Symptoms In Persons Research Articles

The effects of poor housing conditions on depressive symptoms in persons with disabilities: Do residence type and neighborhood resources matter?

BackgroundPoor housing conditions pose significant risks to the health of persons with disabilities. However, it is not well understood how and for whom the relationship between housing conditions and health is more pronounced. ObjectiveThis study aims to estimate the association between poor housing conditions and psychological health, and to explore whether residential characteristics, such as residence type and proximity to community resources, mitigate these risks for community-dwelling adults with disabilities. MethodsData were obtained from three waves of the Disability and Life Dynamic Panel (n = 5,165), a nationally representative study of individuals with disabilities in Korea. Our sample were limited to those aged 20 or older for the purpose of this study. Individual-level fixed effect analyses were conducted to assess the longitudinal association between poor housing conditions and depressive symptoms, accounting for individual-level heterogeneity. We also tested the moderating effects of the residential characteristics, including residence type and proximity to community resources. ResultsPoor housing conditions, characterized by structural unsafety and inadequate ventilation, lighting, and noise protection, were associated with increased depressive symptoms among adults with disabilities. The negative impact of poor housing conditions on depressive symptoms was less pronounced for those living close to community services or in apartment complexes where housing conditions are professionally managed. ConclusionsThe study indicates that the quality of housing and neighborhood environments affects the psychological health of adults with disabilities. These findings support for the need for place-based interventions aimed at improving the residential environments of community-dwelling adults with disabilities.

Evaluating a mobile app’s effects on depression and anxiety in medication-treated opioid use disorder

Depression and anxiety frequently co-occur with opioid use disorder (OUD) yet are often overlooked in standard OUD treatments. This study evaluated the feasibility, acceptability, and preliminary effectiveness of a mobile application designed to address these symptoms in individuals receiving medications for OUD (MOUD). A randomized controlled trial recruited N = 63 adults with OUD who received MOUD and screened positive for moderate depression or generalized anxiety. Participants were randomized to an app-based digital intervention or treatment-as-usual for 4 weeks, and completed follow-ups at 4 and 8 weeks. Primary outcomes were self-reported severity measures for depression and generalized anxiety, and urine drug screens (UDS). Secondary outcomes included self-reported OUD severity, craving intensity, and digital biomarkers derived from passive smartphone sensors. The application was well-received (median app rating = 4/5 stars). The intervention group showed significant reductions in depressive and generalized anxiety symptoms post-intervention and at 8 weeks follow-up (d > 0.70), with large (d = 0.78) and moderate (d = 0.38) effect sizes, respectively, compared to controls. Both groups exhibited substantial decreases in self-reported severity of opioid use symptoms (d > 2.50). UDS suggested similar between-group adherence to MOUD, with a marginal decrease in opioid (MOP) use in the intervention group and increase in controls, yielding medium between group effect sizes (d = 0.44). Passive sensor data suggested significant increases in social connectedness in the intervention group, evidenced by a significant rise in incoming and outgoing calls and text connections. Initial evidence supports the feasibility and acceptability of a digital intervention for treating anxiety and depressive symptoms in persons receiving MOUD. While underpowered to confidently determine statistical significance beyond directionality, the intervention showed promise in reducing depressive and anxiety symptoms, suggesting its potential as a cost-effective and scalable adjunctive therapy alongside standard OUD treatment. Due to the preliminary nature of this pilot study, further research with sample sizes permitting greater statistical power is needed to confirm findings and explore long-term effects.

Relationship Between Voice Problems and Depression Among American Adults.

