Negative Outcomes Research Articles

COPD associated pulmonary hypertension: A post hoc analysis of the PERFECT study.

The PERFECT study, a randomized, controlled, double-blind study of inhaled treprostinil in patients with COPD and associated pulmonary hypertension (PH-COPD) was a negative trial that was terminated early. The reason(s) for the negative outcome remains uncertain. A post hoc analysis of data from the PERFECT study was undertaken to identify adverse responders and possibly potential responders. The goal was also to provide insight into phenotypes for possible inclusion and exclusion in future PH-COPD clinical trials. An adverse response on active treatment was seen in 36.4% (24/66) of the subjects compared to 27.6% (16/58) on placebo. There was no evidence to suggest that hyperinflation, bronchospasm, or occult heart failure played any role in the untoward outcomes of the study. The patients who died during the study all had baseline diffusing capacity for carbon monoxide ≤25% of predicted. Evidence of a potential response was seen in 10.6% (7/66) of the patients who received inhaled treprostinil. Patients who had evidence of a treatment response had a baseline mean pulmonary artery pressure of ≥40 mmHg and a forced expiratory volume in the first second of ≥40%. Change in N-terminal prohormone of brain natriuretic peptide did not predict clinical response. This post hoc analysis provides information that may potentially enable improved selection of patients for future therapeutic trials in PH-COPD. These analyses are post hoc, observational, and exploratory. The thresholds defining the spectrum of responders are preliminary and may require further refinement and validation in future studies.

Effectiveness of psychological interventions for carers of patients with severe mental illness (SMI): a systematic review

ObjectivesInterventions for carers of patients with severe mental illness (SMI) are effective in improving patient outcomes. This review examined the effectiveness of psychological interventions or support designed to help carers...

Dual burden of sarcopenia and impaired oral status on activities of daily living, cognition and swallowing outcomes in post-stroke patients

Background and aimsSarcopenia and poor oral health are common in older patients and are associated with negative outcomes. However, evidence of their combined impact on post-stroke rehabilitation outcomes is limited. This study aimed to investigate the combined impact of sarcopenia and impaired oral health on activities of daily living (ADL), cognition, and swallowing outcomes in post-stroke patients. MethodsA retrospective cohort study was conducted using 1,012 post-stroke patients (median age 75.6 years; 54.1 % men). Sarcopenia was diagnosed using the Asian Working Group for Sarcopenia 2019 criteria. Poor oral health was assessed using the Revised Oral Assessment Guide (ROAG) with a score ≥13 indicating impaired oral status. Functional outcomes were measured using the Functional Independence Measure (FIM) for ADL and cognition, and the Food Intake Level Scale (FILS) for swallowing status. ResultsThe prevalence of sarcopenia was 45.6 % (492/1,080), impaired oral health was 27.5 % (297/1,080), and the coexistence of both conditions was 12.0 % (130/1,080). The coexistence of sarcopenia and impaired oral health was associated with poorer outcomes compared to either condition alone. After adjusting for confounders, the combination of sarcopenia and impaired oral status showed the strongest negative impact on FIM-motor (B=-8.666, 95 % CI -11.484 to -5.847), FIM-cognition (B=-1.122, 95 % CI -1.987 to -0.256), and FILS (B=-0.785, 95 % CI -1.055 to -0.514) scores at discharge. ConclusionThe dual burden of sarcopenia and impaired oral health significantly impacts functional recovery in post-stroke patients. Comprehensive assessments and interventions targeting both conditions may optimize rehabilitation outcomes in this population.

Predictors of Media Emotion Regulation and Its Consequences for Children’s Socioemotional Development

