Effects of stress

Complex cognitive tasks such as mental arithmetic heavily rely on intact, well-coordinated prefrontal cortex (PFC) function. Converging evidence suggests that frontal midline theta (FMT) oscillations play an important role during the execution of such PFC-dependent tasks. Additionally, it is well- established that acute stress impairs PFC function, and recent evidence suggests that FMT is decreased under stress. In this EEG study, we investigated FMT oscillations during a mental arithmetic task that was carried out in a stressful and a neutral control condition. Our results show late- onset, sustained FMT increases during mental arithmetic. In the neutral condition FMT started to increase earlier than in the stress condition. Direct comparison of the conditions quantified this difference by showing stronger FMT increases in the neutral condition in an early time window. Between- subject correlation analysis showed that attenuated FMT under stress was related to slowed reaction times. Our results suggest that FMT is associated with stimulus independent mental processes during the natural and complex PFC- dependent task of mental arithmetic, and is a possible marker for intact PFC function that is disrupted under stress

Interaction of HPA axis genetics and early life stress shapes emotion recognition in healthy adults

Background: Early life stress (ELS) affects facial emotion recognition (FER), as well as the underlying brain network. However, there is considerable inter-individual variability in these ELS-caused alterations. As the hypothalamic-pituitary-adrenal (HPA) axis is assumed to mediate neural and behavioural sequelae of ELS, the genetic disposition towards HPA axis reactivity might explain differential vulnerabilities. Methods: An additive genetic profile score (GPS) of HPA axis reactivity was built from 6 SNPs in 3 HPA axisrelated genes (FKBP5, CRHR1, NR3C1). We studied two independent samples. As a proof of concept, GPS was tested as a predictor of cortisol increase to a psychosocial challenge (MIST) in a healthy community sample of n=40. For the main study, a sample of n=170 completed a video-based FER task and retrospectively reported ELS experiences in the Childhood Trauma Questionnaire (CTQ). Results: GPS positively predicted cortisol increase in the stress challenge over and above covariates. CTQ and genetic profile scores interacted to predict facial emotion recognition, such that ELS had a detrimental effect on emotion processing only in individuals with higher GPS. Post-hoc moderation analyses revealed that, while a less stress-responsive genetic profile was protective against ELS effects, individuals carrying a moderate to high GPS were affected by ELS in their ability to infer emotion from facial expressions. Discussion: These results suggest that a biologically informed genetic profile score can capture the genetic disposition to HPA axis reactivity and moderates the influence of early environmental factors on facial emotion recognition. Further research should investigate the neural mechanisms underlying this moderation. The GPS used here might prove a powerful tool for studying inter-individual differences in vulnerability to early life stress

In-school, nutrition-related learning places in cooperation with out-of school project partners. A comparative case analysis using "Our clever dining room" as an example

Die Initiative "Unser cleveres Esszimmer" fördert an hessischen Schulen als externer Partner Beratungen durch Expertinnen und Experten in den Bereichen Ernährungsbildung und Schulverpflegung. Durch diese Unterstützung konnten an drei teilnehmenden Schulen innerschulische, ernährungsbezogene Lernorte geschaffen werden. Diese Lernorte leisten einen Beitrag zur formellen und informellen Ernährungsbildung an den Schulen. (DIPF/Orig.)The initiative "Our clever dining room" promotes consultation by experts in the fields of nutrition education and school catering in Hessian schools as an external partner. Through this support, it has been possible to create nutrition-related learning spaces in three participating schools. These places of learning contribute to formal and informal nutrition education in schools. (DIPF/Orig.

Nutrition in Pancreatic Cancer: A Review

Background: Pancreatic cancer is the fourth leading cause of cancer-related mortality in both genders. More than 80% of patients suffer from significant weight loss at diagnosis and over time develop severe cachexia. Early nutritional support is therefore essential. Summary: This review evaluates the different nutritional therapies, such as enteral nutrition, parenteral nutrition and special nutritional supplements, on nutritional status, quality of life and survival. Key Message: Due to the high prevalence of malnutrition and the rapid development of anorexia-cachexia-syndrome, early nutritional intervention is crucial and supported by clinical data. Practical Implications: Enteral nutrition should be preferred over parenteral nutrition. Omega-3 fatty acids and L-carnitine are promising substances for the prevention of severe cachexia, but further randomized controlled trials are needed to establish generally accepted guidelines on nutrition in pancreatic cancer