Voice problems have a large impact on quality-of-life and societal participation. It has been previously reported that persons with voice problems have a higher likelihood of depression than those without voice problems. Despite this knowledge, little has changed in clinical practice related to screening for depression or incorporating the presence of depression in treatment planning. This study aims to provide an updated analysis of the prevalence of depressive symptoms in persons with voice disorders to elucidate the current magnitude of the relationship in hopes that this will provoke greater awareness of the co-occurrence of voice problems and depression and improve clinical care. Cross-sectional design with a national survey. None. The study examined the 23,706 adults from the 2022 National Health Interview Survey database. A series of logistic regression models with propensity score matching approaches were used to examine the association between voice problems and depression by accounting for demographics and health conditions. When comparing persons with and without voice problems, there were statistical differences in demographics and health conditions (all P < .05); however, those differences were balanced by propensity score matching methods (all P > .05). The balanced samples revealed that those with voice problems were approximately twice as likely to experience depressive symptoms (odds ratios ranged from 1.532 to 2.024, all P < .05) compared to those without voice problems. Depressive symptoms increased with the severity (P < .0001) and duration of the voice problem (P = .0328). The study found robust associations between voice problems and depression within the current American adult population in 2022. To achieve optimal treatment outcomes, it is critical that the co-occurrence of voice problems and depression is understood, and that treatment planning addressed both conditions, when applicable.

Abstract B030: Assessing COVID-19 vaccination status and symptoms in persons with a history of cancer

Abstract Background: Persons with a history of cancer are at a higher risk of adverse COVID-19 outcomes due to their immunosuppressed status. Vaccination to COVID-19 has proven effective in decreasing complications from COVID-19 infection. This study explored the vaccination status of persons receiving cancer care (received 1st dose/2nd dose/booster) and their symptoms. Methods: Persons with a cancer diagnosis receiving care at a cancer center clinical site were randomly invited to complete a voluntary survey via email, the EMR, or during an in-person appointment. Paper surveys were completed in the clinic, placed in a sealed collection bin, and collected by research staff weekly. Responses were anonymous. Participants were asked if they had received their 1st/2nd COVID-19 vaccine, their symptoms, and if they had/intended to receive the booster. The study was conducted between September 2021 to September 2022. An EMR review of vaccination uptake was conducted to assess representativeness of our sample. Results: 6,302 persons were invited to complete the survey; 1,733 (28%) responded. 1694 (98%) had received at least one vaccine dose. 67.46% of the participants were white, non-Latinx; 25.39% were Black; 3.17% were Asian. 13.25% were 18-50 years; 30.61% were 50-64;36.81% were 65-74; 19.33% were 75+. 33.13% had a breast cancer diagnosis; 5.47% had lung cancer, 5.41% had prostate cancer, 4.29% had colorectal carcinoma, and 47.42% had other cancers. 1016 (58.63%) received their 1st COVID-19 vaccine, 1437 (82.92%) the 1st/2nd dose, and 1052 (60.70%) had received the booster (3rd dose). Frequently reported symptoms were muscle soreness, pain, fatigue, fever and headache. Those over 65 years were significantly more likely to report fatigue (p&amp;lt;0.001), fever (p&amp;lt;0.0001), headache (p&amp;lt;0.0001), nausea (p=0.0005). Black persons were less likely to report fever (OR: 0.54, 95% CI: 0.34 – 0.86, p=0.0097) and more likely to report pain (OR: 1.58, 95% CI: 1.02 – 2.46, p=0.0427). For persons with breast cancer--29.46% reported muscle soreness, 12.95% reported fatigue, 10.13% reported headache, 9.19% reported fever, 7.13% reported pain. We were unable to stratify by other demographics or cancer type due insufficient sample size. EMR review of vaccination uptake revealed 24.17% had not initiated vaccination. Conclusion: Survey respondents were more likely to have initiated the COVID-19 vaccination process. Older adults were more likely to report fatigue, fever, headache and nausea. Black persons were less likely to report fever and more likely to report pain. Anticipating differences in COVID-19 vaccination symptoms allow for the development of tailored education and resources for self-management and care. Citation Format: Iqra Siddiqui, Ana Maria Lopez, FNU Nikita. Assessing COVID-19 vaccination status and symptoms in persons with a history of cancer [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B030.