Media emotion regulation has been defined as parents’ use of media to regulate their children's emotions in early childhood. The purpose of this review is to investigate the predictors of media emotion regulation and its consequences on children's socioemotional development. As predictors of media emotion regulation, parental education level, parental media use, and the child’s temperament were examined. It was observed that parents with low levels of education and higher personal media use more frequently offer their children media emotion regulation than other parents. The relationships between children’s temperamental domains of negative affect and extraversion/surgency and media emotion regulation have been shown as positive, while the relationship between effortful control and media emotion regulation has been displayed as negative. As for the consequences of media emotion regulation on children's socioemotional development, children’s problematic media use, emotional knowledge, and empathy were examined. The relationship between media emotion regulation and problematic media use was displayed as positive; children who frequently experienced media emotion regulation had increased problematic media use. Also, it was shown that media emotion regulation has a negative role in children's emotional knowledge. As children's experience with media emotion regulation increased, their emotional knowledge decreased. Lastly, in the relationship between media emotion regulation and empathy, both positive and negative findings were observed and variables that may influence this relationship were discussed. This study contributes significantly to understanding the conditions under which children more frequently experience media emotion regulation and the role of this experience on children's socioemotional developmentAs the consequences of media emotion regulation on children’s socio-emotional development, children's problematic media use, emotional knowledge, and empathy have been explored. There is a positive relationship between media emotion regulation and problematic media use. As media emotion regulation increases, children's emotional knowledge decreases. Finally, in the relationship between media emotion regulation and empathy, both positive and negative outcomes have been found, suggesting that media content and how children perceive media emotion regulation may influence this relationship. This study offers a significant contribution by exploring the conditions under which children more frequently experience media emotion regulation and its role in children's socio-emotional development.

Post myocardial infarction depression, prevalence, diagnosis, pathophysiologic mechanisms, treatment and management

Background: Myocardial infarction (MI) can have significant physical and mental consequences. Depression is a prevalent psychiatric condition after MI which can reduce the quality of life and increase the mortality rates of patients. The link between depression and poor cardiac outcomes has prompted clinical trials investigating the impact of treating depression on both outcomes. Methods: In this paper, we discussed about post Myocardial infarction depression, its Prevalence, pathophysiologic mechanisms, such as neurobiological mechanisms of post-MI depression, Hypothalamic-pituitary-adrenal axis and autonomic nervous system, environmental factors, like lack of social support, lifestyle changes, economic status and health related anxiety. Results: By 2030, depressive disorders are projected to become the first leading cause of disease burden in high-income countries and the second leading cause globally. Depression is prospectively linked to negative cardiac outcomes, regardless of other cardiovascular risk factors. In individuals who are initially healthy, depression is correlated with a greater likelihood of developing heart disease compared to those without depression. Conclusion: We have concluded that several factors including the dysregulation of the autonomic nervous system and Hypothalamic-pituitary-adrenal axis, various environmental factors, and genetics can be contributed to the correlation between Myocardial infarction and depression. Keywords: Post myocardial infarction, depression, prevalence, diagnosis, pathophysiologic mechanisms, treatment, management

The ultrasonic vocalization (USV) syllable profile during neonatal opioid withdrawal and a kappa opioid receptor component to increased USV emissions in female mice.

Opioid use during pregnancy can lead to negative infant health outcomes, including neonatal opioid withdrawal syndrome (NOWS). NOWS comprises gastrointestinal, autonomic nervous system, and neurological dysfunction that manifest during spontaneous withdrawal. Variability in NOWS severity necessitates a more individualized treatment approach. Ultrasonic vocalizations (USVs) in neonatal mice are emitted in isolation as a stress response and are increased during opioid withdrawal, thus modeling a negative affective state that can be utilized to test new treatments. We sought to identify the behavioral and USV profile, brainstem transcriptomic adaptations, and role of kappa opioid receptors in USVs during neonatal opioid withdrawal. We employed a third trimester-approximate opioid exposure model, where neonatal inbred FVB/NJ pups were injected twice-daily with morphine (10mg/kg, s.c.) or saline (0.9%, 20 ul/g, s.c.) from postnatal day(P) 1 to P14. This protocol induces reduced weight gain, hypothermia, thermal hyperalgesia, and increased USVs during spontaneous morphine withdrawal. On P14, there were increased USV emissions and altered USV syllables during withdrawal, including an increase in Complex 3 syllables in FVB/NJ females (but not males). Brainstem bulk mRNA sequencing revealed an upregulation of the kappa opioid receptor (Oprk1), which contributes to withdrawal-induced dysphoria. The kappa opioid receptor (KOR) antagonist, nor-BNI (30 mg/kg, s.c.), significantly reduced USVs in FVB/NJ females, but not males during spontaneous morphine withdrawal. Furthermore, the KOR agonist, U50,488h (0.625 mg/kg, s.c.), was sufficient to increase USVs on P10 (both sexes) and P14 (females only) in FVB/NJ mice. We identified an elevated USV syllable, Complex 3, and a female-specific recruitment of the dynorphin/KOR system in increased USVs associated with neonatal opioid withdrawal severity.

