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Factors Affecting Caregiver Burden in Informal Caregivers of Patients with Autism Spectrum Disorder
Get PDFIndividuals with Autism Spectrum Disorder (ASD) often require lifelong care to meet their daily needs, which is typically provided by informal sources like family members as well as formal caregivers from home health agencies. The persistent stress of raising a child with ASD can potentially lead to parental burnout, highlighting the importance of understanding the struggles faced by these caregivers. Clinicians must prioritize the well-being of both the individuals with ASD and their dedicated caregivers by gaining a comprehensive understanding of the challenges they encounter.
Our research aims to investigate and comprehend the specific challenges faced by caregivers of individuals diagnosed with ASD. By utilizing the Caregiver Burden Inventory (CBI; Novak & Guest, 1989), we sought to pinpoint the primary elements that contribute to caregiver burden and evaluate how it affects the wellbeing of caregivers. These findings can ultimately lay the foundation for targeted interventions and strategies aimed at lessening the burden on caregivers, ensuring they receive the necessary support to provide optimal care for their loved ones with ASD while maintaining their own well-being
Fos Expression in Lateral Hypothalamus/Perifornical Area is Correlated with Psychosocial Stress-Induced Cocaine-Seeking Behavior in a Sex-Specific Manner
Get PDFCocaine Use Disorder persists as a significant public health concern in the United States. Recent epidemiological data indicate that rates of cocaine-involved overdose deaths are rising, and treatment of Cocaine Use Disorder is challenging due to a lack of FDA-approved medications to help patients achieve abstinence and avoid relapse. Stress can precipitate cocaine craving and trigger relapse episodes, however the underlying neural circuitry by which stressors drive cocaine seeking is not completely understood. Our laboratory has recently identified the potential involvement of the rostrolateral aspect of the periaqueductal gray (rlPAG) in psychosocial stress-induced cocaine-seeking behavior using a rodent model of cocaine relapse. Neuroanatomical evidence points to a dense monosynaptic input from the lateral hypothalamus (LH) to the rlPAG, yet whether activity within the LH is also associated specifically with psychosocial-stress induced cocaine seeking has not been previously explored. In this study, adult male and female Long-Evans rats were allowed to self-administer cocaine (0.5 mg/kg/inf, IV) in 2-h daily sessions for 20 sessions. During sessions 11, 14, 17, and 20, a tactile cue (perforated polycarbonate enclosure) was placed within the operant chamber, and these sessions were immediately followed by either social defeat stress (SDS, n=16; 8M, 8F) or a no-stress empty-cage control condition (EC, n=12; 6M, 6F). Beginning on day 21, animals underwent extinction training during which lever-presses were not reinforced. Once responding was extinguished, rats were re-exposed to the tactile cue that signaled their assigned stress/no-stress stimulus, and reinstatement of cocaine-seeking was measured for 2 h under extinction conditions. Immediately after the reinstatement test, animals were sacrificed, and brains collected and processed via immunohistochemistry for expression of the immediate early gene c-Fos and the neuropeptide orexin within the LH and neighboring Perifornical Area (PfA). Despite no significant difference between groups in the number of Fos+ or orexin+ cells in the LH/PfA, there was a significant positive correlation between Fos expression in non-orexinergic LH/PfA cells and stress-induced cocaine-seeking magnitude specifically within males. Additionally, Fos expression in these cells was also significantly and positively correlated with Fos expression in the rostrolateral periaqueductal gray. Collectively, these findings suggest that a LH --\u3e rlPAG projection may be selectively engaged during psychosocial stress-induced cocaine seeking behavior in male rats
A SOCIAL ECOLOGY MODEL FOR SOCIAL DETERMINANTS OF HEALTH AS PSYCHOSIS RISK FACTORS
Get PDFSocial determinants of health (SDOHs) significantly impact psychosis risk beyond heritability. However, there is a need for an organizing framework to observe how these diverse elements concurrently predict psychosis risk. This study examines SDOHs as psychosis risk factors using a four-level model, aligned with Bronfenbrenner\u27s social ecology theory. The study aims to assess the proposed model’s ability to predict psychosis risk. Specifically, it is hypothesized that each socioecological level of the model would predict psychosis risk with more proximal SDOHs (e.g., individual level vs community) exhibiting stronger predictive power, aligning with Social Ecology theory. College students (N = 210) completed self-report measures of schizotypy, childhood trauma, minority group position, social connectedness, urbanicity, health care access, and SES via online surveys. The overall model accounted for a significant amount of psychosis risk variance (34.8%) with each level contributing significantly. However, contrary to expectations, SDOH proximity did not correspond with predictive ability. Rather, social connectedness, childhood trauma, and healthcare access emerged as salient predictors. The current study provides evidence that a Social Ecology Model, despite limitations, may provide an advantageous framework for future research, risk measurement, and interventions. Current findings reinforce that many of these SDOHs, particularly social connectedness, may be worthwhile targets for interventions