A - 24 Treatment Response to Internet-Delivered Cognitive Behavioral Therapy for Depression in Multiple Sclerosis

Abstract Objective A recent randomized-controlled (phase III) clinical trial examined the efficacy of an internet-delivered cognitive behavioral therapy (iCBT) intervention designed to treat depressive symptoms in persons with multiple sclerosis (PwMS). Significant mean reductions in depressive symptoms were found in the stand-alone iCBT and guided-iCBT conditions compared to the control group. The purpose of the current study was to identify the proportion of PwMS who responded to iCBT (stand-alone and guided) for depression compared to a waitlist control group. Method 224 PwMS completed the Beck Depression Inventory-II (BDI-II) to measure depression severity at baseline and post-intervention. Reliable change index (RCI) scores for depressive symptoms were calculated for each participant. Clinical significance was determined using the 95th percentile cutoff (RCI = ± 1.96). Results Combining the stand-alone and guided-iCBT (n = 147) groups, 89 PwMS (61%) demonstrated a reliable decrease in BDI-II scores, whereas 58 PwMS (39%) did not show a reliable decrease. For waitlist controls (n = 77), 19 PwMS (25%) showed a reliable decrease in BDI-II scores, χ2(2, N = 224) = 33.82, p &amp;lt; 0.001, φ = 0.39. Conclusions We found that the iCBT treatment was highly effective, with 61% of PwMS showing a reliable decline in depressive symptoms compared with only 25% of waitlist controls. Still, generally consistent with previous research, almost 40% of PwMS did not respond to iCBT for depression. Future work will investigate baseline cognitive, psychosocial, and disease-related predictors of response to iCBT to better understand treatment outcomes and possible targets to optimize interventions for depression in MS.

A Descriptive Study to Assess the Impact of Covid-19 and Lockdown on Mental Health of School Children in Selected Schools at Mysuru

Background: Child development includes the biological, psychological and emotional changes that occur in human beings between birth and end of adolescence period. Childhood is classified into three stages of life which involves early childhood, middle childhood, and adolescence. Children might be in special need for support in handling anxiety caused by the disruptive situation. The conditions probably make the situation particularly challenging for young children, which is hypothesized to lead to increased emotional and behavioral problems. The COVID-19 pandemic has generated a lot of anxiety, stress, and grief. These stressors can cause mental health problems for anyone, and they can trigger acute symptoms in persons who already have mental health problems. Methods: The aim of the study is to assess the impact of COVID-19 and lockdown on mental health of school children in selected schools at Mysuru. Research design adopted for the study was descriptive survey design. Non probability convenience sampling technique was adopted to select 50 school children with in the age group of 12 to 15 years. Personal Variable Proforma was used to assess the selected personal variables and Structured Knowledge Questionnaire was used to assess the knowledge of school children regarding impact of COVID-19 and lockdown on mental health of school children in selected schools at Mysuru. Conclusion: The results of the present study revealed that majority of the school children had negative impact regarding COVID-19 and lockdown on mental health. Impact of COVID-19 and lockdown on mental health of school children were not found to be significant with the personal variables. The COVID-19 related interruptions need to be focused some key challenges and measures to control and manage COVID-19 crisis. Health care professionals play a vital role in educating and providing basic health care services to the school children.

The longitudinal study of the relationship between social participation pattern and depression symptoms in frail older adults.

