Subsequent Behavioral Changes Research Articles

Inhibition of the NLRP3/caspase-1 cascade related pyroptosis relieved propofol-induced neuroinflammation and cognitive impairment in developing rats

BackgroundNumerous preclinical studies have demonstrated that prolonged exposure to propofol (A general anaesthetics) can lead to hippocampus injury in immature brains and impact long-term learning and memory functions. Neuroinflammation plays a pivotal role in the impairment of brain function associated with early exposure to anesthetic drugs. Nevertheless, the involvement of hippocampal pyroptosis and neuroinflammation mediated by the NLRP3/caspase-1 signaling cascade in propofol-induced developmental neurotoxicity remains unclear. MethodsPostnatal day (PND) 7 SD rats, PC12 cells, and HAPI cells were used to establish propofol neurotoxicity models in vivo and in vitro, respectively. We examined the potential hippocampal injury and cognitive dysfunction caused by propofol in neonatal rats through the NLRP3/caspase-1 signaling pathway using MCC950 and VX765 to inhibit the pathway. This investigation involved assessing histological changes in the hippocampus, behavioral performance in adulthood, NLRP3-related pyroptosis indicators, and neuroinflammatory cytokines. ResultsBoth in vivo and in vitro studies have demonstrated that exposure to propofol activates the NLRP3/caspase-1 signaling cascade in the hippocampus of PND7 rats, leading to pyroptosis, neuroinflammation, and subsequent hippocampal injury and behavioral changes in adulthood. However, MCC950 and VX765 inhibit the NLRP3/caspase-1 signaling cascade, reversing the developmental neurotoxicity of propofol. ConclusionOur study findings suggest that negative regulation of NLRP3/caspase-1 activation may serve as a potential therapeutic strategy for developmental neuroinflammation induced by propofol.

Learning & motivational talk in smoking cessation interventions: An examination of session language in two randomized trials

ObjectivesMotivational Interviewing (MI), a client-centered approach that seeks to evoke and resolve ambivalence, and health education (HE), which provides health information and advice, may both provide some benefit to unmotivated smokers. In HE, it is possible that client language reflective of new learning, or “learning talk” (LT), and rejection of health advice, or “rejection talk,” (RT), may uniquely reflect intent of subsequent behavior change. MethodsThis project utilized MI and HE sessions from two randomized clinical trials (RCTs), one in a low-income, diverse community civilian sample of 255 unmotivated smokers, and the other in a sample of Veterans with mental illness who were unmotivated smokers (n = 55).Mixed methods approaches were utilized to reliably code sessions using the Motivational Interviewing Skill Code 2.5 (MISC 2.5)1 and a refined Learning Talk coding system2. ResultsReliability of LT and RT codes ranged from fair to excellent (ICCs from 0.43–0.93). ConclusionLT appears to be a unique construct and its impact on post-session changes in smoking is warranted. Practice implicationsThis system can be used in a study to code existing interventions for smokers using both MI and HE techniques and relate in-session client LT to subsequent smoking behaviors.

Heart Zone as a measure to influence traffic safety culture: which factors influence culture change?

Measures to influence traffic safety culture in designated areas (e.g. schools) exist in several different countries across the world. The Norwegian traffic safety scheme Heart Zone is a measure that aims to influence the traffic culture within a specific geographical area. The study examines whether four Norwegian schools have managed to establish a Heart Zone traffic safety culture, factors facilitating and impeding the implementation of Heart Zone traffic safety culture and subsequent changes in parents' traffic safety behavior. The study is based on survey data from four Norwegian schools (n = 220) and qualitative interviews (n = 19). Although the level of implementation varies, results from the interviews and the survey suggest that the schools have established Heart Zone cultures, where large proportions of the parents drop the children off at the recommended drop-off zone, when driving, are attentive to students who come walking/cycling within the Heart Zone and walk or cycle when transporting children within the Heart Zone. The Heart Zone culture is related to changes in parents' traffic safety behaviors and reductions in dangerous traffic situations. The study identifies specific factors facilitating and impeding traffic culture change, related to enclosed geographical areas like the Heart Zone, developing an analytical model that researchers and future traffic culture measures like this can learn from.