“Lo sé que es la salud mental!” : investigar y cuidar como hilos de la misma trama

Uma análise das práticas de cuidado em saúde mental na atenção básica de equipes de seis municípios da região macrometropolitana do Rio Grande do Sul foi o foco do presente estudo. Parte dos resultados obtidos com avaliação do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica, para desdobrar uma pesquisa-intervenção com metodologia avaliativa e participativa de quarta geração que visou uma avaliação qualitativa de boas práticas neste campo. A análise coletiva dos dados foi realizada junto aos Grupos de Interesse, resultando em cinco Eixos Temáticos: Concepções de Saúde Mental, Gestão do Trabalho, Cuidado Tutelar-Psicossocial, Cuidado em Rede e Protagonismo dos Usuários. Suas sínteses apontaram que, a par da invisibilidade de práticas efetivas de saúde mental nos territórios, existe uma transição das tecnologias de cuidado em curso, demandando formações ao modo psicossocial, mas também compartilhamento de modos já inventados em que o cuidado em liberdade se tem realizado.The focus of this study is an analysis of mental health care practices within primary health care teams from six municipalities in the greater metropolitan region of Rio Grande do Sul, Brazil. Part of the results were obtained from an evaluation of the National Program for the Improvement of Access and Quality in Primary Health Care to unfold intervention-research through a participatory, evaluative fourth generation methodology that aimed at the qualitative evaluation of good practice in this field. The collective analysis of the data was carried out with stakeholder groups, resulting in five Thematic Axes: Conceptions of Mental Health, Work Management, Custodial Psychosocial Care, Network Care and End-user as Protagonist. Their conclusions pointed out that, along with the invisibility of effective mental health care practices in the various regions, there is a transition underway within technologies of care that requires specific training in psychosocial health as well as the sharing of new-found practices emerging from out-patient care.Un análisis de las prácticas de cuidado en salud mental en la atención básica de equipos de seis municipios de la región macrometropolitana de Rio Grande do Sul fue el foco del presente estudio. Parte de los resultados obtenidos con evaluación del Programa Nacional de Mejora del Acceso y de la Calidad de la Atención Básica, para desplegar una investigación-intervención con metodología evaluativa y participativa de cuarta generación que visó una evaluación cualitativa de buenas prácticas en este campo. El análisis colectivo de los datos fue realizado junto a los Grupos de Interés, resultando en cinco Ejes Temáticos: Concepciones de Salud Mental, Gestión del Trabajo, Cuidado Tutelar-Psicosocial, Cuidado en Red y Protagonismo de los Usuarios. Sus síntesis apuntaron que, junto a la invisibilidad de prácticas efectivas de salud mental en los territorios, existe una transición de las tecnologías de cuidado en curso, demandando formaciones al modo psicosocial, pero también compartiendo modos ya inventados en que el cuidado en libertad se tiene realizado

A symptom-based approach in predicting ECT outcome in depressed patients employing MADRS single items

Establishing symptom-based predictors of electroconvulsive therapy (ECT) outcome seems promising, however, findings concerning the predictive value of distinct depressive symptoms or subtypes are limited; previous factor-analytic approaches based on the Montgomery-Åsberg Depression Rating Scale (MADRS) remained inconclusive, as proposed factors varied across samples. In this naturalistic study, we refrained from these previous factor-analytic approaches and examined the predictive value of MADRS single items and their change during the course of ECT concerning ECT outcome. We used logistic and linear regression models to analyze MADRS data routinely assessed at three time points in 96 depressed psychiatric inpatients over the course of ECT. Mean age was 53 years (SD 14.79), gender ratio was 58:38 (F:M), baseline MADRS score was M = 30.20 (SD 5.42). MADRS single items were strong predictors of ECT response, remission and overall symptom reduction, especially items 1 (apparent sadness), 2 (reported sadness) and 8 (inability to feel), assessing affective symptoms. Strongest effects were found for regression models including item 2 (reported sadness) with up to 80% correct prediction of ECT outcome. ROC analyses were performed to estimate the optimal cut-point for treatment response. MADRS single items during the course of ECT might pose simple, reliable, time- and cost-effective predictors of ECT outcome. More severe affective symptoms of depression at baseline and a stronger reduction of these affective symptoms during the course of ECT seem to be positively associated with ECT outcome. Precise cut-off values for clinical use were proposed. Generally, these findings underline the benefits of a symptom-based approach in depression research and treatment in addition to depression sum-scores and generalized diagnoses

