Extracellular free water and glutathione in first-episode psychosis-a multimodal investigation of an inflammatory model for psychosis.

Evidence has been accumulating for an immune-based component to the etiology of psychotic disorders. Advancements in diffusion magnetic resonance imaging (MRI) have enabled estimation of extracellular free water (FW), a putative biomarker of neuroinflammation. Furthermore, inflammatory processes may be associated with altered brain levels of metabolites, such as glutathione (GSH). Consequently, we sought to test the hypotheses that FW is increased and associated with decreased GSH in patients with first-episode schizophrenia (SZ) compared with healthy controls (HC). SZ (n = 36) and HC (n = 40) subjects underwent a multi-shell diffusion MRI scan on a Siemens 3T scanner. 1H-MR spectroscopy data were acquired using a GSH-optimized MEGA-PRESS editing sequence and GSH/creatine ratios were calculated for DLPFC (SZ: n = 33, HC: n = 37) and visual cortex (SZ: n = 29, HC: n = 35) voxels. Symptoms and functioning were measured using the SANS, SAPS, BPRS, and GSF/GRF. SZ demonstrated significantly elevated FW in whole-brain gray (p = .001) but not white matter (p = .060). There was no significant difference between groups in GSH in either voxel. However, there was a significant negative correlation between DLPFC GSH and both whole-brain and DLPFC-specific gray matter FW in SZ (r = -.48 and -.47, respectively; both p < .05), while this relationship was nonsignificant in HC and in both groups in the visual cortex. These data illustrate an important relationship between a metabolite known to be important for immune function-GSH-and the diffusion extracellular FW measure, which provides additional support for these measures as neuroinflammatory biomarkers that could potentially provide tractable treatment targets to guide pharmacological intervention

Functional network changes and cognitive control in schizophrenia

Cognitive control is a cognitive and neural mechanism that contributes to managing the complex demands of day-to-day life. Studies have suggested that functional impairments in cognitive control associated brain circuitry contribute to a broad range of higher cognitive deficits in schizophrenia. To examine this issue, we assessed functional connectivity networks in healthy adults and individuals with schizophrenia performing tasks from two distinct cognitive domains that varied in demands for cognitive control, the RiSE episodic memory task and DPX goal maintenance task. We characterized general and cognitive control-specific effects of schizophrenia on functional connectivity within an expanded frontal parietal network (FPN) and quantified network topology properties using graph analysis. Using the network based statistic (NBS), we observed greater network functional connectivity in cognitive control demanding conditions during both tasks in both groups in the FPN, and demonstrated cognitive control FPN specificity against a task independent auditory network. NBS analyses also revealed widespread connectivity deficits in schizophrenia patients across all tasks. Furthermore, quantitative changes in network topology associated with diagnostic status and task demand were observed. The present findings, in an analysis that was limited to correct trials only, ensuring that subjects are on task, provide critical insights into network connections crucial for cognitive control and the manner in which brain networks reorganize to support such control. Impairments in this mechanism are present in schizophrenia and these results highlight how cognitive control deficits contribute to the pathophysiology of this illness