Functional connectivity changes in the brain of adolescents with internet addiction: A systematic literature review of imaging studies

Internet usage has seen a stark global rise over the last few decades, particularly among adolescents and young people, who have also been diagnosed increasingly with internet addiction (IA). IA impacts several neural networks that influence an adolescent’s behaviour and development. This article issued a literature review on the resting-state and task-based functional magnetic resonance imaging (fMRI) studies to inspect the consequences of IA on the functional connectivity (FC) in the adolescent brain and its subsequent effects on their behaviour and development. A systematic search was conducted from two databases, PubMed and PsycINFO, to select eligible articles according to the inclusion and exclusion criteria. Eligibility criteria was especially stringent regarding the adolescent age range (10–19) and formal diagnosis of IA. Bias and quality of individual studies were evaluated. The fMRI results from 12 articles demonstrated that the effects of IA were seen throughout multiple neural networks: a mix of increases/decreases in FC in the default mode network; an overall decrease in FC in the executive control network; and no clear increase or decrease in FC within the salience network and reward pathway. The FC changes led to addictive behaviour and tendencies in adolescents. The subsequent behavioural changes are associated with the mechanisms relating to the areas of cognitive control, reward valuation, motor coordination, and the developing adolescent brain. Our results presented the FC alterations in numerous brain regions of adolescents with IA leading to the behavioural and developmental changes. Research on this topic had a low frequency with adolescent samples and were primarily produced in Asian countries. Future research studies of comparing results from Western adolescent samples provide more insight on therapeutic intervention.

Horizontal Gaze Assessment: An Extensive Narrative Review

Bipedalism was a significant milestone in the evolutionary development of Homo sapiens sapiens, influencing neocortical evolution and subsequent behavioral changes. Coordinated visual and sensory inputs are crucial for posture, environmental interaction, and surgical planning, with horizontal gaze being a pivotal parameter. This narrative review aims to explore various geometric measures used to assess horizontal gaze in patients, highlighting their applications in surgical planning. A literature review was conducted in indexed databases using Mesh terms like "Cervical Vertebrae" and "Visual Fields" along with keywords such as "horizontal gaze" and "sagittal spine parameters." Among 477 initially identified articles, 41 were selected for inclusion after rigorous filtering. The most recognized method for assessing horizontal gaze is the Chin Brow Vertical Angle (CBVA), initially described in patients with ankylosing spondylitis. Clinical photography is employed as a tool for CBVA calculation, while other measures like McGregor slope and Slope of the Line of Sight have been considered as alternatives to CBVA. Each method presents its unique advantages and limitations. This review highlights the need for further research into horizontal gaze measurement methods. Developing novel approaches to determine horizontal gaze can significantly enhance surgical planning and, consequently, improve patient outcomes. The ongoing exploration of these geometric measures offers promising prospects for advancing the field and optimizing patient care.

Can period-related symptoms predict menstrual manipulation among Australian female cyclists?

ABSTRACT This study explored the extent of menstrual manipulation and its associated impact on period-related symptoms and training disruptions in Australian Female Cyclists. 205 female cyclists, from recreational to elite level, participated in an online “Female Cyclist Questionnaire (FCQ)”. The FCQ utilised a series of validated questionnaires to obtain demographic information and menstrual function of the respondents, and to investigate their menstrual manipulation habits and perceptions on how their period-related symptoms affected their well-being, mood, energy and training tolerance. More than 80% of the cyclists reported that their period-related symptoms impacted upon training and 41% made training adjustments based on these symptoms. Two-thirds of respondents thought their training should be phase-controlled yet only half discussed their hormonal cycles with their coaches. Menstrual manipulation was predicted by reduced “workout tolerance” in these cyclists (odds ratio = 0.632). Half of the respondents reported compromised ability to tolerate high-intensity interval training with period-related symptoms. Period pain, increased irritability, lower energy levels and more sugar cravings were commonly reported but did not predict menstrual manipulation. The data indicated that period-related symptoms are present in Australian female cyclists across all levels of participation. However, the perceived impact to training and subsequent behavioural changes varied among individuals.

