Adverse Childhood Experiences Are Associated with Reduced Psychological Resilience in Youth: A Systematic Review and Meta-Analysis

Background: Adverse childhood experiences (ACEs) are presumed to influence internalizing and externalizing behaviors that can significantly debilitate long-term biopsychological development in individuals. Psychological resilience has been shown to effectively mediate the relationship between ACEs and negative health outcomes since individuals with low levels of resilience may have difficulty with bouncing back from toxic exposure to ACEs. Thus, the present systematic review and meta-analysis was aimed toward synthesizing current knowledge of the relationship between ACEs and psychological resilience in youths. Methods: A combination of key words relevant to the present study was searched on the PubMed, EMBASE, Scopus, Cochrane, and Google Scholar databases. The results were restricted to English publications and human studies, with subjects ranging between the age of 0 to 35 years. Effect-size measures inclusive of pooled correlation coefficients for correlation analyses and pooled odds ratios for regression analyses, respectively, were calculated using random-effect models to determine the relationship between ACEs and psychological resilience. Results: The searches identified 85 potentially relevant studies. Among them, 76 were excluded due to limited access, irrelevant data, and the fact that the variables of interest were not explicitly measured or disclosed, leaving a final total of nine studies considered valid for the meta-analysis. Findings from correlational meta-analysis (n = 6) revealed a significantly negative association between ACEs and resilience (β = −0.120 [−0.196, −0.043]). The meta-analysis of the studies (n = 3) reporting dichotomous outcomes (ACE ≥ 1 vs. no ACE) indicated that subjects who experienced an ACE were 63% less likely to display high resilience, in comparison to subjects without such experiences. Conclusion: Our results support a negative association between ACEs and psychological resilience and highlight the multiple dimensions that constitute resilience in an ACE-exposure context. These findings may be particularly useful to policy makers and healthcare institutions in terms of helping them devise effective medical interventions and community outreach programs intended to develop resilience in youths, thus reducing health-risk behaviors and negative health outcomes.

Critique of the Royal Australian and New Zealand College of Psychiatrists Psychedelic Therapy Clinical Memorandum, Dated May 2020

Objective: The Royal Australian and New Zealand College of Psychiatrists (RANZCP) has positioned itself against medically controlled patient access (at this current time) to 3,4-methylenedioxymethamphetamine (MDMA) and psilocybin-assisted therapies in its Therapeutic Use of Psychedelic Substances Clinical Memorandum, May 2020. The main reason given by the RANZCP for its stance is safety concerns. Methods: Every reference in the clinical memorandum (CM) was checked against the original publications used by RANZCP to justify its position. In addition, the search engines Google Scholar, PubMed, ScienceDirect, the Multidisciplinary Association for Psychedelic Therapies (MAPS) website, the Therapeutic Goods Administration (TGA) website, relevant Australian and New Zealand legislation were searched for pertinent and up-to-date- information. Results: There is no scientific or medical evidence from the last 70 years to suggest that either psilocybin or MDMA, when administered as an adjutant to therapy in a controlled clinical setting, are linked to either mental illness or negative health outcomes. On the contrary, MDMA and psilocybin have been shown to be safe, non-toxic, non-addictive, and efficacious when administered in a medically-controlled clinical environment. All associated risks are apparent in an uncontrolled setting. Conclusion: The RANZCP’s position is based on outdated, irrelevant, misinterpreted, and misinformed evidence. With the recent positive media coverage of the efficacy of these medicines when used as an adjunct to therapy, there is an intrinsic risk of self-medication or underground therapy. This means that any medical discussion must also purvey the ethical responsibilities and social duties associated with these substances.

