Effects of an incremental theory of the personality intervention on psychophysiological responses to social stress during the transition to college

This randomized controlled trial (NCT04786496) examined the effects of a preventive intervention based on Incremental Theory of the Personality (ITP) on psychophysiological responses to social stress and evaluated whether levels of depression moderate the intervention effects. The participants, 107 first-year university students, were randomly assigned to one of three conditions: ITP intervention, ITP + a self-affirmation intervention (SA), and a control condition (CC). Indicators of the Hypothalamic–Pituitary–Adrenal axis, autonomic nervous system, and subjective mood were assessed with the Trier Social Stress Task. Participants in the ITP condition displayed a lower decline in respiratory sinus arrythmia (RSA) compared to those in the CC during the first phases of the task [Slopes: -0.08 (0.09) vs -0.21 (0.09), z = 2.86, p = .004] and a higher decrease in cortisol at recovery [β = -0.18 (0.08), z = -2.37, p = .018]. Depressive symptoms moderated the effect of ITP [β = -0.10 (0.05), z = -2.15, p =.032] and ITP+SA [β = -0.09 (0.04), z = -2.06, p =.039] in the decline during stress and recovery in RSA. In participants with low/medium levels of depressive symptoms, both interventions predicted a lower decline during stress [Slopes: -0.06 (0.09) for ITP, -0.17 (.09) for ITP+SA, and -0.26 (0.09) for CC] and higher recovery in RSA [Slopes: 0.18 (0.01) for ITP, 0.24 (0.01) for ITP+SA, and 0.30 (0.01) for CC]. The findings suggest that the ITP intervention has the potential to be an effective preventive intervention to reduce the stress response.

Kidney-Targeted Redox Scavenger Therapy Prevents Cisplatin-Induced Acute Kidney Injury

Cisplatin-induced acute kidney injury (CI-AKI) is a significant co-morbidity of chemotherapeutic regimens. While this condition is associated with substantially lower survival and increased economic burden, there is no pharmacological agent to effectively treat CI-AKI. The disease is hallmarked by acute tubular necrosis of the proximal tubular epithelial cells primarily due to increased oxidative stress. We investigated a drug delivery strategy to improve the pharmacokinetics of an approved therapy that does not normally demonstrate appreciable efficacy in CI-AKI, as a preventive intervention. In prior work, we developed a kidney-selective mesoscale nanoparticle (MNP) that targets the renal proximal tubular epithelium. Here, we found that the nanoparticles target the kidneys in a mouse model of CI-AKI with significant damage. We evaluated MNPs loaded with the reactive oxygen species scavenger edaravone, currently used to treat stroke and ALS. We found a marked and significant therapeutic benefit with edaravone-loaded MNPs, including improved renal function, which we demonstrated was likely due to a decrease in tubular epithelial cell damage and death imparted by the specific delivery of edaravone. The results suggest that renal-selective edaravone delivery holds potential for the prevention of acute kidney injury among patients undergoing cisplatin-based chemotherapy.

The Contribution of Neuroscience and Health Psychology to Macroergonomics

When a work system is considered we must focus on people that are part of the system as an active agent that can participate and interact all along the working process. In this process, stress contributes to increasing the probability of diseases and accidents. Therefore, one of the main objectives, from a preventive perspective, is to reduce stress levels. Related to this, the characteristics of healthy organizations will be described as a model to promote health. The objective of this chapter is to offer a broad and multidisciplinary perspective of prevention risk in the workplace centered in the worker, taking the view of neuroscience and health psychology. For that purpose, stress interventions in the organizations and in the individuals will be outlined. Finally, this chapter would finish proposing a preventive intervention to improve healthier work environments, taking into account neurosciences and health psychology. This proposal will be based on improving lifestyle, education for health, and self-respect.