Development and Outcomes of Returning Polycyclic Aromatic Hydrocarbon Exposure Results in the Washington Heights, NYC Community.

Report-back of research results (RBRR) is becoming standard practice for environmental health research studies. RBRR is thought to increase environmental health literacy (EHL), although standardized measurements are limited. For this study, we developed a report back document on exposure to air pollutants, Polycyclic Aromatic Hydrocarbons, during pregnancy through community engaged research and evaluated whether the report increased EHL. We used focus groups and surveys to gather feedback on the report document from an initial group of study participants (Group 1, n = 22) and then sent the revised report to a larger number of participants (Group 2, n = 168). We conducted focus groups among participants in Group 1 and discussed their suggested changes to the report and how those changes could be implemented. Participants in focus groups demonstrated multiple levels of EHL. While participant engagement critically informed report development, a survey comparing feedback from Group 1 (initial report) and Group 2 (revised report) did not show a significant difference in the ease of reading the report or knowledge gained about air pollutants. We acknowledge that our approach was limited by a lack of EHL tools that assess knowledge and behavior change, and a reliance on quantitative methodologies. Future approaches that merge qualitative and quantitative methodologies to evaluate RBRR and methodologies for assessing RBRR materials and subsequent changes in knowledge, attitudes, and behavior, may be necessary.

Development of a behaviour change intervention to increase the delivery of upper limb constraint-induced movement therapy programs to people with stroke and traumatic brain injury

Purpose Constraint-induced movement therapy (CIMT) is a recommended intervention for arm recovery after acquired brain injury but is underutilised in practice. The purpose of this study is to describe the development of a behaviour change intervention targeted at therapists, to increase delivery of CIMT. Methods A theoretically-informed approach for designing behaviour change interventions was used including identification of which behaviours needed to change (Step 1), barriers and enablers that needed to be addressed (Step 2), and intervention components to target those barriers and enablers (Step 3). Data collection methods included file audits and therapist interviews. Quantitative data (file audits) were analysed using descriptive statistics. Qualitative data analysis (interviews) was informed by the Theoretical Domains Framework (TDF) and Behaviour Change Wheel. Results Fifty two occupational therapists, physiotherapists and allied health assistants participated in focus groups (n = 7) or individual interviews (n = 6). Key barriers (n = 20) and enablers (n = 10) were identified across 11 domains of the TDF and perceived to influence CIMT implementation. The subsequent behaviour change intervention included training workshops, nominated team champions, community of practice meetings, three-monthly file audit feedback cycles, poster reminders and drop-in support during CIMT. Conclusion This study describes the development of a behaviour change intervention to increase CIMT delivery by clinicians. Trial registration Australian New Zealand Clinical Trials Registry, Trial ID: ACTRN12617001147370.

Anxiety and Alzheimer's disease pathogenesis: focus on 5-HT and CRF systems in 3xTg-AD and TgF344-AD animal models.

Dementia remains one of the leading causes of morbidity and mortality in older adults. Alzheimer's disease (AD) is the most common type of dementia, affecting over 55 million people worldwide. AD is characterized by distinct neurobiological changes, including amyloid-beta protein deposits and tau neurofibrillary tangles, which cause cognitive decline and subsequent behavioral changes, such as distress, insomnia, depression, and anxiety. Recent literature suggests a strong connection between stress systems and AD progression. This presents a promising direction for future AD research. In this review, two systems involved in regulating stress and AD pathogenesis will be highlighted: serotonin (5-HT) and corticotropin releasing factor (CRF). Throughout the review, we summarize critical findings in the field while discussing common limitations with two animal models (3xTg-AD and TgF344-AD), novel pharmacotherapies, and potential early-intervention treatment options. We conclude by highlighting promising future pharmacotherapies and translational animal models of AD and anxiety.