Cognitive Frailty: An Update

This review article provides an update of the empirical research on cognitive fragility conducted in the last four years. The studies retrieved were classified in four different categories. The first category includes articles relating cognitive frailty to cognitive reserve and which continue to highlight the importance of educational level. The second category includes recent research on cognitive fragility biomarkers, involving neuroimaging, metabolism and, in a novel way, microbiota. The third category includes research on how cognitive frailty is related to motor development and physical functioning, exploring e.g. the use of technology to study motor markers of cognitive frailty. Finally, in the fourth category, research clarifying the difference between reversible frailty and potentially reversible cognitive frailty has led to new interventions aimed at reducing cognitive frailty and preventing negative health outcomes. Interventions based on physical activity and multicomponent interventions are particularly emphasized. In addition, recent research explores the long-term effects of dual interventions in older adults living in nursing homes. In summary, research on cognitive frailty has increased in recent years, and applied aspects have gained importance.

Evaluation of the impact of pre- and post-harvest maize handling practices on mycotoxin contamination on smallholder farms in Guatemala

Mycotoxins are secondary metabolites produced by fungi including Aspergillus and Fusarium that commonly contaminate crops, such as maize, resulting in economic losses and food insecurity. Mycotoxins can contaminate crops during pre- and post-harvest stages. Consumption of mycotoxin-contaminated foods has been linked to a variety of negative health outcomes including liver cancer, stunting, and neural tube defects. In countries such as Guatemala where maize constitutes a major portion of the diet, mycotoxins can be a significant contributor to disease burden. This review describes maize pre- and post-harvest practices in Guatemala that can lead to the development of mycotoxins and subsequent exposure to humans and animals, current information gaps, and opportunities for future research. There are specific challenges to minimising fungal growth and subsequent mycotoxin production during storage of maize in Guatemala, including reducing moisture content, minimising pest damage, and controlling temperature. Research on maize-handling practices that are associated with the greatest mycotoxin exposure in Guatemala is needed to prioritise allocation of resources and reduce exposure.

Evaluation and Treatment of Post-Extubation Dysphagia: The Importance of the Speech Pathologist in the Intensive Care Unit

Purpose: Post-extubation dysphagia is associated with negative health outcomes including pneumonia, prolonged hospital stay, in-hospital mortality, and inability to discharge home. The purpose of this review article is to summarize published research on screening, evaluating, and treating post-extubation dysphagia. Method: Review of published literature on post-extubation dysphagia to shape best practice guidelines for speech pathologists. Results: Current research on post-extubation dysphagia focuses heavily on screening and evaluation. There are limited data on targeted treatment methods for post-extubation dysphagia. Conclusions: Speech pathologists play a critical role in helping patients safely return to oral alimentation following prolonged endotracheal intubation. Speech pathologists should use the available research to shape best practice guidelines within their facility for who, when, and how to evaluate for dysphagia following extubation.

Negative Clusters Associated With Cannabis Use: Tangled Up in Blues

Previous studies concerning older adults have focused on whether cannabis use leads to positive or negative outcomes. In this study, we identified clusters of negative health outcomes associated with medical cannabis use. In total, we examined eight health outcomes: pain, sleep, falls, memory, digestive issues, mental health conditions, exercise, and general productivity reported by 2,968 persons over 60 who participated in the Illinois Medical Cannabis Program. We used association analysis to simultaneously identify groups of negative outcomes reported by participants. The distribution of non-positive outcomes shows a bell-shaped curve: 1.4% of participants responded that cannabis use improved all outcomes, while 4.1% of participants answered that cannabis use did not. When looking at negative outcomes, 86% of participants reported none worsened, and 11% reported one of the outcomes was affected. Only a small fraction of the participants (3%) claimed more than one negative outcomes after cannabis use.