Insurance Status and Its Effect on Mothers with Postpartum Depression (PPD) in the United States
Get PDFPostpartum depression (PPD) is a significant health issue in the US today: 1 in 8 new mothers experience symptoms of PPD. Understanding how social determinants of health impact the short and long-term health outcomes of patients with PPD is key to providing interventions that are effective, efficient, equitable, and patient-centered. In this literature review, we aimed to shed light on the association between discrepancies in health outcomes of mothers with PPD and their insurance status. A search was conducted across PubMed and ProQuest Central databases focusing on literature from 2014 onwards. Studies that explored factors contributing to PPD, the impact of PPD on breastfeeding and child development, and how insurance status influenced maternal healthcare access were selected for inclusion. Several longitudinal studies underscored the lasting impact of PPD on maternal and child health, emphasizing the need for comprehensive support services. We found that insurance status, particularly Medicaid coverage, played a significant role in access to postpartum care, with observed disparities in readmission rates and availability of mental health treatments. Understanding the intricate interplay of biological, genetic, and environmental factors influencing PPD is crucial for designing effective prevention and intervention strategies. Further, addressing systemic barriers and healthcare disparities is imperative in mitigating the impact of PPD. Future research should explore alternative treatment modalities, tackle healthcare disparities, and consider other socio-cultural factors influencing PPD prevalence and outcomes
Lower Extremity Weakness in the Setting of COVID Myositis
No full textBilateral lower extremity weakness has numerable causes including stroke, peripheral neuropathy, deconditioning, Guillain-Barre, Multiple Sclerosis, anterior cord syndrome, trauma, spinal epidural abscess and many more. It is imperative however, that we investigate and understand more rare causes of lower extremity weakness. Here we present the case of a 74-year-old female presented to the ED with a complaint of lower extremity weakness due to Covid myositis causing significant bilateral lower extremity weakness
Mechanisms of Extracellular Vesicle Uptake and Implications for the Design of Cancer Therapeutics
Get PDFThe translation of pre-clinical anti-cancer therapies to regulatory approval has been promising, but slower than hoped. While innovative and effective treatments continue to achieve or seek approval, setbacks are often attributed to a lack of efficacy, failure to achieve clinical endpoints, and dose-limiting toxicities. Successful efforts have been characterized by the development of therapeutics designed to specifically deliver optimal and effective dosing to tumour cells while minimizing off-target toxicity. Much effort has been devoted to the rational design and application of synthetic nanoparticles to serve as targeted therapeutic delivery vehicles. Several challenges to the successful application of this modality as delivery vehicles include the induction of a protracted immune response that results in their rapid systemic clearance, manufacturing cost, lack of stability, and their biocompatibility. Extracellular vesicles (EVs) are a heterogeneous class of endogenous biologically produced lipid bilayer nanoparticles that mediate intercellular communication by carrying bioactive macromolecules capable of modifying cellular phenotypes to local and distant cells. By genetic, chemical, or metabolic methods, extracellular vesicles (EVs) can be engineered to display targeting moieties on their surface while transporting specific cargo to modulate pathological processes following uptake by target cell populations. This review will survey the types of EVs, their composition and cargoes, strategies employed to increase their targeting, uptake, and cargo release, and their potential as targeted anti-cancer therapeutic delivery vehicles
Turning Toward Being: The Podcast: Chip Souba
No full textIn this conversation, Emeritus Dean of the Geisel School of Medicine at Dartmouth, Chip Souba shares the challenges faculty confront when exploring and engaging ontological inquiry within STEM oriented fields of study, including medicine
The Camden Study - A Pregnancy Cohort Study of Pregnancy Complications and Birth Outcomes in Camden, New Jersey, USA.