The detection of self–group conflicts in exercise behaviors differs with social network centrality: ERP evidence

BackgroundThe influence of social norms on exercise behaviors has been explored in studies over the years. However, little is known about whether an individual’s role (central or peripheral) in his or her social network, which is associated with social skills, could shift his or her susceptibility to normative effects on exercise behaviors. To that end, event-related potentials (ERPs) were recorded to examine the underlying cognitive mechanism of the effects of network centrality on normative social influence. MethodsWe manipulated network centrality by assigning participants to exercise support groups, with group members who were their nominated friends (high centrality) or nonnominated classmates (low centrality). Participants were asked to evaluate their willingness to engage in various exercises, after viewing discrepant group ratings (peer influence) or not viewing (no-influence). ResultsPeer influence evoked a larger negative-going feedback-related negativity (FRN) wave, which was linked to automatic social conflict detection, and a larger positive-going P3 wave, which was linked to subsequent conformity behavioral changes. However, effects on the FRN, not the P3, were observed only in the high-centrality group. ConclusionOur results highlight the important roles of network centrality in encoding self–group exercise attitude discrepancy rather than in decision-making regarding exercise attitude adjustments. Interventions aimed at promoting exercise behaviors should be considered in a broader social environmental framework.

Pediatrician-Delivered Smoking-Cessation Messages for Parents: An Update.

Clinicians who care for children and adolescents are well positioned to help parents quit smoking – the leading preventable cause of disease and death in the US. Understanding parents’ preferences for smoking-cessation messages may help clinicians tailor interventions to increase the likelihood of quitting. A concept from behavioral economics, called message framing, can be leveraged to motivate adult smokers to quit and may help motivate parents to quit. 1 Jenssen B.P. Kelly M.K. Faerber J. et al. Pediatrician Delivered Smoking Cessation Messages for Parents: A Latent Class Approach to Behavioral Phenotyping. Acad Pediatr. 2021; 21: 129-138https://doi.org/10.1016/j.acap.2020.07.018 Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar In our study, “Pediatrician Delivered Smoking Cessation Messages for Parents: A Latent Class Approach to Behavioral Phenotyping,” using a discrete choice experiment and latent class analysis, we identified subgroups of parents who smoke with preferences for certain types of motivational messages: messages focused on the impact of smoking on the child, messages that were gain-framed rather than loss-framed messages (emphasizing benefits of engaging over costs of failing to engage in treatment), and messages focused on the financial impact of smoking. 1 Jenssen B.P. Kelly M.K. Faerber J. et al. Pediatrician Delivered Smoking Cessation Messages for Parents: A Latent Class Approach to Behavioral Phenotyping. Acad Pediatr. 2021; 21: 129-138https://doi.org/10.1016/j.acap.2020.07.018 Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar We proposed that future work should explore how to best incorporate these messages into clinical practice as well as examine the relationship between tailored messages and subsequent behavior change. Since the publication of our study, others have expanded work in this field. In this progress report, we consider our study’s findings within the context of other studies published since January 2021, when we submitted our manuscript for publication, and discuss: 1) tailored content to help individuals who smoke quit, 2) methods to create a new system for smoking cessation for parents of pediatric patients, and 3) preliminarily evaluation of this new system in clinical practice.

Neuroinflammation and hypersensitivity evidenced by the acute and 28-day repeated dose toxicity tests of ostrich oil in mice.

The ostrich oil (OO) has been topically used for decades to treat skin diseases. Its oral use has been encouraged through e-commerce advertising several health benefits to OO without scientific evidence on its safety or effectiveness. This study presents the chromatographic profile of a commercially available OO and its acute and 28-day repeated dose in vivo toxicological profiles. OO anti-inflammatory and antinociceptive effects were also investigated. Omega-9 (ω-9; oleic acid; 34.6%) and -6 (linoleic acid; 14.9%) were detected as OO main constituents. A high single dose of the OO (2g/kg of ω-9) demonstrated no or low acute toxicity. However, when orally treated with OO (30-300mg/kg of ω-9) for 28 consecutive days, mice exhibited altered locomotor and exploratory activities, hepatic damage, and increased hindpaw sensitivity accompanied by increased levels of cytokine and brain-derived neurotrophic factor in their spinal cords and brains. Lack of anti-inflammatory or antinociceptive activities was also evidenced in 15-day-OO treated mice. These results indicate that chronic consumption of OO induces hepatic injury, in addition to neuroinflammation and subsequent hypersensitivity and behavioural changes. Thus, there is no evidence to support OO use to treating illness in humans.