Sensitive infant care tunes a frontotemporal interbrain network in adolescence

Caregiving plays a critical role in children’s cognitive, emotional, and psychological well-being. In the current longitudinal study, we investigated the enduring effects of early maternal behavior on processes of interbrain synchrony in adolescence. Mother-infant naturalistic interactions were filmed when infants were 3–4 months old and interactions were coded for maternal sensitivity and intrusiveness with the Coding Interactive Behavior Manual. In early adolescence (Mean = 12.30, SD = 1.25), mother-adolescent interbrain synchrony was measured using hyperscanning EEG during a naturalistic interaction of positive valence. Guided by previous hyperscanning studies, we focused on interbrain connections within the right frontotemporal interbrain network. Results indicate that maternal sensitivity in early infancy was longitudinally associated with neural synchrony in the right interbrain frontotemporal network. Post-hoc comparisons highlighted enhancement of mother-adolescent frontal-frontal connectivity, a connection that has been implicated in parent-child social communication. In contrast, maternal intrusiveness in infancy was linked with attenuation of interbrain synchrony in the right interbrain frontotemporal network. Sensitivity and intrusiveness are key maternal social orientations that have shown to be individually stable in the mother-child relationship from infancy to adulthood and foreshadow children’s positive and negative social-emotional outcomes, respectively. Our findings are the first to demonstrate that these two maternal orientations play a role in enhancing or attenuating the child’s interbrain frontotemporal network, which sustains social communication and affiliation. Results suggest that the reported long-term impact of maternal sensitivity and intrusiveness may relate, in part, to its effects on tuning the child’s brain to sociality.

Beyond Empathy: Analyzing Compassion Fatigue Among Counselor

Compassion fatigue is an emotional response characterized by a diminished capacity or interest in empathizing with others. This phenomenon often results from continuous exposure to traumatic narratives recounted by clients, leading to negative behavioral and emotional outcomes in counselors. Compassion fatigue can impair the ability to support others and hinder overall productivity. Counselors are particularly vulnerable to experiencing compassion fatigue. Given the increasing number of counselors, it is imperative to investigate the prevalence and characteristics of compassion fatigue. This study aims to delineate the features of compassion fatigue among 45 counselors at East & Central Java. The research employs a quantitative descriptive methodology. The Professional Quality of Life Scale (ProQOL) was adapted for this study, encompassing three subscales that assess compassion fatigue, compassion satisfaction, and burnout. This instrument represents an advanced iteration of the original compassion fatigue scale.

Factors Affecting Cardiorespiratory Fitness in Middle-Aged Men

Abstract Introduction: Cardiorespiratory fitness (CRF) is “the ability of the circulatory and respiratory systems to supply oxygen during sustained physical activity (PA).” CRF is a well-established predictor of a wide range of negative health outcomes. Six-minute walk distance (6MWD) will very well aid in the assessment of CRF. Materials and Methods: A cross-sectional study was conducted using convenience sampling on men aged 40–65 from the community of Ahmedabad. Six-minute walk test was used to assess CRF. All participants’ body mass index (BMI), waist circumference (WC), PA levels (Rapid Assessment of PA [RAPA]), fatigue levels (Fatigue Severity Scale [FSS]), depression, anxiety, and stress were analyzed. Regression analysis was done using the SPSS 20.0 version. Results: Sixty-five participants with a mean age of 53.48 ± 7.76 years participated in the study. The mean 6MWD was 486.6 ± 110.13 m. Association of 6MWD with BMI was 1%, with WC was 2.2%, with RAPA was 28.9%, with FSS was 45.8%, with depression was 23.6%, with anxiety was 31.4%, and with stress was 38.1%. Conclusion: CRF of middle-aged men was found to be low. BMI and WC had minimal effect while PA levels, fatigue levels, depression, anxiety, and stress levels had an influence on CRF. Further studies should be designed to improve the factors affecting CRF in middle-aged men.