A Public Health Analysis of the Relationship Between Loneliness, Isolation, and Dementia

Loneliness and isolation are now characterised as major public health problems largely because of reported associations with negative health outcomes including dementia. We adopt a public health perspective and review the relationship between loneliness/isolation and dementia focussing on how these concepts are defined, measured, and reported. We identified community based longitudinal studies which measured loneliness/isolation at baseline and dementia at follow up (minimum 12 months) published up to February 2021. We identified 12 papers for loneliness and 15 for isolation which demonstrated substantial heterogeneity in how exposure (loneliness/ isolation) and outcome (dementia) were measured and reported. For example, dementia was measured in 5 different ways: death, hospitalisation, clinical diagnosis, dementia screening tools or cognitive function. Evidence to support a relationship between loneliness/isolation and dementia is inconclusive largely because of this methodological heterogeneity. Using consistent exposure and outcome measures is a prerequisite for determining the health consequences of loneliness and isolation.

Association of GrimAge DNA methylation components and 2-year mortality in the Health and Retirement Study

DNA methylation (DNAm) patterns related to age and aging phenotypes (i.e., epigenetic clocks) are of growing interest as indicators of biological age and risk of negative health outcomes. We investigated associations between the components of GrimAge, an epigenetic clock estimated from DNAm patterns for seven blood protein levels and smoking pack years, and 2-year mortality in the Health and Retirement Study (HRS) to determine if any of the DNAm subcomponents were driving observed associations. A representative subsample of individuals who participated in the HRS 2016 Venus Blood Study were included in this analysis (N=3430). DNAm was measured with the Infinium Methylation EPIC BeadChip. Deaths that occurred between 2016 and 2018 contributed to 2-year mortality estimates (N=159, 4.5% of the sample). Weighted logistic regression estimated the association first between GrimAge and 2-year mortality and second between the DNAm subcomponents and 2-year mortality. All models were adjusted for age, sex, race/ethnicity, education, current smoking status, smoking pack years and cell composition of the biological sample. The average GrimAge for participants with and without 2-year mortality was 77 years 68 years respectively. A one-year increase in GrimAge was associated with 17% higher odds of 2-year mortality (95% CI: 1.16, 1.17). Two of the seven DNAm blood protein subcomponents of GrimAge (TIMP metallopeptidase inhibitor 1, adrenomedullin) and DNAm smoking pack years were associated with 2-year mortality and DNAm smoking pack years appeared to drive the overall GrimAge association with 2-year mortality. GrimAge was a better predictor of 2-year mortality than the DNAm subcomponents individually.

Doing Time: Experiences of Care Home Residents in Germany During the Early Phase of the COVID-19 Pandemic

Residents of care homes across the globe are affected by the spread of SARS-CoV-2 as they have been identified as a high-risk group and because they experienced strict social isolation regulations during the first wave of the pandemic. Social isolation of frail older people is strongly associated with negative health outcomes. The aim of this research project was to investigate how residents in care homes experienced social isolation during the first phases of contact ban in Germany. This paper draws on structured interview data collected from 22 residents in two care homes during early June 2020 in Frankfurt/Main. The findings show that their experiences were shaped by three factors: care home staffs’ approach to handling the contact ban; biographical sense of resilience; and a hierarchy of life issues. The findings highlight the importance of locally specific response mechanisms in care homes, and the need to contextualize residents’ experiences.

Association between smell and taste dysfunction and obesity and metabolic syndrome in older adults

Background: Obesity and metabolic syndrome (MS) are prevalent and associated with negative health outcomes in the elderly. There is a need to identify risk factors for these diseases in this population. Methodology: The 2013-14 National Health and Nutrition Examination Survey was used in this study. Adults aged 60 or under were categorized into normosmia, hyposmia, anosmia, and combined anosmia + hyposmia using the Pocket Sniff Test. Taste was evaluated using quinine and NaCl solutions. Multivariate logistic regression models were used to characterize associations between smell and taste status and obesity and MS. Results: In univariate obesity analysis, normosmia, combined anosmia + hyposmia, and 0.32M NaCl taste dysfunction were significant. 0.32M NaCl taste dysfunction remained significant in multivariate analysis. MS was significantly associated with only tongue tip quinine dysfunction in univariate and multivariate analyses. Conclusions: Salty taste dysfunction was found to be negatively associated with obesity while bitter taste dysfunction was found to be positively associated with MS.