Mental health challenges are encountered by frail older adults as the population ages. The extant literature is scant regarding the correlation between depressive symptoms and social participation among frail older adults. This study is based on an analysis of data from China Health and Retirement Longitudinal Study (CHARLS) participants aged 60 and older who are frail. A frailty index (FI) was developed for the purpose of assessing the frailty level of the participants. Additionally, latent class analysis (LCA) was employed to classify the participants' social engagement patterns in 2015 and 2018. The study used ordered logistic regression to examine the relationship between social participation type and depressive symptoms. We also used Latent Transition Analysis (LTA) methods to explore the impact of changes in social activity types on depressive symptoms after three years of follow-up in 2018. In addition, the response surface analysis (RSM) investigation explored the relationship among FI, depression, and social participation. A total of 4,384 participants completed the baseline survey; three years later, 3,483 were included in the follow-up cohort. The baseline survey indicates that female older adults in rural areas who are single, have lower incomes, shorter sleep durations, and lighter weights exhibited more severe depressive symptoms. Social participation patterns were categorized into five subgroups by LCA. The findings indicate that individuals classified as "board game enthusiasts" (OR, 0.62; 95% CI, 0.47-0.82) and those as "extensive social interaction" (OR,0.67; 95% CI, 0.49-0.90) have a significantly lower likelihood of developing depressive symptoms compared to the "socially isolated" group. We also discovered that "socially isolated" baseline participants who transitioned to the "helpful individual" group after three years had significantly greater depressed symptoms (OR, 1.56; 95% CI, 1.00-2.44). More social activity types and less FI are linked to lower depression in our study. The results of the study emphasize the importance of social participation patterns and the number of social participation types in relation to the severity of depression among frail older adults individuals. This study's findings may provide important insights for addressing depressive symptoms in frail older adults person.

Improving efficacy of repetitive transcranial magnetic stimulation for treatment of Parkinson disease gait disorders.

Parkinson disease (PD) is a neurodegenerative disorder that causes motor and cognitive deficits, presenting complex challenges for therapeutic interventions. Repetitive transcranial magnetic stimulation (rTMS) is a type of neuromodulation that can produce plastic changes in neural activity. rTMS has been trialed as a therapy to treat motor and non-motor symptoms in persons with Parkinson disease (PwP), particularly treatment-refractory postural instability and gait difficulties such as Freezing of Gait (FoG), but clinical outcomes have been variable. We suggest improving rTMS neuromodulation therapy for balance and gait abnormalities in PwP by targeting brain regions in cognitive-motor control networks. rTMS studies in PwP often targeted motor targets such as the primary motor cortex (M1) or supplementary motor area (SMA), overlooking network interactions involved in posture-gait control disorders. We propose a shift in focus toward alternative stimulation targets in basal ganglia-cortex-cerebellum networks involved in posture-gait control, emphasizing the dorsolateral prefrontal cortex (dlPFC), cerebellum (CB), and posterior parietal cortex (PPC) as potential targets. rTMS might also be more effective if administered during behavioral tasks designed to activate posture-gait control networks during stimulation. Optimizing stimulation parameters such as dosage and frequency as used clinically for the treatment of depression may also be useful. A network-level perspective suggests new directions for exploring optimal rTMS targets and parameters to maximize neural plasticity to treat postural instabilities and gait difficulties in PwP.

Tear Film Conditions and Depression Symptoms in Persons with Obesity.

Most persons with obesity who have undergone gastric bypass surgery present depressive symptoms. Depression and anxiety have been associated with tear film disorders. This study aimed to investigate whether there is a correlation between tear film conditions and depression symptoms in patients subjected to bariatric surgery. The participants completed a Patient Health Questionnaire to detect depression symptoms. The break-up time and Schirmer test were subsequently applied; the measurements were performed three times, and the average time was subsequently recorded. The results revealed that the Schirmer test score and PH-9 score were negatively correlated, but this was not the case for the break-up time test. Depression symptoms may correlate with lower tear production from the principal tear gland, but they may not have the same effect on meibomian gland production in adults undergoing bariatric surgery. In addition to routine control, bariatric surgery patients should be periodically evaluated by an ophthalmologist and/or psychologist who is aware of potential comorbidities. Furthermore, the observed association between depression symptoms and tear deficiencies highlights the importance of further investigations to gain a better understanding of these mechanisms.