Effect of the large waves of COVID-19 on false-positive results in annual lung cancer screening.

e18596 Background: Chest X ray (CXR) has been the most common screen test procedure for detection of lung cancer. We have shown that repeat visitors (R) had a significantly lower proportion of CXR abnormalities requiring medication than the first-time visitors (F) at annual lung cancer screening. (Kimura T. Health Prim Car, 2021). In 2022, Japan experienced three large waves of COVID-19 mainly the Omicron variants (the 6th: Jan-Mar, the 7th: Jul-Sep and the 8th: Oct to present). The later the wave, the larger the scale. The Omicron variant spreads more easily than the original or the Delta variants up to the 5th waves. The hypothesis was that these COVID waves may have influenced lung cancer screening. Methods: Our clinic “MedCity21” is a university outpatient clinic for a complete medical check-up as part of a private health screening program. Of course, we check temperature, respiratory symptoms, and any history of COVID infection and vaccination of the participants (pts). Our facility allows COVID-infected pts to have medical check-ups four weeks after they are cured. The pts with abnormalities detected on CXR were notified by telephone request and invited to our specialty clinic for chest CT scan as further examination. Each year from 2018 to 2022, we examined the varieties of abnormal shadows on CXR and CT scans and compared the differences between 2022 and each year before to 2022 using the chi-squared tests. Results: In 2022, there were 14522 pts of which F and R were 27.1% and 72.9% respectively. The percentage of pts with a history of COVID was 1.68% in January, but gradually increased, reaching a plateau of 20% in October. There were 231pts (1.6%) with CXR abnormalities requiring further investigation. The rates in F and R were 1.3% and 1.7%, respectively. A total of 132 pts (56.7%) of 63 pts in F and 69 pts in R underwent chest CT scans at our facility after the call for recommendation for further investigation. The distribution of CXR and CT variations was consistent with our previous report. There was one confirmed case of lung cancer among F, and 2 among R in 2022. It should be noted that the CT confirmation revealed that there were 10 pts with nodular shadow on CXR, of whom 5 were found to have COVID infection after 1 month follow-up. Conclusions: There was a significant decrease in the number of first-time visitors in 2022 compared to previous years (p < 0.001). The percentage of cases returning to our clinic for CT for further investigation has decreased dramatically (p < 0.001). These were attributed to the large COVID waves. Notably, for the first time in the last 5 years, the detection rates of CXR abnormalities were reversed for R and F. In some cases, nodule shadows were difficult to determine whether they were lung cancer or COVID. The number of people with previous COVID-19 infection will continue to increase. The COVID pandemic and subsequent behavioral changes have affected the way people manage their health status.

Development and Evaluation of a Rat Model of Full-Thickness Cartilage Defects.

Cartilage defects of the knee joint caused by trauma are a common sports joint injury in the clinic, and these defects result in joint pain, impaired movement, and eventually, knee osteoarthritis (kOA). However, there is little effective treatment for cartilage defects or even kOA. Animal models are important for developing therapeutic drugs, but the existing models for cartilage defects are unsatisfactory. This work established a full-thickness cartilage defects (FTCD) model by drilling holes in the femoral trochlear groove of rats, and the subsequent pain behavior and histopathological changes were used as readout experiments. After surgery, the mechanical withdrawal threshold was decreased, chondrocytes at the injured site were lost, matrix metalloproteinase MMP13 expression was increased, and type II collagen expression decreased, consistent with the pathological changes observed in human cartilage defects. This methodology is easy and simple to perform and enables gross observation immediately after the injury. Furthermore, this model can successfully mimic clinical cartilage defects, thus providing a platform for studying the pathological process of cartilage defects and developing corresponding therapeutic drugs.