Get PDFBACKGROUND: Pregnancy is a unique stage of the life course characterized by trade-offs between the nutritional, immune, and metabolic needs of the mother and fetus. The Camden Study was originally initiated to examine nutritional status, growth, and birth outcomes in adolescent pregnancies and expanded to study dietary and molecular predictors of pregnancy complications and birth outcomes in young women.
METHODS: From 1985-2006, 4765 pregnant participants aged 12 years and older were recruited from Camden, NJ, one of the poorest cities in the US. The cohort reflects a population under-represented in perinatal cohort studies (45% Hispanic, 38% non-Hispanic Black, 17% White participants; 98% using Medicaid in pregnancy). Study visits, including questionnaires, dietary assessments, and biospecimen collection, occurred in early and late pregnancy as well as at delivery. Medical records were abstracted, and a subset of mothers and infants participated in a six-week postpartum visit.
RESULTS: Findings from the Camden Study have added to the understanding of adolescent and young adult maternal health and perinatal outcomes. These include associations of adolescent linear growth while pregnant with smaller neonatal birth size, low dietary zinc intake in early pregnancy with increased risk of deliveryweeks, and higher circulating fatty acid levels with greater insulin resistance. More recent analyses have begun to unpack the biochemical pathways in pregnancy that may be shaped by race as an indicator of systemic racism.
CONCLUSIONS: The Camden Study data and biorepositories are well-positioned to support future research aimed at better understanding perinatal health in under-represented women and infants. Linkages to subsequent health and administrative records and the potential for recontacting participants over 18-39 years after initial participation may provide key insights into the trajectories of maternal and child health across the life course
A Fresh Take: Seasonal Changes in Terrestrial Freshwater Inputs Impact Salt Marsh Hydrology and Vegetation Dynamics (Estuaries and Coasts, (2024), 10.1007/s12237-024-01392-1)
Get PDFSalt marshes exist at the terrestrial-marine interface, providing important ecosystem services such as nutrient cycling and carbon sequestration. Tidal inputs play a dominant role in salt marsh porewater mixing, and terrestrially derived freshwater inputs are increasingly recognized as important sources of water and solutes to intertidal wetlands. However, there remains a critical gap in understanding the role of freshwater inputs on salt marsh hydrology, and how this may impact marsh subsurface salinity and plant productivity. Here, we address this knowledge gap by examining the hydrologic behavior, porewater salinity, and pickleweed (Sarcocornia pacifica also known as Salicornia pacifica) plant productivity along a salt marsh transect in an estuary along the central coast of California. Through the installation of a suite of hydrometric sensors and routine porewater sampling and vegetation surveys, we sought to understand how seasonal changes in terrestrial freshwater inputs impact salt marsh ecohydrologic processes. We found that salt marsh porewater salinity, shallow subsurface saturation, and pickleweed productivity are closely coupled with elevated upland water level during the winter and spring, and more influenced by tidal inputs during the summer and fall. This seasonal response indicates a switch in salt marsh hydrologic connectivity with the terrestrial upland that impacts ecosystem functioning. Through elucidating the interannual impacts of drought on salt marsh hydrology, we found that the severity of drought and historical precipitation can impact contemporary hydrologic behavior and the duration and timing of the upland-marsh hydrologic connectivity. This implies that the sensitivity of salt marshes to climate change involves a complex interaction between sea level rise and freshwater inputs that vary at seasonal to interannual timescales