Burden of family caregivers in Alzheimer’s disease: The role of caregivers’ perception of cognitive impairment

Objectives This study examined the role of caregivers’ perception of cognitive impairment in burden of family caregivers in Alzheimer’s disease (AD). We hypothesized that the evaluation of cognitive impairment by family caregivers plays a pivotal role in burden. Methods The study included 110 dyads (person with AD and their caregiver) recruited from a Memory Unit in France. The cognitive impairment and depressive symptoms of person with AD were evaluated by a geriatrician using the Mini Mental State Examination (MMSE) and the Geriatric Depression Scale (GDS-15). Caregivers provided self-reports on the perception of cognitive impairment (IQCODE) of the care recipient, the caregiving burden (ZBI), depressive symptoms (GDS-15), and self-esteem (RSE). Descriptive analyses, comparison of different caregiver burden groups, and multinomial logistic regression analyses to understand correlates of caregiver burden were conducted with SPSS®, version 20. Results The findings show that the caregivers are on average 60 years old and the majority are women. They care for persons with AD, who are on average 82 years old and most of whom are women. Our results show that the duration of caregiving, depression of the caregiver, and caregivers’ perception of cognitive impairment contribute significantly to burden of caregiver. Discussion This study shows that it is necessary to adopt the caregiver-centered approach to support the dyad. The role of the caregivers’ perception of cognitive impairment in AD should be developed when supporting caregivers in suffering.

Effects of Savings on Depressive Symptoms Among Homeless People in Korea: Using Propensity Score Matching

Researchers have found that the accumulation of assets through savings may serve a vital function in enhancing mental health and well-being. However, the question of how the status of savings affects the level of depressive symptoms in homeless persons remains largely unexplored. This study examines the relationship between savings and depressive symptoms in homeless individuals by utilizing the 2016 National Survey on Homeless People. We employed propensity score matching to reduce selection bias and multivariate logistic regression to probe the effects of savings on depressive symptoms. We found that after taking into account the covariates, a lower level of savings was associated with a higher level of depressive symptoms. Our findings imply that an asset-based policy orientated toward those facing homelessness could have a significant effect on reducing depressive symptoms.

The Future of Speech Therapy for Autism: Bridging Technology and Personalized Care

Researchers have been working on autism since the 1980s [1]. Autism spectrum disorder (AUD) is a complex neurodevelopment condition that affects people's interaction with others, behavior, communication, and social interaction. Although autism may be a lifelong condition, appropriate support, services, and treatments can improve a person's symptoms and daily functioning. Individuals with autism often face challenges with speech and language development are prominent. Speech therapy (ST) plays a role in gaining control over verbal communication. An effective speech therapy can enhance the quality of life by addressing communication difficulties. Traditionally, the treatment of autism has a multidisciplinary approach that aims to address the diverse needs of individuals on the spectrum. Advancements in technology are revolutionizing the field by offering various possibilities for personalized care and improved outcomes. Healthcare professionals diagnose autism by assessing a person's development patterns and behaviors. Currently, speech therapy is delivered through face-to-face interactions with a trained therapist. Because parents of autistic children consistently identify language and social communication skills as a top priority. This approach has limitations, like scheduling conflicts, limited access to geographical constraints, and specialized care [2]. Telepractice platforms and virtual reality systems (VR), offer novel opportunities for accessible, personalized, and engaging therapy experiences. Telepractice is an online therapy service via technology-based platforms that allows long-distance interventions, breaking geographical barriers and expanding access to specialized care. Specifically, telepractice capitalized on communication practices such as video conferencing, and data tracking tools to facilitate effective communications and reduce barriers like distance. It is a very effective and low-cost method for conducting and completing online sessions for individuals with autism spectrum disorder [3]. The use of mobile technology in various countries become a necessity in the lives of people and also makes it a potential medium of intervention for people diagnosed with autism. It also enhances social skills, language development, and communication abilities. Virtual reality is an essential tool for healthcare intervention, offering realistic scenarios for practicing communication strategies and social interaction. Virtual reality interventions can lead to more stable and faster communication skills over time [4]. Advancements in artificial intelligence has enabled therapists to analyze data and identify patterns to meet the unique needs of each individual with autism. Technology is poised to facilitate collaboration and communication among individuals, and promote consistency across various settings. Researchers are involved in creating and training robots to interact with autistic children. We can empower individuals with autism to reach their full communication potential with the help of these latest technologies.

