Year: 2023

Categories : NeurologyTags :

Review Re-evaluates Biomarker for Imaging Neuroinflammation

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Photo by Mart Production on Pexels

Neuroinflammation can lead to serious neurological or psychiatric diseases, for which there is presently one biomarker available for medical imaging to visualise cerebral inflammation. Trouble is, it has been unclear how to interpret this biomarker. Researchers have now found that a large quantity of this protein indicates a large quantity of inflammatory cells, but its presence is not a sign of their overactivation. These results, published in Nature Communications, pave the way for optimal observation of neuroinflammatory processes with other potential biomarkers, and a re-evaluation of prior research.

In the brain, microglial cells play an important role in inflammation and its potential overactivation. They can be ”activated” when dysfunction occurs, phagocytise pathological cells or proteins and even produce protective substances. Currently, in medical imaging, only one marker can be used to locate and measure microglia non-invasively and in vivo: the TSPO protein, which is present in these cells. This protein can be observed by Positron Emission Tomography (PET), a common imaging technique.

A TSPO of insight

”Hundreds of studies have used PET scans of this protein to explore and quantify microglia. However, no study has succeeded in precisely interpreting the significance of its quantity in the context of an inflammatory reaction,” explains Stergios Tsartsalis, senior clinical associate in the Department of Psychiatry at the UNIGE Faculty of Medicine. Together with other researchers, Stergios Tsartsalis sought to determine if a large quantity of TSPO correspond to a large quantity of inflammatory cells, and whether it is a sign of their overactivation.

The international research team worked on the brains of mouse models of Alzheimer’s disease, amyotrophic lateral sclerosis and multiple sclerosis, and on post-mortem brain samples from patients affected by the same diseases. ”We discovered that a high density of TSPO protein is indeed an indicator of a high density of microglia. On the other hand, the observation of TSPO does not allow us to say whether or not the inflammatory cells are overactivated,” explains the UNIGE researcher, co-first author of the study.

Re-reading the past, optimising the future

This discovery highlights the value of medical imaging of TSPO: it makes it possible to identify cases where the neuroinflammatory disease is linked to a deregulation in the number of glial cells. In addition, the scientists have identified two markers of the state of microglia activation in humans – the LCP2 and TFEC proteins – setting the stage for new medical imaging approaches.

”These results represent a further step towards understanding the role of microglia in neuroinflammation. They will help to optimise the focus of future studies and also to review the conclusions of previous research,” enthuses Stergios Tsartsalis.

Source: Université de Genève

Categories : Mental Health NeurologyTags :

We may now Know the Reason why SSRIs Take so Long to Kick in

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Source: CC0

Selective serotonin reuptake inhibitors (SSRIs) normally take a few weeks before any improvements manifest, but the reasons why it takes so long have remained unclear since their first introduction 50 years ago. Now, new research provides the first human evidence that this is due to physical changes in the brain, which leads to greater brain plasticity developing over the first few weeks of SSRI intake. This may also begin to explain one of the mechanisms of how antidepressants work.

This work is presented at the ECNP conference in Barcelona, and also has been accepted in a peer-reviewed journal.

Clinician have long been puzzled as to why SSRIs take a relatively long time before having an effect. Researchers in Copenhagen, Innsbruck, and University of Cambridge have undertaken a randomised, double-blind placebo-controlled study in a group of healthy volunteers which shows a gradual difference in how many nerve cell connections (synapses) the brain cells have between those taking the antidepressants and a control group, depending on how long the treatment lasts.

In the study, 17 volunteers were given a 20mg daily dose of the SSRI escitalopram, with 15 volunteers given a placebo. Between three and five weeks after starting the trial, their brains were scanned with a PET (Positron Emission Tomography) scanner, which showed the amount of synaptic vesicle glycoprotein 2A in the brain: this is an indicator of the presence of synapses, so the more of the protein is found in an area, the more synapses are present in that area (ie, greater synaptic density). These scans showed significant between-group differences in how the synapse density evolved over time.

Researcher Professor Gitte Knudsen (of Copenhagen University Hospital) said:

“We found that with those taking the SSRI, over time there was a gradual increase in synapses in the neocortex and the hippocampus of the brain, compared to those taking placebo. We did not see any effect in those taking placebo.”