Behavioral Health Integration in Primary Care

Behavioral Health Integration in Primary Care Casey Zapata, Depts. of Psychology and English, Demetrius Carter, & MaryKate Crawford, and Samantha Mladen, Emily Donovan, Amber Fox, & Kristen O’Loughlin, Dept. of Psychology Graduate Students, with Dr. Bruce Rybarczyk, Dept. of Psychology Background/Aims: Due to limited access to mental health care, many patients present to primary care with mental health concerns, such as depression and anxiety. Integrated primary care (IPC), an emerging practice model that integrates behavioral health providers with medical providers in primary care, has been demonstrated to improve patient outcomes. This project aims to characterize patients being seen in safety-net IPC, both demographically and clinically. Methods: The data were collected across three safety-net clinics in the Richmond area. The sample consisted of 96 adult patients: 68 female (71%), 24 male (25%), 1 non binary (1%), and 3 not collected (3%); 54 African-American (56%), 29 White (30%), 1 Asian (1%), 1 Other (1%), and 11 not collected (12%). Measures included a patient-completed checklist of patients’ behavioral health concerns, the PHQ-9 for depression, the GAD-7 for anxiety, and clinician-completed chart review for demographic factors. Results: Of the 72 patients who completed the GAD-7, patients reported 13 (18%) severe symptoms of anxiety, 11 (15%) moderate symptoms, 15 (21%) mild symptoms, and 33 (46%) subclinical symptoms. For the 37 patients who completed the PHQ-9, patients reported 7 (19%) severe depressive symptoms, 10 (27%) moderately severe symptoms, 12 (32%) moderate symptoms, 6 (16%) mild symptoms, and 2 (5%) subclinical symptoms. The six most commonly patient-reported problems were stress (n= 73), anxiety (n= 70), depression (n= 65), sleep (n = 55), grief (n = 53), and irritability (n= 53). When asked to rank their top three concerning problems, the five concerns most commonly ranked as top problems were: : (1) anxiety (n = 29), (2) stress (n = 28), (3) depression (n = 27), (4) sleep (n=16), and (5) weight (n=15). Further, 56 (58%) participants reported both depression and anxiety as among their top three concerns. Discussion: Anxiety and depression were reported by the majority of patients, with 33% experiencing at least moderate anxiety and 78% experiencing at least moderate depression. Additionally, anxiety and depression were cited as the third most commonly reported concerns, respectively, as well as ranked within the top three most concerning problems for most participants. Stress, anxiety, depression, and sleep were included in both the most commonly reported problems and the most common top three concerns of participants, suggesting that these concerns are both pervasive and troublesome for participants. Over time, this project will prioritize increasing sample size and tracking longitudinal trends. The continued study of safety-net IPC may allow for increasing access to behavioral health, identifying common behavioral health concerns in primary care, and meeting unmet patient needs.https://scholarscompass.vcu.edu/uresposters/1340/thumbnail.jp

Should there be a female age limit on public funding for Assisted Reproductive Technology? Differing conceptions of justice in resource allocation

Should there be a female age limit on public funding for assisted reproductive technology (ART)? The question bears significant economic and sociopolitical implications and has been contentious in many countries. We conceptualise the question as one of justice in resource allocation, using three much-debated substantive principles of justice—the capacity to benefit, personal responsibility, and need—to structure and then explore a complex of arguments. Capacity-to-benefit arguments are not decisive: There are no clear cost-effectiveness grounds to restrict funding to those older women who still bear some capacity to benefit from ART. Personal responsibility arguments are challenged by structural determinants of delayed motherhood. Nor are need arguments decisive: They can speak either for or against a female age limit, depending on the conception of need used. We demonstrate how these principles can differ not only in content but also in the relative importance they are accorded by governments. Wide variation in ART public funding policy might be better understood in this light. We conclude with some inter-country comparison. New Zealand and Swedish policies are uncommonly transparent and thus demonstrate particularly well how the arguments we explore have been put into practice

MORe PREcISE: a multicentre prospective study of patient reported outcome measures in stroke morbidity: a cross sectional study

Background and Purpose The use of patient reported outcomes measures (PROMs) may offer utility that are important for stroke survivors. This study assessed the PROMIS-10, which contains Mental health (MH) and Physical Health (PH) domains, with an additional five stroke specific questions. The aim of this study was to evaluate the association between the MH and PH measures following a stroke and pre-existing health conditions. Methods A multicentre prospective cohort study at 19 hospital sites across England and Wales during 2019 was conducted. The association between each PROMIS-10 domain and demographic and health conditions were calculated using a multilevel multivariable linear and present the adjusted mean difference (aMD). Results The study enrolled 549 stroke survivors within 14 days of the index event, 232 were women (42.3%) and with a mean age of 72.7 years (SD = 12.9, range 25 to 97). The MH domain was scored as poor in 3.9% of participants, and very good or excellent in almost a half (48.4%). In contrast the PH domain was scored as poor in 39.9%, compared to very good or excellent in 8.5%. The MH domain was associated with pre-existing diabetes (aMD = − 2.01; 95%CI -3.91, − 0.12; p = 0.04), previous stroke (aMD = − 3.62; 95%CI -5.86, − 1.39; p = 0.001), age (aMD = 0.07; 95%CI: 0.01, 0.14; p = 0.037), and female sex (aMD = 1.91; 95%CI 0.28, 3.54; p = 0.022). The PH domain was found to be associated with sex (female) (aMD = 2.09; 95%CI 0.54, 3.65; p = 0.008) and previous stroke (aMD = − 3.05; 95%CI -5.17, − 0.93; p = 0.005). Conclusions Almost half of stroke survivors reported poor PH using a PROM with less reporting poor MH. age, and sex were associated with both MH and PH domains, and additionally pre-exising diabetes and stroke were associated with poorer MH. Clinical management offers an opportunity to investigate and intervene to prevent long term poorer health in stroke survivors