Comorbid Hypothyroidism and Low-Alanine Aminotransferase-Associated Sarcopenia Associated with Shortened Survival: A Retrospective Study of 16,827 Patients over a 21-Year Period

Background: Hypothyroidism is very common worldwide. It is known to be associated with frailty which, in turn, is associated with increased morbidity and mortality in the elderly. Low ALT blood activity is an established marker for sarcopenia and frailty. The incidence and outcomes of the association between low ALT values and hypothyroidism, as manifested in elevated blood TSH levels, is unknown. The objective of this study was to assess if low ALT values could improve the prediction of clinical outcome in hypothyroid patients. Methods: This was a retrospective analysis of hospitalized patients in a large, tertiary hospital. Results: Over a period of 21 years, an overall population of 16,827 patients were identified as eligible to participate in this study. Within the study population, 726 (4.3%) were classified as suffering from hypothyroidism (TSH values > 6 MIU/L) and 2184 (13%) were classified as patients with sarcopenia (ALT < 12 IU/L). Within our patient population, hypothyroidism was associated with sarcopenia in a statistically significant manner (p = 0.011). Patients classified as suffering from both hypothyroidism and sarcopenia had significantly shorter survival: A multivariate analysis showed that the frail and hypothyroid group of patients had a statistically significant risk of mortality in the next 5 years (HR = 3.6; CI 2.75–4.71; p < 0.001). Conclusions: Sarcopenia and frailty are common comorbidities, bearing negative long-term clinical outcomes. Low ALT values could serve as a useful biomarker for screening of patients already diagnosed with hypothyroidism.

Assessing the Impact on Gentrification of Senate Bill (SB) 375 Streamlining: Case Study of Sacramento, CA

This study investigates whether the development streamlining provisions in California’s Senate Bill 375 (2008) – which reduce the review required under the California Environmental Quality Act for qualifying transit-oriented development (TOD) projects – contribute to gentrification. Gentrification can have positive and negative outcomes for nearby communities, including the disproportionate displacement of marginalized communities of color and low-income residents (Drexel University Urban Health Collaborative (UHC) 2019). We use case studies of three TOD projects in Sacramento that utilized SB 375 streamlining. We find medium evidence of gentrification from all three projects, with the Sacramento Commons project showing the most signs of gentrification.

Reactive Oxygen Species in Cystic Kidney Disease.

Polycystic kidney disease (PKD) is a rare but significant renal condition with major implications for global acute and chronic patient care. Oxidative stress and reactive oxygen species (ROS) can significantly alter its pathophysiology, clinical outcomes, and treatment, contributing to negative outcomes, including hypertension, chronic kidney disease, and kidney failure. Inflammation from ROS and existing cysts propagate the generation and accumulation of ROS, exacerbating kidney injury, pro-fibrotic signaling cascades, and interstitial fibrosis. Early identification and prevention of oxidative stress and ROS can contribute to reduced cystic kidney disease progression and improved longitudinal patient outcomes. Increased research regarding biomarkers, the pathophysiology of oxidative stress, and novel therapeutic interventions alongside the creation of comprehensive guidelines establishing methods of assessment, monitoring, and intervention for oxidative stress in cystic kidney disease patients is imperative to standardize clinical practice and improve patient outcomes. The integration of artificial intelligence (AI), genetic editing, and genome sequencing could further improve the early detection and management of cystic kidney disease and mitigate adverse patient outcomes. In this review, we aim to comprehensively assess the multifactorial role of ROS in cystic kidney disease, analyzing its pathophysiology, clinical outcomes, treatment interventions, clinical trials, animal models, and future directions for patient care.

Effectiveness of Emotional-Focused Coping on Heart-Focused Anxiety in Patients Prior to cardiac Catheterization

Background: Heart-focused anxiety involves a concentration on and a fear of cardiac-related feelings and their anticipated negative outcomes (such as a life-threatening arrhythmia or abrupt cardiac death). It results in continuing concerns about heart function, avoiding activities that are thought to cause cardiac symptoms, and frequent behavior of requesting assistance in medical settings. Study purpose: This study aimed to measure the effectiveness of Emotional-Focused Coping on Heart-Focused Anxiety in Patients Prior to cardiac Catheterization. Materials and methods: A quasi-experimental study using (pretest and posttest design with a control group). A purposive sampling technique was used to gather the study information from 120 patients prior to cardiac catheterization by using the beck anxiety inventory scale. The study is conducted in Al-Najaf Al-Ashraf Government, Al-Najaf Center for Cardiac Surgery and Trans-Catheter Therapy. Results: A statistically significant difference is found in participants anxiety level prior to cardiac catheterization between the first measure before applying the coping techniques and the second measure after the application of coping strategies (Mean difference =13.500, P <0.0005) Conclusion: The emotional focused coping strategies are proves as easy interventions to apply and effective in terms of reducing the level of heart-focused anxiety prior to cardiac catheterization