The neocortex, which takes up around half of the brain’s volume, deals with higher functions, such as sensory perception, emotion, and cognition. The hippocampus, which is found deep in the brain, handles functions of memory and learning.

Professor Knudsen continued, “This points towards two main conclusions. Firstly, it indicates that SSRIs increase synaptic density in the brain areas critically involved in depression. This would go some way to indicating that the synaptic density in the brain may be involved in how these antidepressants function, which would give us a target for developing novel drugs against depression. The second point is that our data suggest that synapses build up over a period of weeks, which would explain why the effects of these drugs take time to kick in.

Commenting, Professor David Nutt (Imperial College, London) said “The delay in therapeutic action of antidepressants has been a puzzle to psychiatrists ever since they were first discerned over 50 years ago. So these new data in humans that uses cutting edge brain imaging to demonstrate an increase in brain connections developing over the period that the depression lifts are very exciting.  Also they provide more evidence enhancing serotonin function in the brain can have enduring health benefits.”

This is an independent comment, Professor Nutt was not involved in this work..

Source: EurekAlert!

Categories : Exercise Mental HealthTags :

Can Running Beat Antidepressants as a Treatment for Depression?

On By ModernMedia
Photo by Ketut Subiyanto on Pexels

The first study to compare effects of antidepressants with running exercises for anxiety, depression and overall health shows that they have about the same benefits for mental health, with health benefits for those assigned to running.

Professor Brenda Penninx from Vrije University, Amsterdam, presented the work at the ECNP conference in Barcelona (after recent publication in the Journal of Affective Disorders). Prof Penninx said, “We wanted to compare how exercise or antidepressants affect your general health, not just your mental health.”  

The 16-week course of running over the same period scores higher in terms of physical health improvement, whereas antidepressants lead to a slightly worse physical condition, as has been suggested by previous studies.  However, the drop-out rate was much higher in the group which initially chose exercise.

The researchers studied 141 patients with depression and/or anxiety. They were offered a choice of treatment; SSRI antidepressants for 16 weeks, or group-based running therapy for 16 weeks. 45 chose antidepressants, with 96 participating in running. The members of the group which chose antidepressants were slightly more depressed than the members of the group which chose to take running.

Professor Penninx said, “This study gave anxious and depressed people a real-life choice, medication or exercise. Interestingly, the majority opted for exercise, which led to the numbers in the running group being larger than in the medication group.”

Treatment with antidepressants required patients to adhere to their prescribed medication intake but this generally does not directly impact on daily behaviours. In contrast, exercise directly addresses the sedentary lifestyle often found in patients with depressive and anxiety disorders by encouraging persons to go outside, set personal goals, improve their fitness and participate in a group activity.  

The antidepressant group took the SSRI Escitalopram for 16 weeks. The running group aimed for two to three closely supervised 45-minute group sessions per week (over 16 weeks). The adherence to the protocol was lower in the running group (52%) than in the antidepressant group (82%), despite the initial preference for running over antidepressants.

At the end of the trial, around 44% % in both groups showed an improvement in depression and anxiety, however the running group also showed improvements in weight, waist circumference, blood pressure, and heart function, whereas the antidepressant group showed a tendency towards a slight deterioration in these metabolic markers.

“Both interventions helped with the depression to around the same extent. Antidepressants generally had worse impact on body weight, heart rate variability and blood pressure, whereas running therapy led to improved effect on general fitness and heart rate for instance. We are currently looking in more detail for effects on biological aging and processes of inflammation’,” Prox Benninix said.

Physical activity is a good option, but antidepressants still have a role

Prof Benninx noted that it is not a case of one or the other when it comes to treating depression. “It is important to say that there is room for both therapies in care for depression. The study shows that lots of people like the idea of exercising, but it can be difficult to carry this through, even though the benefits are significant. We found that most people are compliant in taking antidepressants, whereas around half of the running group adhered to the two-times-a-week exercise therapy. Telling patients to go run is not enough. Changing physical activity behaviour will require adequate supervision and encouragement as we did by implementing exercise therapy in a mental health care institution.”

She added: “Antidepressants are generally safe and effective. They work for most people. We know that not treating depression at all leads to worse outcomes; so antidepressants are generally a good choice. Nevertheless, we need to extend our treatment arsenal as not all patients respond to antidepressants or are willing to take them. Our results suggest that implementing exercise therapy is something we should take much more seriously, as it could be a good – and maybe even better – choice for some of our patients.  