Impact of vortioxetine on depressive symptoms moderated by symptoms of anxiety in persons with post-COVID-19 condition: A secondary analysis

ObjectiveRecovery from a COVID-19 infection can lead to post-COVID-19 condition (PCC), which causes a multitude of debilitating symptoms that negatively affect an individual's health-related quality of life, including depressive and anxiety symptoms. We aim to examine the mediatory effects of anxiety on depressive symptoms in persons with PCC receiving vortioxetine. MethodsWe performed a post-hoc analysis of a randomized, double-blinded, placebo-controlled clinical trial investigating vortioxetine treatment on cognitive functioning in persons with PCC. Anxiety and depressive symptoms were measured by the 7-Item Generalized Anxiety Disorder (GAD-7) Scale and the 16-Item Quick Inventory of Depressive Symptomatology (QIDS-SR-16), respectively. ResultsBased on data of 147 participants, GAD-7 scores were significantly positively associated with QIDS-SR-16 scores (β=0.038, 95 % CI [0.029,0.047], p < 0.001). After adjusting for covariates, a significant group (χ2=176.786, p < 0.001), time (χ2=8.914, p = 0.003), and treatment x time x GAD-7 score interaction (χ2=236.483, p < 0.001) effect was observed. Vortioxetine-treated participants had a significant difference in overall change in depressive symptoms (mean difference=-3.15, SEM=0.642, 95 % CI [-4.40,-1.89], p < 0.001). ConclusionAnxiety symptoms were significantly associated with depressive symptoms in persons with PCC. Antidepressant efficacy on ameliorating depressive symptoms is dependent on improving anxiety symptoms, underscoring significant implications in improving treatment efficacy and patient quality of life.

Does Social Support Play a Role in the Expression and Everyday Functioning Impact of Apathy in HIV Disease?

Clinically notable apathy occurs in approximately one-third of persons living with HIV (PLWH). Drawing from psychological theory, this cross-sectional study examined the interplay between apathy and social support in persons with (n = 143) and without (n = 61) HIV disease. Analyses were conducted using multiple regression and mediation procedures with 95th percentile bootstrap confidence intervals. Positive HIV serostatus and lower social support were associated with more frequent apathy, independent of other mood symptoms. Social support did not moderate apathy's associations with everyday functioning among PLWH, but post hoc analyses revealed that apathy mediated the relationship between social support and everyday functioning among PLWH. Stronger social support may provide a buffer against the frequency of apathy symptoms in persons with and without HIV disease. The relationship between lower social support and poorer everyday functioning in HIV might be partly explained by apathy. Longitudinal research is needed to examine the mechanisms of these relationships.

A diet low in fermentable oligo-, di-, monosaccharides and polyols improves abdominal and overall symptoms in persons with all subtypes of irritable bowel syndrome.

A diet low in fermentable oligo-, di-, monosaccharides and polyols (LFD) improves symptoms in patients with irritable bowel syndrome (IBS). Previous studies have focused on patients with IBS and diarrhea (IBS-D). It is unclear whether LFD is effective for IBS with constipation (IBS-C) or IBS with mixed bowel habits (IBS-M). This open-label, real-world study evaluates the relative effectiveness of the LFD among IBS subtypes. This study analyzes data from a service that provides low-FODMAP meals to individuals with IBS. Participants met with a registered dietitian and completed the IBS symptom severity survey (IBS-SSS) before and after undergoing a 2-4-week period of FODMAP restriction. The primary endpoint was the proportion of participants with ≥50-point decrease in IBS-SSS between the three IBS subtypes. After FODMAP restriction, 90% of participants with IBS-D, 75% with IBS-C, and 84% with IBS-M met the primary endpoint (p = 0.045). Similar improvement was seen for a 100-point decrease, but the difference between IBS subtypes was not significant (p = 0.46). After FODMAP restriction, all groups had statistically significant improvement in total IBS-SSS as well as individual symptom categories. Improvement in IBS-SSS subcategories was similar among the groups except for the categories of bloating severity (IBS-M had greatest improvement) and bowel movement satisfaction (IBS-C had less improvement). Though the proportion of responders was highest for IBS-D and lowest for IBS-C, the LFD led to robust improvement in overall symptoms in all IBS subtypes. Key individual symptoms also showed significant improvements in all IBS subtypes.