Early Detection and Prevention of Schizophrenic Psychosis—A Review

Psychotic disorders often run a chronic course and are associated with a considerable emotional and social impact for patients and their relatives. Therefore, early recognition, combined with the possibility of preventive intervention, is urgently warranted since the duration of untreated psychosis (DUP) significantly determines the further course of the disease. In addition to established diagnostic tools, neurobiological factors in the development of schizophrenic psychoses are increasingly being investigated. It is shown that numerous molecular alterations already exist before the clinical onset of the disease. As schizophrenic psychoses are not elicited by a single mutation in the deoxyribonucleic acid (DNA) sequence, epigenetics likely constitute the missing link between environmental influences and disease development and could potentially serve as a biomarker. The results from transcriptomic and proteomic studies point to a dysregulated immune system, likely evoked by epigenetic alterations. Despite the increasing knowledge of the neurobiological mechanisms involved in the development of psychotic disorders, further research efforts with large population-based study designs are needed to identify suitable biomarkers. In conclusion, a combination of blood examinations, functional imaging techniques, electroencephalography (EEG) investigations and polygenic risk scores should be considered as the basis for predicting how subjects will transition into manifest psychosis.

POLICY OF PREVENTIVE WORK WITH JUVENILE DRUG USERS IN THE USA

This article deals with the problem of preventive work with young drug users. This is one of the most important problems in the world, including the USA. Substance misuse can put individual users and others among them at risk of harm. Early substance misuse and substance use disorders are associated with a variety of negative results, including deteriorating relationships, poor school performance, loss of employment, diminished mental health and increases in sickness and death. It is therefore critical to prevent the full spectrum of substance misuse problems in addition to treating those with substance use disorders. The aim of the study is to reveal the peculiarities of preventive work with young drug users in USA. Theoretical research methods have been used in this study: analysis of scientific sources, systematisation and generalisation of available data; defining of the essence of basic concepts; identification of the current state of the problem. The results of investigation give possibility to state that preventing or reducing early substance use initiation, substance misuse and the harms related to misuse requires the implementation of the effective programs and policies that address substance misuse across the lifespan. The effective prevention programs exist in the USA, and if implemented well, they can markedly reduce substance misuse and related threats to the health of population. There are three main categories of prevention interventions: universal, selected and indicated. Universal interventions are aimed at all members of a given population; selective interventions are aimed at a subgroup determined to be at high risk for substance; indicated interventions are targeted to individuals who are already using substance but have not developed a substance use disorder. It is recommended to provide a mix of universal, selective and indicated preventive intervention. Different programs are used for different categories of population. The program «Family Partnership» is focused on children younger than age 5. «The Good Behavior Game» and «Classroom-Centered Intervention» is an universal elementary school-based prevention program. For adolescents aged 10 to 18 programs «Life Skills Training» and «Towards No Drug Abuse» are used. There are also family-based programs («Strengthening Family», «For Parents and Youth»), program for College Students («Brief Alcohol Screening»), Internet-based program («I hear what you are saying») and many others. drug; juvenile; youth; preventive work; rehabilitation; programs of prevention; USA.

Dental Policy Lab 2 - towards paying for health in dentistry

The first Alliance for a Cavity-Free Future (ACFF)/King's College London Dental Policy Lab, held in 2017, identified the need for a review of dental payment systems in order to see progress towards achieving improvements in caries and cavities. The lack of incentivisation for preventive intervention and care has long been a barrier to progress. The second Dental Policy Lab, held in July 2018, focused on this issue with the overarching question: 'How can we create and implement acceptable prevention-based dental payment systems to achieve and maintain health outcomes?' Using a design approach and participatory research, 29 participants from five stakeholder categories developed a blueprint report that aims to serve as a framework to adapt or create remuneration systems that are compatible with evidence-based dentistry with a focus on preventive care. Aimed at policymakers and policy entrepreneurs, this blueprint provides guidance and potential solutions using several international examples. The report and accompanying infographic explored in this paper have been well received and have helped to frame discussions in several country settings, with a direct implementation which is being trialled in France in 2021.