“In addition, let’s also face potential side effects our treatments can have. Doctors should be aware of the dysregulation in nervous system activity that certain antidepressants can cause, especially in patients who already have heart problems. This also provides an argument to seriously consider tapering and discontinuing antidepressants when depressed or anxious episodes have remitted. In the end, patients are only truly helped when we are improving their mental health without unnecessarily worsening their physical health.”

Source: EurekAlert!

Categories : COVID Diseases, Syndromes and ConditionsTags :

Not Just ‘Long COVID’: Researchers Find ‘Long Colds’

On By ModernMedia
Photo by Kelly Sikkema on Unsplash

A new study from Queen Mary University of London, published in The Lancet’s EClinicalMedicine, has found that people may experience long-term symptoms, termed ‘long colds’, after non-COVID acute respiratory infections.

The ‘long cold’s’ most common symptoms included coughing, stomach pain, and diarrhoea more than four weeks after the initial infection. While the severity of an illness appears to be a key driver of risk of long-term symptoms, just why some people suffer extended symptoms while others do not is a focus of further research.

The findings suggest that there may be long-lasting health impacts following non-COVID acute respiratory infections such as colds, influenza, or pneumonia, that are currently going unrecognised. However, the researchers do not yet have evidence suggesting that the symptoms have the same severity or duration as long COVID.

The research compared the prevalence and severity of long-term symptoms after an episode of COVID versus an episode of another acute respiratory infection that tested negative for COVID. Those recovering from COVID were more likely to experience light-headedness or dizziness and problems with taste and smell compared to those who had a non-COVID respiratory infection.

While long COVID is now a recognised condition, there have been few studies comparing long-term symptoms following SARS-CoV-2 coronavirus infection versus other respiratory infections.

The study is the latest output from COVIDENCE UK, Queen Mary University of London’s national study of COVID, launched back in 2020 and still in follow-up, with over 19 000 participants enrolled. This study analysed data from 10 171 UK adults, with responses collected via questionnaires and statistical analysis carried out to identify symptom clusters.

Giulia Vivaldi, researcher on COVIDENCE UK from Queen Mary University of London and the lead author of the study, said: “Our findings shine a light not only on the impact of long COVID on people’s lives, but also other respiratory infections. A lack of awareness – or even the lack of a common term – prevents both reporting and diagnosis of these conditions.

“As research into long COVID continues, we need to take the opportunity to investigate and consider the lasting effects of other acute respiratory infections.

“These ‘long’ infections are so difficult to diagnose and treat primarily because of a lack of diagnostic tests and there being so many possible symptoms. There have been more than 200 investigated for long COVID alone.”

Source: Queen Mary University of London

Categories : Cancer PaediatricsTags :

Cannabis for Children’s Cancer Symptoms Lacks Hard Evidence

On By ModernMedia
Credit: National Cancer Institute

For the management of children’s cancer symptoms, cannabis products have increased in popularity, but questions remain over their efficacy and safety. A recent review of published studies to date shows a lack of evidence to determine the dosing, safety, and efficacy of medical marijuana or cannabis-containing products for managing symptoms experienced by children with cancer. The analysis is published online in CANCER, a peer-reviewed journal of the American Cancer Society.

Although great strides have been made in treatments for childhood cancer, even leading to cures for many patients, many children still suffer from symptoms such as pain, anxiety, and weight loss related to cancer and its treatment. Over the last decade, cannabis products, both synthetic cannabinoids and natural phytocannabinoids, have gained popularity with patients and families for managing such symptoms, but paediatric oncologists are cautious to authorise cannabis for their patients given the limited data to inform dosing, product selection, and safety monitoring.

To provide insights for clinicians and parents, and to inform an upcoming clinical trial, a team led by Lauren E. Kelly, PhD, associate professor of pharmacology and therapeutics in the Rady Faculty of Health Sciences at the University of Manitoba, searched the medical literature to summarise existing knowledge about the potential benefits and harms of cannabis products in children with cancer.

The investigators identified 19 unique studies with a total of 1927 participants with cancer: eight retrospective chart reviews, seven randomised controlled trials, two open‐label studies, and two case reports. The products studied included medical-grade cannabinoids (such as the prescription drug nabilone), synthetic cannabinoids, and unspecified cannabis herbal extracts. Products were most commonly used to manage chemotherapy‐induced nausea and vomiting.

