Impact of the Novel CoronaviruS (COVID-19) on Frontline PharmacIsts Roles and ServicEs: INSPIRE Worldwide Survey.

BACKGROUND: Pharmacy has been recognized as a vital healthcare profession during the COVID-19 pandemic. The primary objective of the INSPIRE Worldwide survey was to determine the impact of COVID-19 on pharmacy practice and pharmacists\u27 roles around the world. METHODS: A cross-sectional online questionnaire with pharmacists who provided direct patient care during the pandemic. Participants were recruited through social media, with assistance from national and international pharmacy organizations between March 2021-May 2022. The questionnaire was divided into (1) demographics, (2) pharmacists\u27 roles, (3) communication strategies, and (4) practice challenges. The data were analyzed using SPSS 28, and descriptive statistics were used to report frequencies and percentages. RESULTS: A total of 505 pharmacists practicing in 25 countries participated. The most common role that pharmacists undertook was responding to drug information requests (90%), followed by allaying patients\u27 fears and anxieties about COVID-19 (82.6%), and addressing misinformation about COVID-19 treatments and vaccinations (80.4%). The most common challenges were increased stress levels (84.7%), followed by medication shortages (73.8%), general supply shortages (71.8%), and inadequate staffing (69.2%). CONCLUSIONS: Pharmacists within this study were significantly impacted by the COVID-19 pandemic and took on new or adapted roles (e.g., providing COVID-specific information, managing patients\u27 emotions, and educating on public health measures) to meet the needs of their communities. Despite, the significant challenges (e.g., increased stress, supply chain challenges, addressing misinformation, and staffing shortages) faced by pharmacists, they continued to put their patients\u27 needs first and to provide pharmacy services

Neural mechanisms of negative reinforcement in children and adolescents with autism spectrum disorders

Abstract Background Previous research has found accumulating evidence for atypical reward processing in autism spectrum disorders (ASD), particularly in the context of social rewards. Yet, this line of research has focused largely on positive social reinforcement, while little is known about the processing of negative reinforcement in individuals with ASD. Methods The present study examined neural responses to social negative reinforcement (a face displaying negative affect) and non-social negative reinforcement (monetary loss) in children with ASD relative to typically developing children, using functional magnetic resonance imaging (fMRI). Results We found that children with ASD demonstrated hypoactivation of the right caudate nucleus while anticipating non-social negative reinforcement and hypoactivation of a network of frontostriatal regions (including the nucleus accumbens, caudate nucleus, and putamen) while anticipating social negative reinforcement. In addition, activation of the right caudate nucleus during non-social negative reinforcement was associated with individual differences in social motivation. Conclusions These results suggest that atypical responding to negative reinforcement in children with ASD may contribute to social motivational deficits in this population

Do Neural Correlates of Grip Force Predict Cognitive Impairment in Older Adults Living With HIV?

As a result of an aging population of people living with HIV (PLWH), geriatric syndromes, including frailty and cognitive impairment, have become highly prevalent and burdensome. The purpose of the current study was to investigate the neural correlates of grip force generation and cognitive impairment, as indexed by the Global Deficit Score (GDS), in PLWH. Eighteen participants completed a functional MRI task in which they were asked to repeatedly generate 0%, 20%, 50%, or 80% of their maximum force, neuropsychological battery, a physical mobility assessment, and questionnaires about their health. When generating higher versus lower levels of force, activation was observed in the right anterior prefrontal cortex. Activation in the basal ganglia may predict grip strength outside of the scanner but does not predict cognitive impairment. No associations were observed between neural correlates of grip strength and GDS.</p