Lansia Sebagai Populasi Rentan Dimasa Pandemi Covid-19: Scoping Review

Elderly are a vulnerable society in term of COVID-19. This is related to decrease immunity and comorbid diseases suffered by the elderly. The mortality rates of elderly suffered COVID-19 was high worldwide, including Indonesia. This study aimed to describe the vulnerability of the elderly and their relationship to COVID-19. The study applied a scoping review. The articles were searched in PubMed database. The keywords used are elderly, aged, older people and covid19, corona virus disease, SARS-Cov19 and selected in full text. As the results, there were 22,939 articles found but the author only took 7 articles according to the study context. The results show that the average age of the elderly who were affected by COVID-19 was 72.43 with a standard deviation of 4.1. Women were more affected by as many as 241 respondents (56.97%). The elderly are a vulnerable group due to decreased immunity and degenerative processes. Immunization for the elderly can be given as a preventive intervention. The elderly are vulnerable population of various diseases, including covid-19. A weakened immune system coupled with chronic disease can increase the risk of COVID-19 in the elderly. Due to the degeneration process among elderly, it is high risk of COVID-19 infection that causes severe disorders, even death among them.Keywords: COVID-19, Elderly, Immunity, Vaccination AbstrakLanjut usia (lansia) merupakan kelompok rentan terserang COVID-19. Hal tersebut terkait dengan penurunan daya tahan tubuh dan penyakit komorbid yang diderita lansia. Data mortalitas akibat COVID-19 pada lansia masih tinggi hampir di semua Negara, termasuk Indonesia. Penelitian ini bertujuan untuk mendeskripsikan kerentanan lansia dan hubungannya dengan COVID-19. Metode penelitian yang digunakan adalah scoping review, dengan pencarian artikel menggunakan database PubMed. Kata kunci yang digunakan adalah elderly, aged, older people and covid19, corona virus disease, SARS-Cov19 dan dipilih secara full text. Pada penelitian artikel didapatkan 22.939 artikel namun penulis hanya mengambil 7 artikel sesuai dengan konteks penelitian. Berdasarkan hasil scoping review dari 7 artikel mengenai lansia dan covid-19 didapatkan bahwa rata-rata usia lansia yang terserang COVID-19 adalah 72.43 dengan standard deviasi 4.1. Perempuan lebih banyak terserang yaitu sebanyak 241 responden (56.97%). Lansia merupakan kelompok rentan karena penurunan imunitas dan proses degenerative. Imunisasi bagi lansia dapat diberikan sebagai upaya pencegahan. Lansia rentan terserang berbagai penyakit, termasuk COVID-19. Sistem imun yang melemah ditambah adanya penyakit kronis dapat meningkatkan risiko covid-19 pada lansia. Dengan terjadinya proses degenerasi pada lansia, hal tersebut mendukung risiko terjadinya infeksi COVID-19 yang menimbulkan gangguan yang parah, bahkan kematian pada lansia.Kata kunci: Lansia, Covid-19.

Factors Influencing Health Workers’ Compliance with the WHO Intermittent Preventive Treatment for Malaria in Pregnancy Recommendations in the Northern Region, Ghana