In the randomised controlled trials, patients who used cannabinoids were more likely to experience drowsiness, feeling high, dizziness, and dry mouth. Also, trial participants who received cannabinoids were almost four times more likely to drop from the study due to adverse events, compared with the control group who received placebo. Across all included studies, no serious cannabis‐related adverse events were reported.

Dr Kelly and her colleagues noted that most studies did not adequately describe the types, dosing, frequencies, and routes of administration of cannabis products, and outcomes were mixed and were reported in different ways. Therefore, researchers should develop standards for reporting cannabis exposures, cannabis‐related effects, and patient outcomes.

“It was difficult to measure benefit across studies, given a range of different outcomes and study designs; however, in interventional studies with active control groups, cannabinoids performed better in managing nausea and vomiting. Data are lacking on cannabinoids’ effects on pain, mood, sleep, and health-related quality of life,” said Dr Kelly. “Given that some children report benefits and some children experience adverse events, it is critical that more rigorous studies evaluating the effects of cannabinoids on children with cancer are conducted and shared with parents, patients, and the health care community.”

This literature review informed the design of a three-arm tolerability trial later this year.

Source: Wiley

Categories : Medical Research & Technology Mental HealthTags :

Wearable Device may Detect Skin Electrical Impulses Associated with Mood Changes in Bipolar Disorder

On By ModernMedia

Researchers have used wearable technology to measure electrical impulses in the skin and other physiological biomarkers possibly linked to mood changes in bipolar disorder. Though at an early stage, they hope their work will be able to build on these patterns to detect mood swings in bipolar disorder sufferers, so helping in diagnosis and potentially offering more rapid and personalised treatments. They presented their research at the 36th ECNP Congress in Barcelona, and more information is available on GitHub.

Bipolar disorder (formerly called manic-depressive illness or manic depression) is a mental illness that causes swings in a person’s mood, energy, activity levels, and concentration. These shifts can make it difficult to carry out day-to-day tasks and can make interactions with other people difficult. The degree of mood swing can vary from person to person, from feeling manic (very “up”) to feeling depressed. At present, these mood swings are mostly diagnosed subjectively, through interview with doctors or by questionnaires. This takes time, and requires an immediate medical presence.

Now a group of Barcelona-based psychiatrists, in collaboration with data scientist in Edinburgh, have used a research grade wearable device to continuously collect several physiological biomarkers during the diverse phases and episodes of bipolar disorder. Among the collected physiological biomarkers is electrodermal activity which uses changes in the skin’s electrical conductivity to indicate the level of stress through the reactivity of the nervous system. This is a potential immediate indicator of whether someone is in a manic, depressive or in a normal mood state.

They recruited 38 patients with bipolar disorder, and 19 healthy controls, all from the Barcelona area.

Researcher Diego Hidalgo-Mazzei said “Each participant was fitted with a commercially available Empatica E4 bracelet, which they were asked to wear for around 48 hours. This can measure a variety of physiological changes, but we were most interested in measuring small electrophysiological changes in the skin of the wearer. We found that bipolar disorder patients in their depressed phase had on average a significantly lower skin electrical activity than the rest of the bipolar group or the healthy control group. We also found that as an individual moved from manic to depressive state (or vice versa), this was detectable by a change in skin surface electrical activity.

“It is important for the patient and doctor to know how and when these mood fluctuations take place. It is important also to highlight that the treatment is different for manic or depressive states. This can help with a prompt diagnosis and early personalized treatment, but it can also help in preventing adverse outcomes, for example in alerting to an increased risk of suicide, or of mood swings which may lead to dangers with activities such as driving. It is also easier to treat patients if we know if they are in a manic phase or a depressed phase. Until now, these mood swings have mostly been diagnosed subjectively, through interview with doctors or by questionnaires, and this had led to real difficulties. Arriving at the correct drug is difficult, with only around 30 to 40% of treated individuals having the expected response. We hope that the additional information these systems can provide will give us greater certainty in treating patients.

“We are still some way from that though. This is an exploratory observational study, so we need to look at a larger sample and use machine learning to analyse all the biomarkers collected by the wearers to confirm the findings to determine patterns which might indicate a specific episode. This may not be ideal for every bipolar disorder sufferer, in every circumstance, but a potential pattern may help in the future the people hardest hit by the mood changes which affect their lives”.