Understanding the impact of domestic violence on children's mental health and exploring effective intervention strategies

Exposure to domestic violence in the home can have profound and long-lasting effects on children's mental health and development. An extensive body of research has demonstrated the links between witnessing domestic abuse and increased risks of psychological disorders such as anxiety, depression, and post-traumatic stress disorder in affected children. However, not all children exposed to violence experience negative outcomes, and interventions can help mitigate harm. This research aims to synthesize what is known about the multifaceted psychological consequences of domestic violence exposure for children and identify effective support strategies. A comprehensive literature review was undertaken to understand prevalence rates, forms of abuse, and potential moderating and mediating factors. Key findings indicate that while abuse types, including physical, emotional, verbal, and financial violence, can all impact children's mental health, factors like age, gender, resilience characteristics, and social support networks influence outcomes. Trauma-focused therapies, parent-child interaction programs, play-based interventions, and school-based supports show promise as evidence-based approaches. Recommendations target collaboration between policymakers, practitioners, and researchers to strengthen legislation, implement multidisciplinary treatment, and conduct further longitudinal studies. The goal is to illuminate this critical issue and guide the development and evaluation of integrated systems of care focused on child wellness and family violence prevention.

Air pollution below US regulatory standards and cardiovascular diseases using a double negative control approach

Growing evidence suggests that long-term air pollution exposure is a risk factor for cardiovascular mortality and morbidity. However, few studies have investigated air pollution below current regulatory limits, and causal evidence is limited. We use a double negative control approach to examine the association between long-term exposure to air pollution at low concentration and cardiovascular hospitalizations among US Medicare beneficiaries aged ≥65 years between 2000 and 2016. The expected values of the negative outcome control (preceding-year hospitalizations) regressed on exposure and negative exposure control (subsequent-year exposure) are treated as a surrogate for omitted confounders. With analyses separately restricted to low-pollution areas (PM2.5 < 9 μg/m³, NO2 < 75.2 µg/m3 [40 ppb], warm-season O3 < 88.2 μg/m3 [45 ppb]), we observed positive associations of the three pollutants with hospitalization rates of stroke, heart failure, and atrial fibrillation and flutter. The associations generally persisted in demographic subgroups. Stricter national air quality standards should be considered.

Validation of a 5-Year Prognostic Model for Parkinson's Disease.

A simple prognostic model was previously developed to predict the probability of recently-diagnosed patients reaching negative outcomes (postural instability, dementia or death) in a 5-year period. To validate this model in an independent cohort and establish utility at later time points. Validation was performed using data collected in an incident cohort at baseline, 2 and 4 years. Predicted negative outcome probabilities were compared to actual 5-year outcomes. The model, based on age, MDS-UPDRS axial score and 60-second animal fluency, predicted poor 5-year outcome when applied at baseline, (area under the curve (AUC) 0.80), 2 years (AUC 0.82) and 4 years (AUC 0.71). Power calculations showed that selecting a subgroup with prognostic score >0.5 reduced the sample size required for a disease-modifying trial. This 5-year prognostic model has good accuracy when employed up to 4 years from diagnosis and may help stratification for disease-modifying trials.

Raising post‐secondary education participation of young people transitioning from care: The effects of extended legislative support

AbstractOut‐of‐home care is associated with a range of negative social outcomes for the young people who experience it. The most promising path to improved life chances for care‐experienced young people is arguably through education, especially post‐secondary education. Currently, no national data are collected on the post‐secondary education participation of care‐experienced young people. However, the evidence that exists suggests their participation rate is likely very low. Historically, one reason for post‐secondary participation gaps has been the fact that care ended abruptly at 18 years, forcing care‐experienced young people into independence much faster and earlier than the vast majority of their same‐age peers. The recent extension to care to 21 years for most young people in care across all Australian jurisdictions has changed the out‐of‐home care landscape considerably. A central question is whether the extension of care will, in itself, result in increased post‐secondary education access and success for care‐experienced young people. We address this question through an examination of the current out‐of‐home care and education landscape, including state and territory legislation, Australian Government policy and current post‐secondary settings and outcomes.