The Impact of Social Media Interventions on Weight Reduction and Physical Activity Improvement Among Healthy Adults: Systematic Review.

A sedentary lifestyle and being overweight or obese are well-established cardiovascular risk factors and contribute substantially to the global burden of disease. Changing such behavior is complex and requires support. Social media interventions show promise in supporting health behavior change, but their impact is unclear. Moreover, previous reviews have reported contradictory evidence regarding the relationship between engagement with social media interventions and the efficacy of these interventions. This review aimed to critically synthesize available evidence regarding the impact of social media interventions on physical activity and weight among healthy adults. In addition, this review examined the effect of engagement with social media interventions on their efficacy. CINAHL and MEDLINE were searched for relevant randomized trials that were conducted to investigate the impact of social media interventions on weight and physical activity and were published between 2011 and 2021 in the English language. Studies were included if the intervention used social media tools that provided explicit interactions between the participants. Studies were excluded if the intervention was passively delivered through an app website or if the participants had a known chronic disease. Eligible studies were appraised for quality and synthesized using narrative synthesis. A total of 17 papers reporting 16 studies from 4 countries, with 7372 participants, were identified. Overall, 56% (9/16) of studies explored the effect of social media interventions on physical activity; 38% (6/16) of studies investigated weight reduction; and 6% (1/16) of studies assessed the effect on both physical activity and weight reduction. Evidence of the effects of social media interventions on physical activity and weight loss was mixed across the included studies. There were no standard metrics for measuring engagement with social media, and the relationship between participant engagement with the intervention and subsequent behavior change was also mixed. Although 35% (6/16) of studies reported that engagement was not a predictor of behavior change, engagement with social media interventions was found to be related to behavior change in 29% (5/16) of studies. Despite the promise of social media interventions, evidence regarding their effectiveness is mixed. Further robust studies are needed to elucidate the components of social media interventions that lead to successful behavior change. Furthermore, the effect of engagement with social media interventions on behavior change needs to be clearly understood. PROSPERO International Prospective Register of Systematic Reviews CRD42022311430; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=311430.

Perception of and Preparedness for the COVID-19 Endemic in the Udon Thani Province

This study aimed to understand the perception toward endemic preparedness, adoption of the HBM seeks to improve the level of response of Udon Thani people toward governmental messages regarding transforming the Pandemic into an Endemic. To fulfill the study’s aim, confidence toward various governmental activities and control measures. A cross-sectional survey was conducted among 120 participants across the Udon Thani Province using questionnaires implemented through Google Forms. The results were explained using descriptive and binary logistic regression analysis. Among the 120 participants, 97 (80.83%) were aware of COVID-19, and 88 (73.33%) had good knowledge. The behavioral change was observed in 97 (80.83%), and variables in the health belief model showed a significant association with the behavioral change. Most participants living across Udon Thani approached the COVID-19 endemic similarly, irrespective of age, education, or relation to the healthcare field. Perceptions of the community as explained by the health belief model were greatly influenced by the primary healthcare approach by the government and for the subsequent behavioral change.

Injected serotonin decreases foraging aggression in black widow spiders (Latrodectus hesperus), but dopamine has no effect

A fundamental goal of animal behavior research is to discover the proximate mechanisms driving individual behavioral differences. Biogenic amines are known to mediate various aspects of behavior across many species, including aggression, one of the most commonly measured behavioral traits in animals. Arthropods provide an excellent system to manipulate biogenic amines and quantify subsequent behavioral changes. Here, we investigated the role of dopamine (DA) and serotonin (5-HT) on foraging aggression in western black widow spiders (Latrodectus hesperus), as measured by the number of attacks on a simulated prey animal in the web. We injected spiders with DA or 5-HT and then quantified subsequent changes in behavior over 48 h. Based on previous work on insects and spiders, we hypothesized that increasing DA levels would increase aggression, while increasing 5-HT would decrease aggression. We found that injection of 5-HT did decrease black widow foraging aggression, but DA had no effect. This could indicate that the relationship between DA and aggression is complex, or that DA may not play as important a role in driving aggressive behavior as previously thought, at least in black widow spiders. Aggressive behavior is likely also influenced by other factors, such as inter-individual differences in genetics, metabolic rates, environment, and other neurohormonal controls.