COGNITIVE IMPAIRMENT, FRAILTY, AND GRIP FORCE GENERATION IN PEOPLE LIVING WITH HIV

People living with HIV (PLWH) face an earlier onset and higher rates of geriatric syndromes, including frailty and cognitive impairment. Grip force, an index of frailty, is sensitive to cognitive decline, central nervous system integrity, and may independently predict adverse health outcomes. The current study evaluates frailty, weakness, and cognitive impairment, as well as the neural correlates of grip force as they predict cognitive impairment. PLWH aged 55+ (N = 26; M = 61.9, SD = 4.7; 53.8% female; 76.9% Black) completed an fMRI task in which they were asked to generate 0%, 20%, 50%, and 80% of their maximum force, a neuropsychological battery, and a physical assessment. Cognitive impairment was indexed using the Global Deficit Score (GDS). Per Fried’s Frailty Phenotype, 3.8% of the sample was robust, 57.7% was pre-frail, and 38.5% was frail. Impairment in memory significantly predicted GDS, controlling for age (B = 0.3, t = 4.9, p < .001). Robust frailty status significantly predicted GDS, controlling for age (B = -1.1, t = -2.4, p < .05). Age was also a significant predictor of GDS, controlling for frailty status (B = -0.1, t = -2.7, p < .05). Weakness, as indexed by grip strength, predicted frailty (F = 4.5, p < .05). Additional analyses will be conducted to examine activation in brain regions germane to force generation during the fMRI task as a predictor of GDS. To our knowledge, this is the first study to examine neural correlates of grip force generation in PLWH

Neutrophil-to-Lymphocyte Ratio Amplifies the Effects of Aging on Decrements in Grip Strength and its Functional Neural Underpinnings

The neutrophil to lymphocyte ratio (NLR) is a trans-prognostic biomarker of physiologic stress and inflammation linked to muscle weakness in older adults. Generation of grip force coincides with sustained activity in the primary sensorimotor cortex (SM1). The current study investigates whether whole-brain functional connectivity, i.e., degree centrality (CD) of SM1 relates to grip strength and whether both functional measures are predicted by advancing age as a function of the NLR. A structural regression model investigated main and interactive effects of age and NLR on grip strength and CD of SM1 in 589 adults aged 21-85 years (M = 45.87, SD = 18.06). The model including the entire sample had good fit (χ2(4) = 1.63, p = .804). In individuals aged 50 years and older, age predicted lower grip strength and SM1 CD as a function of increasing NLR. In a model stratified by sex, the effect of age, NLR, and their interaction on grip strength are significant for older men but not older women. Analyses support CD of SM1 at rest as a neural biomarker of grip strength. Grip and its neural underpinnings decrease with advancing age and increasing NLR in mid- to late-life. Age-related decrements in grip strength and functional connectivity of brain regions involved in the generation of dynamic grip appear to be accelerated as a function of systemic physiological stress and inflammation, particularly in older men

A 4-Session Written Emotional Disclosure Intervention Lowers 6-Month Sympathoadrenal Urinary Output in Persons Living with HIV

We previously reported that a brief guided written emotional disclosure (WED) intervention resulted in significant reductions in post-traumatic stress disorder (PTSD) for women with HIV, but not for men. Urinary epinephrine (E) and norepinephrine (NE) are elevated in PTSD, but it is unclear whether 4-week WED mitigates adrenergic catecholamine output in men and women living with HIV. The current study tested the effect of a 4-week WED intervention on 6-month change in urinary E and NE. Fourteen women and 11 men living with HIV randomized to four 30-min expressive writing sessions of trauma writing or daily events writing in the parent trial. These individuals were included based upon complete urine specimens provided at baseline, 1-, and 6-months after the intervention. Total volume (µg) and concentration (µg/ml) of urinary E and NE were derived from the specimens. Four repeated measures analyses of covariance (ANCOVA) were run to evaluate study outcomes for trauma- versus daily-writing groups using intervention group as the between-subject factors and three time points as the within-subject factor, controlling for age and sex. A group x time interaction was observed wherein the trauma writing treatment group showed a significantly greater decrease in total urinary E output, F(2, 46) = 4.03, p =.03, and concentration, F(2, 46) = 4.74, p =.01. Post-hoc analyses revealed the interaction effect for the total, F(2, 22) = 4.82, p =.03, and concentration, F(2, 22) = 7.57, p =.005, of urinary E output over 6-months was driven by women. Interaction effects were not observed for total or concentration of urinary NE output. Significant reductions in the total output and concentration of urinary E were found up to 6-months following initiation of a 4-session guided written emotional disclosure intervention. These effects were driven by women enrolled in the intervention. •Urinary epinephrine (E) and norepinephrine measured before and after intervention.•Written emotional disclosure (WED) led to lower total E output vs. daily writing group.•Intervention effects for WED were present for women but not men at 6-months.•First study showing WED reduces sympathoadrenal output in PWH