For information on the wearable device see https://e4.empatica.com/e4-wristband

Source: EurekAlert!

Categories : General Interest Obstetrics & GynaecologyTags :

Interview: A Simple Device Used after Birth can Help Save Lives, Says Award-winning Young Innovator

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Last month, she won the Mandela Rhodes Foundation’s award for social impact in Africa for a device that can help save the lives of women who suffer excessive bleeding after child birth. PHOTO: Nasief Manie/Spotlight

By Biénne Huisman for Spotlight

As a child growing up in the Ugandan capital of Kampala, Maureen Etuket used a screwdriver to dismantle electronic appliances and toy trucks. “I was around eight, nine years old,” she says. “I guess it just excited me.”

Slightly over a decade later, this curiosity is driving her quest to find solutions to public healthcare challenges.

Last month, Etuket’s Smart PVD device [Postpartum Haemorrhage Volumetric Drape] won the Mandela Rhodes Foundation’s award for social impact in Africa – the 2023 Äänit Prize – with a cash grant of $38 000. At the awards ceremony in Cape Town, judges described the device as “a brilliantly practical intervention that can immediately and directly improve outcomes for patients”.

Inside the Anatomy Building on the University of Cape Town (UCT)’s Health Sciences campus, Etuket explains that she and her team devised a prototype after spending three months in maternity wards at Kawempe National Referral Hospital in Kampala.

“We went almost every day. We had day shifts and night shifts,” she recalls. “I started asking the question to nurses and midwives, how do you know that a woman is likely to get to PPH?” PPH or post-partum haemorrhage is excessive bleeding after a baby’s birth, which could cause a severe drop in blood pressure leading to shock and death if not treated.

“Like, how do you tell? What criteria do you use? And the nurses told me that they had been doing this for a long time. They said they just observe and know. And I thought to myself, if that was working, we would have [fewer] women dying from PPH.”

How does the Smart PVD device work?

“There’s something already on the market – an under-buttock drape bag attached to the bed while a woman is giving birth, which measures amount of blood loss,” says Etuket. “[It’s] basically a bag where the blood flows into. We then created an electronic module that has a probe and a buzzer, which we put inside this bag, and it gives a beeping sound when the blood has reached a certain level. This alarm alerts a midwife to recognise the need to attend to a particular case. So the blood collection module is disposable. And the electronic module, which has the probe and the buzzer, is reusable.”

Etuket declines to share pictures, citing intellectual property rights.

“I really think that this is one of the simplest innovations,” she says. “We’ve been pitching it and talking about it, and everyone that listens is just like it’s common sense, right?” Apart from the Äänit Prize, they have received $16 000 from the Makerere University’s research and innovations fund and $55 000 from the science and technology secretariat in Uganda.

Moving to Cape Town

Etuket moved to Cape Town in 2021, courtesy of a Mandela Rhodes Foundation scholarship. “I applied for a Masters in health innovation at UCT under the Mandela Rhodes Foundation. So, I’m Christian. I believe in the hand of God in everything I do. I made just that one application. Like, there were options to put three universities, three courses, all that. I just wanted health innovation at UCT, and I got it.”

Her Masters supervisor was Professor Sudesh Sivarasu, internationally renowned for medical device innovation and head of UCT’s MedTech laboratory.

“There were so many questions we had at Pumzi Devices about how to transition an innovation to the market and no one really had the answers because it’s a new space. At a certain point, some of us had to travel to Scotland just to sit with experts to guide us through a protocol design process. No one in Uganda really had a clear picture of [this] so that’s what prompted me to do the Masters in health innovation,” says Etuket.

Find your purpose

Presently, she is pursuing a PhD in industrial engineering at Stellenbosch University under the supervision of Professor Sara Grobbelaar and Dr Faatiema Salie. Yet she spends most of her time at UCT, where Sivarasu is her external co-supervisor. Etuket’s PhD’s working title is “Exploring the development of a localisation roadmap for medical devices in South Africa using an Innovation Systems Framework”. She explains that this line of study – systems engineering – is drawing her thinking wider to understand the systems around biomedical design and innovation.

Going forward, Etuket will continue to lecture students back home in Uganda – online – while being open to further her learning and practice where it is apt or required around the world.

