolar disorder and controls: 6-year longitudinal study

BJPsych Open ◽

10.1192/bjo.2021.66 ◽

2021 ◽

Vol 7 (4) ◽

Author(s):

Timea Sparding ◽

Erik Joas ◽

Caitlin Clements ◽

Carl M. Sellgren ◽

Erik Pålsson ◽

...

Keyword(s):

Bipolar Disorder ◽

Cognitive Functioning ◽

Cognitive Performance ◽

Repeated Measures ◽

Cognitive Test ◽

Healthy Controls ◽

Cross Sectional ◽

Time Interaction

Background Cross-sectional studies have found impaired cognitive functioning in patients with bipolar disorder, but long-term longitudinal studies are scarce. Aims The aims of this study were to examine the 6-year longitudinal course of cognitive functioning in patients with bipolar disorder and healthy controls. Subsets of patients were examined to investigate possible differences in cognitive trajectories. Method Patients with bipolar I disorder (n = 44) or bipolar II disorder (n = 28) and healthy controls (n = 59) were tested with a comprehensive cognitive test battery at baseline and retested after 6 years. We conducted repeated measures ANCOVAs with group as a between-subject factor and tested the significance of group and time interaction. Results By and large, the change in cognitive functioning between baseline and follow-up did not differ significantly between participants with bipolar disorder and healthy controls. Comparing subsets of patients, for example those with bipolar I and II disorder and those with and without manic episodes during follow-up, did not reveal subgroups more vulnerable to cognitive decline. Conclusions Cognitive performance remained stable in patients with bipolar disorder over a 6-year period and evolved similarly to healthy controls. These findings argue against the notion of a general progressive decline in cognitive functioning in bipolar disorder.

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