P107 Cost, Control, Compromise: Exploring the lived experience of narcolepsy in Australia

Abstract Introduction Persons with narcolepsy wrote of dissatisfaction with healthcare and unmet psychosocial needs in submissions made to the 2019 parliamentary inquiry on sleep. This study aimed to explore the needs, concerns, and barriers faced by Australians living with narcolepsy. Methods 126 self-reported persons with narcolepsy were recruited from support groups, with one-on-one interviews randomly conducted until saturation (n=24). Interviews were transcribed and analyzed using the framework approach by a multidisciplinary team of five researchers. Results Preliminary analysis highlighted a large psychosocial burden that affected the daily life of those with narcolepsy. Participants described the pervasiveness of symptoms and daily unpredictability of not knowing when symptoms would occur. Subsequent behavioral changes related to self-preservation were identified, including avoidance and self-management of care to exert control. Self-perception and adjustment to living with narcolepsy were informed by external opinions (e.g. societal/workplace expectations, family/friend opinion). Management of narcolepsy involves daytime naps; however, participants feared being negatively judged and perceived as lazy/unproductive if they napped. This led to an unwillingness to disclose/seek accommodations post-diagnosis. Executive dysfunction was frequently described, including impaired ability to recall names, times/dates, and appointments that contributed to school/workplace disruption. Discussion Participants living with narcolepsy spoke of a complex and burdensome condition requiring multidisciplinary management. Significant functional/psychosocial impairment was described, yet participants were not able to access NDIS support. Despite being known for its sleep-related symptoms, participants highlighted cognitive impairment and the subsequent impact on daily function as a concern that many felt was inadequately addressed.

201 Caregiver perceptions of a lifestyle education tool and subsequent behavior changes with elexacaftor/tezacaftor/ivacaftor initiation

201 Caregiver perceptions of a lifestyle education tool and subsequent behavior changes with elexacaftor/tezacaftor/ivacaftor initiation

The impact of the COVID-19 pandemic on other infections differs by their route of transmission: A retrospective, observational study in Japan

IntroductionThe Coronavirus disease 2019 (COVID-19) pandemic and people's subsequent behavioral changes have decreased the cases of respiratory infection worldwide. However, research on infectious diseases with other transmission modes is insufficient. The aim was to assess the impact of the COVID-19 pandemic on non-respiratory infectious diseases: infectious enterocolitis, sexually transmitted diseases such as human immunodeficiency virus (HIV) infection and syphilis, and tick-borne diseases. MethodsThis retrospective, cohort study used comprehensive surveillance data from the National Institute of Infectious Diseases in Japan from January 1, 2018, to December 31, 2021. The number of cases of infectious diseases before the COVID-19 pandemic (2018–2019) was compared with that during the COVID-19 pandemic (2020–2021). Reduction rates were calculated as the number of disease cases during the COVID-19 pandemic in 2020 and 2021, respectively, divided by the mean number of disease cases in 2018 and 2019. ResultsThe total numbers of cases of infectious enterocolitis, sexually transmitted diseases, and tick-borne diseases during the study period were 2,507,304 cases, 24,972 cases, and 3012 cases, respectively. The number of cases decreased for infectious enterocolitis and sexually transmitted diseases during the COVID-19 pandemic compared with before the COVID-19 pandemic, with an approximately 40–50% decrease in enterocolitis and 30–55% decreases in sexually transmitted diseases. However, cases of tick-borne diseases changed little, with a 0.2% increase in 2020 and a 6% increase in 2021. ConclusionThe COVID-19 pandemic had a different impact on the number of cases of infectious diseases depending on their mode of transmission.