Parents’/caregivers’ fears and concerns about their child’s epilepsy: A scoping review

Background: Childhood epilepsy is a serious and common neurological condition and can have life-long consequences and its impact can pervade all aspects of family life. Whilst the medical management of seizures is important, much of the day-to-day home management of epilepsy is invisible to people external to the family, including health care professionals, and parents’/caregivers’ fears and concerns can go unacknowledged and unaddressed by health care professionals. Objective: This objective of this review was to examine parents’/caregivers’ fears and concerns regarding their child’s epilepsy, the impact of these fears and concerns on family life, the social and emotional well-being of parents/caregivers and any factors which mitigate these fears and concerns. Design: Scoping review using a modified version of Arksey and O’Malley’s framework. Data sources: Relevant studies were identified using key search terms in Scopus, Medline, CINAHL and PsychInfo databases in March 2021 with hand checking of reference lists. Search terms were developed using population (parents/caregivers of children aged ≤ 18 years with epilepsy, families); concept (parents’/caregivers’ fears, concerns, anxiety about their child’s epilepsy); and context (any setting). A further search was run in April 2022. Other inclusion criteria: English language empirical studies, 2010–2021. Study appraisal methods: A minimum of two reviewers independently screened articles and undertook data extraction and decisions were consensually made. Methodological quality appraisal was undertaken using the Mixed Methods Appraisal Tool v2018. A data extraction table was created to chart all studies. The conduct and reporting of this study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) (S1 Table). There is no published copy of the review protocol. Main findings: The search identified a total of 4077 papers (after duplicates were removed) of which 110 were assessed for eligibility. Twenty-four papers published between 2010–2021 were included in the review and each paper was treated as a separate study. The review findings indicate that parents’/caregivers’ fears and concerns stem from more than their child’s seizures and relate to many wider aspects of family life. These fears and concerns had far-reaching influences on their parenting/caregiving, and on the lifestyle and activities of their child and their family. What was less evident was what parents/caregivers wanted in terms of support or how they thought health professionals could acknowledge and/or allay their fears and concerns. The discussion is framed within the compassion-focused therapy model as a basis for generating new thinking about the impact of these fears and concerns and the need for a new agenda for clinical consultations in childhood epilepsy. Conclusions: The review concludes with a proposal that a more compassionate agenda underpins the dialogue between parents/caregivers and clinicians to encompass and mitigate the wider emotional, psychosocial, and societal threats that impact on the parent/caregivers of children with epilepsy

Valley View Farm: Main House

Prepared by the Fall 2011 Conservation of Historic Building Materials class. This historic structure report provided an assessment of present conditions, historic context, and recommendations for on going preservation of the main house located at Valley View Farm in Cartersville, Georgia. The purpose of this HSR is to provide the owners of the main house with a holistic examination of the structure and integrity of the house. Recommendations made are based on the Secretary of Interior’s Standards for Treatment of Historic Properties to maximize optimal long term preservation of this National Register property.https://scholarworks.gsu.edu/history_heritagepreservation/1041/thumbnail.jp

Hands Up, Now What?: Black Families’ Reactions to Racial Socialization Interventions

Given the heightened national attention to negative race-related issues and the subsequent community solution-oriented outcry (e.g., Black Lives Matter movement), it is crucial to address healing from racial discrimination for Black Americans. Clinical and community psychologists have responded by developing and implementing programs that focus on racial socialization and psychological wellness, particularly given disproportionate issues with utilization, access, and the provision of quality services within urban and predominantly Black communities. The aim of this article is to describe 2 applied programs (Engaging, Managing, and Bonding through Race and Family Learning Villages), which seek to address and heal racial stress through crucial proximal systems—families and schools—and to highlight participant reactions. These programs offer solutions through strengths-based and participatory approaches which draw from Black Americans’ own protective mechanisms related to improved mental health. We conclude with a discussion on practice, assessments, and models specific to racial stress for researchers, practitioners, and consumers of mental health services