At 28 years old, Etuket’s drive and achievements make her a role model for many. However, she is reluctant to wear the label of “a pioneering young black woman,” voicing caution over mantels based on race and gender. “I notice that when we start to have those mindsets, we may end up trampling on people, on men. We have to work together. There is room for all of us,” she says.

The first born of four siblings, Etuket’s father was a computer engineer and her mother an accountant and businesswoman. Elaborating on leadership, she says, “I think it’s important to pray for people. That’s where we get guidance on how to lead. I tell people, not everyone should do a PhD, maybe not everyone should do a Masters, but find your purpose and fulfil it.”

Republished from Spotlight under a Creative Commons 4.0 Licence.

Source: Spotlight

Categories : Medical Industry Mental HealthTags :

Rollout of Coaching Programme Reduces Burnout in Medical Residents

On By ModernMedia
Photo by SJ Objio on Unsplash

Researchers found that a national level programme to reduce burnout levels, which disproportionately affects women, was even more successful than its pilot programme two years prior. They published their findings in the journal JAMA Network Open.

“We did a pilot programme in 2021 to see if it would work and it did,” said study co-author Tyra Fainstad, MD, associate professor at the University of Colorado School of Medicine. “Then we expanded it to 26 graduate medical institutions in 19 states. There were 1017 participants. We saw significant improvement in every wellbeing outcome we assessed including all three subscales involved in burnout.”

Burnout within the health care community is a national epidemic disproportionally affecting women. Last year, the US Surgeon General declared it a `crisis’ deserving ‘bold, fundamental change’ though little was known about scalable, effective solutions to the problem.

Women are hit harder by burnout for reasons that include bias and sexism at work, pay disparities as well as a disproportionate burden of home management and child/elder care, the researchers said.

Fainstad and co-author Adrienne Mann, MD, both faculty in the CU Department of Medicine, created the web-based Better Together Physician Coaching Program at CU Anschutz with the goal of reducing that burnout. Then they replicated it to a national level and published their findings.

While the pilot programme saw improvements in `imposter syndrome’ (feeling as if you ‘don’t really belong in the job’) and self-compassion, the expanded national study also showed significant improvements in outcomes across the board including moral injury and flourishing, offering actual evidence that the program works.

“Physician trainees who received online group coaching over four months had substantial reductions in multiple dimensions of professional distress (burnout, moral injury and imposter syndrome) and improvements in well-being (self-compassion and flourishing),” said Mann.

Mann and Fainstad are both certified life coaches. Better Together is owned and operated by the University of Colorado. It’s not a business, they said, and they don’t personally profit financially from it. The program is available to any heath care institution, school of medicine, department, or residency program wishing to meaningfully support the wellbeing of their clinicians and trainees.

Better Together is web-based. Participants take part in two videoconferencing coaching calls per week where up to five people can be coached live on any topic with an unlimited audience. Calls are recorded for later listening on a private podcast.

Participants can also access unlimited, anonymous written coaching in a forum by submitting a narrative reflection and receive a coach’s response published to Better Together’s secure, members-only website. There are also weekly self-study sessions using videos and worksheets. They focus on topics pertinent to the physician lifestyle such as goal setting, cultivating a growth mindset, receiving critical feedback, imposter syndrome and perfectionism.

The researchers use the Maslach Burnout Inventory (MBI) to measure their work. The MBI has three subscales: emotional exhaustion (EE) or feeling emotionally exhausted from work; Depersonalisation (DP), detached and impersonal treatment of patients; Professional accomplishment (PA), beliefs around competence and success at work.

The EE score is a key construct in health care related burnout. A one point increase in the EE scale has been associated with a 7% increase in suicidal ideation and a 5-6% increase in major medical errors.

The researchers said a reduced mean EE score among those that took part in the training and an increased EE score in those that did not.

“From what we see in this study, coaching helps in every aspect of burnout,” Fainstad said. “The multi-modal nature of our program is unique. You can interact in many ways. That partially explains the powerful impact -that and the group nature of our coaching.”

Mann said the majority are watching others being coached and share in the experience.

“That is deeply connecting. They try to see themselves in someone else’s story,” she said. “When someone is on a view screen you have compassion and empathy for them and, by extension, learn to practice compassion and empathy for yourself.”

While few strategies to address burnout have shown much overall effect, Fainstad said this study demonstrates that group coaching works.

“We’re now showing that we have an actual evidence-based answer to burnout,” she said.