Association between fatigue and depressive symptoms in persons with post-COVID-19 condition: a post hoc analysis

Objective Post-COVID-19 Condition (PCC) is a prevalent, persistent and debilitating phenomenon occurring three or more months after resolution of acute COVID-19 infection. Fatigue and depressive symptoms are commonly reported in PCC. We aimed to further characterize PCC by assessing the relationship between fatigue and depressive symptom severity in adults with PCC. Methods A post hoc analysis was conducted on data retrieved from a randomized, double-blinded, placebo-controlled study evaluating vortioxetine for cognitive deficits in persons with PCC. We sought to determine the relationship between baseline fatigue [i.e. Fatigue Severity Scale (FSS) total score] and baseline depressive symptom severity [i.e. 16-item Quick Inventory of Depressive Symptomatology (QIDS-SR-16) total score] in adults with PCC. Results The statistical analysis included baseline data from 142 participants. After adjusting for age, sex, education, employment status, history of major depressive disorder (MDD) diagnosis, self-reported physical activity, history of documented acute SARS-CoV-2 infection and body mass index (BMI), baseline FSS was significantly correlated with baseline QIDS-SR-16 (β = 0.825, p = .001) Conclusion In our sample, baseline measures of fatigue and depressive symptoms are correlated in persons living with PCC. Individuals presenting with PCC and fatigue should be screened for the presence and severity of depressive symptoms. Guideline-concordant care should be prescribed for individuals experiencing clinically significant depressive symptoms. Fatigue and depressive symptom severity scores were not pre-specified as primary objectives of the study. Multiple confounding factors (i.e. disturbance in sleep, anthropometrics and cognitive impairment) were not collected nor adjusted for in the analysis herein. Trial registration Unrestricted Research Grant from H. Lundbeck A/S, Copenhagen, Denmark. ClinicalTrials.gov Identifier: NCT05047952

Disrupted hemodynamic response within dorsolateral prefrontal cortex during cognitive tasks among people with multiple sclerosis-related fatigue.

Mental fatigue is an early and enduring symptom in persons with autoimmune disease particularly multiple sclerosis (MS). Neuromodulation has emerged as a potential treatment although optimal cortical targets have yet to be determined. We aimed to examine cortical hemodynamic responses within bilateral dorsolateral prefrontal cortex (dlPFC) and frontopolar areas during single and dual cognitive tasks in persons with MS-related fatigue compared to matched controls. We recruited persons (15 MS and 12 age- and sex-matched controls) who did not have physical or cognitive impairment and were free from depressive symptoms. Functional near infrared spectroscopy (fNIRS) registered hemodynamic responses during the tasks. We calculated oxyhemoglobin peak, time-to-peak, coherence between channels (a potential marker of neurovascular coupling) and functional connectivity (z-score). In MS, dlPFC demonstrated disrupted hemodynamic coherence during both single and dual tasks, as evidenced by non-significant and negative correlations between fNIRS channels. In MS, reduced coherence occurred in left dorsolateral PFC during the single task but occurred bilaterally as the task became more challenging. Functional connectivity was lower during dual compared to single tasks in the right dorsolateral PFC in both groups. Lower z-score was related to greater feelings of fatigue. Peak and time-to-peak hemodynamic response did not differ between groups or tasks. Hemodynamic responses were inconsistent and disrupted in people with MS experiencing mental fatigue, which worsened as the task became more challenging. Our findings point to dlPFC, but not frontopolar areas, as a potential target for neuromodulation to treat cognitive fatigue.

End of life care: how nurses can use a compassionate approach.