Developing a research agenda on NATure-based and Animal-assisted Intervention Strategies (NATAIS) in people with neurodegenerative diseases with a specific focus on social isolation and loneliness: a group concept mapping procedure

BackgroundSocial isolation and feelings of loneliness are very prevalent in people with neurodegenerative diseases and are associated with a lower quality of life and other negative outcomes. These problems were increased during the COVID-19 pandemic resulting in initiatives to address social isolation. Given the potential benefits of nature-based and animal-assisted intervention strategies (NATAIS), it is crucial to further investigate if and how these strategies might minimize negative effects of social isolation and feelings of loneliness in this population. Therefore, the aim of this project was to develop a research agenda for NATAIS in people with neurodegenerative diseases, especially during challenging times, such as pandemics.MethodsThis article outlines the process and results of a group concept mapping procedure aimed at developing a research agenda based on a logic model. In total, 19 work group members participated through a combination of in-person and online group meetings. Additionally, face-to-face group sessions were held at two international scientific conferences, during which feedback was solicited from 12 experts in the field of NATAIS and psychogeriatrics.ResultsThe group concept mapping procedure resulted in 14 clusters describing various future research topics, which were further refined and detailed during group discussions. The remaining eleven clusters, encompassing important research themes within the field of NATAIS, were organized into a logic model and summarized into the research agenda. The overarching cluster ‘ethical issues, possible risk factors, and their solutions’ was considered the most relevant during times of increased social isolation, such as during a pandemic, along with the necessity for more accessible NATAIS.ConclusionsThis project resulted in a research agenda, directing future research and fostering collaboration between practitioners and researchers in the field of NATAIS. Such an enhanced partnership between science and practice has the potential to significantly contribute to the well-being of people with neurodegenerative diseases, in their daily lives and also during pandemics.

Identifying the Impact of Chlamydia trachomatis Screening and Treatment on Mother-to-Child Transmission, and Respiratory Neonatal Outcomes in Mexico.

Chlamydia trachomatis (C. trachomatis) screening and treatment in pregnancy allows the opportunity to reduce adverse pregnancy and neonatal outcomes worldwide. Although C. trachomatis infection is easily treated and cured with antibiotics, only some countries have routine pregnancy screening and treatment programs. We therefore evaluated whether just one maternal screening for C. trachomatis is enough to prevent adverse pregnancy and negative neonatal outcomes. Among the 4087 first-time gynecological-obstetric consultations granted at the National Institute of Perinatology in 2018, we selected the study population according to a case-cohort design. Antenatal C. trachomatis screening and treatment interventions were performed on 628 pregnant women using COBAS® TaqMan CT. C. trachomatis DNA was also detected in samples from 157 infants of these mothers. In the maternal cohort, incidence of C. trachomatis infection was 10.5%. The vertical transmission rate was 1.5% for the cohort of mothers who tested positive for C. trachomatis and received treatment, and 29.7% for those with a negative test. By evaluating symptomatic neonatal infection, the hazard rate of perinatal pneumonia was 3.6 times higher in C. trachomatis-positive babies than in C. trachomatis-negative babies. Despite the low rate of mother-to-child transmission in women positive for C. trachomatis, possible maternal infection that is not detected in pregnancy significantly increases the risk of neonatal infection with consequent perinatal pneumonia.

ESG ratings and female corporate leadership: Evidence from African firms

Despite increasing scholarly research on the dynamic causal link between environmental, social, and governance (ESG) drive and female corporate leadership, limited knowledge exists regarding the African context. This study decreases this research dearth and uncovers bidirectional causality within African firms between 2010 and 2022. Empirical results indicate that female leadership significantly influences future ESG ratings, and ESG implementation negatively affects female leadership. Ceteris paribus, managerial myopia will likely maintain this negative outcome. These findings lead to managerial and policy implications aligned with the United Nations’ Sustainable Development Goals and the African Union Agenda 2063.