Fainstad and Mann said burnout is a product of the current, often toxic, medical culture pervading every aspect of the profession.

“Culture is a belief system,” Fainstad said. “And while structural changes are absolutely necessary to fix our medical system, working with individuals who have been harmed along the way will be imperative to healing.”

Mann suggested a step towards healing the culture would be making coaching programs like Better Together accessible to everyone – not necessarily mandatory but at least made available by institutions.

“There are other coaching programs in this space but this one is rigorously evidence-based. We studied it,” Mann said. “There are no downsides. It helps in all aspects of burnout.”

Source: University of Colorado Anschutz Medical Campus

Categories : VaccinesTags :

Vaccine Acceptance is Sometimes Influenced in Unexpected Ways

On By ModernMedia
Photo by Mika Baumeister on Unsplash

Using simulations, researchers at Vanderbilt University have uncovered new insights into vaccine hesitancy have shown that external factors such as vaccine mandates and availability have varied and sometimes contradictory influences on people’s willingness to get vaccinated. The research was published in the journal PLOS Global Public Health, and the simulations are available to be reviewed on GitHub.

Building on a new mathematical model that represents vaccine hesitancy as a belief that can influence whether parents vaccinate their children, Nicole Creanza, assistant professor of biological sciences, and postdoctoral scholar Kerri-Ann Anderson extended their work to include the effect of external factors that affect vaccine availability, such as vaccine mandates and vaccine inaccessibility.

“Instead of modelling vaccine mandates and inaccessibility as a physical driver or barrier to vaccination, respectively, we considered their effects from a cultural perspective,” Anderson said. “We model the effects of these external factors by considering how beliefs interact with them to shape vaccination behaviours. Our data shows that a vaccine mandate has a lesser consequence on a person’s motivation to vaccinate if they already had very positive feelings about vaccines.”

The findings also demonstrate that when large groups trust vaccines, they usually get vaccinated. But if there aren’t enough vaccines, even those who trust them might not get them. In addition, when vaccine mandates are in place, it can seem like everyone is getting vaccinated. But more people than researchers expected might still be unsure about vaccines and not get them.

“We hope that our research emphasises how important it is to not generalise populations based on a single characteristic or assume populations behave similarly or beliefs have similar influences across varying circumstances,” Anderson said.

“This research provides a better understanding of how public health policies could interact with cultural dynamics to bring about unexpected outcomes,” Creanza said. The research was funded by the John Templeton Foundation, and both researchers are members of the Evolutionary Studies Initiative.

Next, Creanza and Anderson aim to make a model to explore how people respond when a new vaccine (eg for COVID), is introduced. When a novel vaccine is initially introduced, people tend to exhibit more unpredictable behaviour, even those who have confidence in established vaccines, Creanza said.

Source: Vanderbilt University

Categories : COVID Pain ManagementTags :

Does COVID Infection or Vaccination Worsen Migraines?

On By ModernMedia
Photo by Usman Yousaf on Unsplash

Headaches are a frequent complaint of those with a COVID infection, or have received a COVID vaccination, and it is thought that it may subsequently increase the frequency of migraines. To put this to the test, an observational study published in the European Journal of Neurology investigated the effects on migraine frequency of having had either been infected with COVID or having received a COVID vaccination.

Among 550 adults who had received migraine-related care at a Spanish headache clinic, 44.9% (247) reported COVID at least once and 83.3% (458) had been vaccinated; 61 patients (24.7%) reported migraine worsening since COVID and 52 (11.4%) since vaccination.

In participants who perceived that their migraines worsened, those who had been infected were 2.5-times more likely to be concerned about migraine worsening and patients who had been vaccinated were 17.3-times more likely to have this concern.

When investigators examined patients’ e-diary information, they observed no significant difference in headache frequency one month before and after infection or vaccination, even when comparing patients with and without self-reported migraine worsening.

“In the case of COVID-19, we reported previously that indeed headache is a frequent and disabling symptom of the infection; yet, it may not necessarily be linked to an increase in migraine frequency,” the authors wrote. “In light of our results, we believe that clinicians should deliver to patients a more reassuring message that COVID-19 and COVID-19 vaccines may marginally affect migraine course and that probably the impact of the infection and vaccines is less than the individual rhythmicity to have attacks. This information may help minimise their worry.”

Source: Wiley