Background Although IPTp-SP is a lifesaving WHO recommended preventive intervention for pregnant women in malaria-endemic regions, IPTp-SP uptake in the Northern region of Ghana is much lower than the sub-optimal national coverage level. Assessing the extent of health workers’ compliance and its associated factors will generate valuable pointers to be targeted at the program level. The study examined the factors influencing health workers’ compliance with the WHO recommended guidelines for IPTp-SP in the Northern Region. Methods A cross-sectional study among 315 health workers in the Northern region was conducted. Semi-structured questionnaires were used to collect data on health workers’ sociodemographic characteristics, facility-based factors and knowledge level. Data were collected on health workers’ compliance with the recommended practices through covert observations using a checklist. Facility observations were carried out using a checklist. Crude and adjusted logistic regression were used to determine predictors of health workers’ compliance, at 5% significance level adjusting for clustering. Results Of the 315 health workers studied, the median age was 29 years (26 – 34 years). Females constituted 252 (80.5%) of the 313 workers. The majority 148 (47.44%) of the 312 health workers were midwives. Overall, 56.2% (CI 51.0 – 62.0) were adequately complying with the recommended guidelines. Lower levels of compliance were recorded in health centers 15.6% (5.0 - 33.0) and CHPS compounds 21.2% (11.0 - 35.0). The factors associated with compliance included health workers’ knowledge (aOR = 7.64, 95% CI 4.21 - 13.87, p<0.001), job satisfaction (aOR 10.87, 95%CI 7.04 - 16.79, p<0.001), in-service training (aOR 10.11, 95%CI 4.53 - 22.56, p<0.001), supervision (aOR 4.01, 95%CI 2.09 - 7.68, p<0.001), availability of job aids (aOR 3.61, 95%CI 2.44 - 5.35, p<0.001), health workers experience (aOR = 10.64, 95% CI 5.99 - 18.91, p<0.001) and facility type (aOR 0.03, 95%CI 0.01 - 0.07, p<0.001). Conclusion Compliance with the recommended IPTp-SP guidelines is suboptimal in the region, with lower-level health facilities recording the least compliance levels. Health centers and CHPS facilities should be prioritized in distributing limited resources to improve health worker quality of care for antenatal care clients.

Molecular targets regulating endoplasmic reticulum-mitochondria crosstalk for NAFLD treatment

Non-alcoholic fatty liver disease (NAFLD) as the most common chronic liver disease poses a significant impact on public healthcare and economic risk worldwide. As a multifactorial disease, NAFLD is usually associated with many comorbidities such as obesity, insulin resistance, hypertension, hyperlipidemia, diabetes, and cardiovascular disease. Without effectively preventive intervention, the advanced stage of NAFLD, non-alcoholic steatohepatitis (NASH), can progress to cirrhosis and hepatocellular carcinoma (HCC). However, there is no approved therapeutic treatment. Excessive fat accumulation in the liver is the hallmark of NAFLD, which can lead to mitochondrial dysfunction and endoplasmic reticulum (ER) stress. Dysfunction of two organelles also induces the upregulation of reactive oxygen species (ROS), activation of the unfolded protein response (UPR), and disruption of calcium transport, which promote NAFLD progression. Herein, this review summarized the current understanding of the roles of mitochondrial dysfunction and ER stress in the pathogenesis of NAFLD. Specifically, this review focused on the key molecules associated with the ER-mitochondria communication and different treatment options by targeting ER stress and mitochondrial dysfunction to treat NAFLD or NASH. Clinical trials to evaluate the therapeutic efficacy of representative agents, such as natural products, metabolites, and modulators of stress, have been reviewed and analyzed. Overall, recent findings suggest that targeting ER stress and mitochondrial dysfunction holds a promise for NAFLD treatment.

Reducing suicide risk in parentally bereaved youth through promoting effective parenting: testing a developmental cascade model

Children who experience parental death are at increased risk for suicide. The Family Bereavement Program (FBP) is an upstream preventive intervention for parentally bereaved families that was found to reduce suicide risk in parentally bereaved youth up to 6 and 15 years later. We tested whether FBP-induced improvements in effective parenting led to changes in multiple proximal factors that prior theory and research implicated in the cascading pathway to suicide risk, namely, aversive self-views, caregiver connectedness, peer connectedness, complicated grief, depressive symptoms, and emotion suppression. The sample was 244 bereaved youth and their surviving caregiver from 156 families. Families were randomized into the FBP (12 group-based sessions for parents, youth, and two joint sessions) or a literature control condition. Multimethod and multiinformant data were collected at baseline, posttest, 6-year and 15-year follow-up assessments. Results showed that program-induced improvements in effective parenting at posttest were associated with reduced aversive self-views and increased caregiver connectedness at the 6-year follow-up, and each mediator was in turn associated with reduced suicide risk at the 6- and 15-year follow-up. The mediated pathways via aversive self-views remained significant while controlling for caregiver connectedness. Self-related concepts may be important targets in upstream suicide prevention for at-risk youth.