The reality of death and dying is a central facet of life, often surrounded by feelings of sadness, fear and uncertainty. Nurses have an essential role in caring for people who are approaching the end of life and their families, while being mindful of the current demands and challenges in health and social care services. In this article, the author suggests that being more open to the reality of death as part of life may assist nurses in being more attuned to the personal needs of those who are dying. The article emphasises the importance of considering each person's symptoms and concerns through the lens of compassion to address pain, fear and distress. While the focus is on caring for people who are approaching the end of life, the author asserts that there is much that nurses can learn from those they care for about the beauty of life and the naturalness of death.

Monkeypox Virus Infections After 2 Preexposure Doses of JYNNEOS Vaccine - United States, May 2022-May 2024.

Two doses of JYNNEOS vaccine are effective in preventing many mpox cases and can reduce the severity of symptoms in infected persons. However, infections among fully vaccinated persons can occur. During May 2022-May 2024, a total of 271 mpox cases among fully vaccinated persons were reported to CDC from 27 U.S. jurisdictions. These reported infections are estimated to have occurred in <1% of fully vaccinated persons. Compared with cases among unvaccinated persons, infections among fully vaccinated persons were more likely to occur among non-Hispanic White men aged 30-39 years, were associated with increased numbers of sexual partners, and resulted in less severe disease (p<0.001). Among infections in fully vaccinated persons with complete data, infections after vaccination were reported more commonly after receipt of heterologous (subcutaneous and intradermal) (46%) or homologous subcutaneous (32%) JYNNEOS vaccination than after homologous intradermal (22%) vaccination. Disparate time intervals from vaccination to infection among fully vaccinated persons suggest that immunity is not waning. The median interval between the second vaccine dose and illness onset was longer for cases among persons who had received 2 intradermal doses (median=363 days; IQR=221-444 days) compared with cases in persons who had received 2 subcutaneous doses (median=263 days; IQR=47-334 days) (p<0.001). The implications of this finding are not known; however, these data should increase confidence in the effectiveness of vaccine doses that were administered intradermally, the preferred method of administration during the peak of the outbreak when vaccine supply was limited. Persons recommended to receive the JYNNEOS vaccine should receive 2 doses, irrespective of the route of administration, and at this time, additional doses are not recommended for the affected population.

The prevalence of mild cognitive impairment in breast cancer patients receiving chemotherapy according to the criteria of the National Institute on Aging-Alzheimer's Association (NIA-AA).

Breast cancer patients receiving chemotherapy can develop cognitive impairment. There is no gold standard for defining cognitive impairment. We applied the National Institute on Aging-Alzheimer's Association (NIA-AA) criteria for mild cognitive impairment (MCI) to determine its prevalence in breast cancer patients receiving adjuvant chemotherapy and examine differences between patients with and without MCI. We used pre-existing cognitive data on 5 neuropsychological test outcomes (verbal memory, processing speed, executive functioning, and verbal fluency) gathered from 240 breast cancer patients who received adjuvant conventional (n = 154) or high-dose chemotherapy (n = 86). Assessments occurred 6 or 12months post-chemotherapy and results were compared with data from 66 women without cancer. MCI was defined by the following: (i) presence of concern regarding a change in cognition, (ii) impairment in one or more cognitive tests (1.5 standard deviation below a normative mean), (iii) preservation of independence in functional abilities, and (iv) the absence of dementia. Twenty percent (n = 49) of breast cancer patients who received chemotherapy (conventional therapy n = 29 (12%), high-dose therapy = 20 (8.3%)) met the criteria for MCI, compared with 7.6% (n = 5) of controls. Prevalence was significantly different between patients and controls (P = 0.020, and corrected for IQ P < 0.001). Patients with MCI had significant lower education levels (P < 0.002) and premorbid IQ (P = 0.001) compared with patients without MCI. Twenty percent of breast cancer patients treated with chemotherapy met NIA-AA criteria for MCI, compared with 7.6% of the controls. These criteria, which include formal test performance as well as a person's symptoms and functional status, can be useful in clinical practice and scientific research.