Predicting Antidepressant Effects of Ketamine: the Role of the Pregenual Anterior Cingulate Cortex as a Multimodal Neuroimaging Biomarker

Background: Growing evidence underscores the utility of ketamine as an effective and rapid-acting treatment option for major depressive disorder (MDD). However, clinical outcomes vary between patients. Predicting successful response may enable personalized treatment decisions and increase clinical efficacy. Methods: We here explored the potential of pregenual anterior cingulate cortex (pgACC) activity to predict antidepressant effects of ketamine in relation to ketamine-induced changes in glutamatergic metabolism. Prior to a single i.v. infusion of ketamine, 24 patients with MDD underwent functional magnetic resonance imaging during an emotional picture-viewing task and magnetic resonance spectroscopy. Changes in depressive symptoms were evaluated using the Beck Depression Inventory measured 24 hours pre- and post-intervention. A subsample of 17 patients underwent a follow-up magnetic resonance spectroscopy scan. Results: Antidepressant efficacy of ketamine was predicted by pgACC activity during emotional stimulation. In addition, pgACC activity was associated with glutamate increase 24 hours after the ketamine infusion, which was in turn related to better clinical outcome. Conclusions: Our results add to the growing literature implicating a key role of the pgACC in mediating antidepressant effects and highlighting its potential as a multimodal neuroimaging biomarker of early treatment response to ketamine. Keywords: antidepressant effects; ketamine; multimodal neuroimaging biomarker; pgACC; pregenual anterior cingulate cortex

Environmental Risk Factors for Chronic Pancreatitis and Pancreatic Cancer

Chronic pancreatitis has long been thought to be mainly associated with immoderate alcohol consumption. The observation that only ∼10% of heavy drinkers develop chronic pancreatitis not only suggests that other environmental factors, such as tobacco smoke, are potent additional risk factors, but also that the genetic component of pancreatitis is more common than previously presumed. Either disease-causing or protective traits have been indentified for mutations in different trypsinogen genes, the gene for the trypsin inhibitor SPINK1, chymotrypsinogen C, and the cystic fibrosis transmembane conductance regulator (CFTR). Other factors that have been proposed to contribute to pancreatitis are obesity, diets high in animal protein and fat, as well as antioxidant deficiencies. For the development of pancreatic cancer, preexisting chronic pancreatitis, more prominently hereditary pancreatitis, is a risk factor. The data on environmental risk factors for pancreatic cancer are, with the notable exception of tobacco smoke, either sparse, unconfirmed or controversial. Obesity appears to increase the risk of pancreatic cancer in the West but not in Japan. Diets high in processed or red meat, diets low in fruits and vegetables, phytochemicals such as lycopene and flavonols, have been proposed and refuted as risk or protective factors in different trials. The best established and single most important risk factor for cancer as well as pancreatitis and the one to clearly avoid is tobacco smoke

Korruption: ein ungerechtfertigter Eingriff in internationale Menschenrechte? Chancen und Grenzen einer opferbezogenen Korruptionsperspektive

<p><b>Daily carbohydrate (A) and sugar (B) intake by groups and subgroups.</b> Carbohydrate (A) and sugar intake (B) as illustrated in percent. The boxes cover the first quartile on the bottom and the third quartile on the top. Whiskers reach from the minimum to the maximum value excluding outliers (illustrated by dots). Shift-working group and shift-working nursing-staff subgroup cover identical cohorts. NG, non-shift-working group; SG, shift-working group; SN, shift-working nursing-staff subgroup; NO, non-shift-working office-staff subgroup; NN, non-shift-working nursing-staff subgroup *p<0.05.</p

Coronavirus-Pandemie: Wirksame Regeln für Herbst und Winter aufstellen : 6. Ad-hoc-Stellungnahme - 23. September 2020

Wirksame Regeln für Herbst und Winter zur Bekämpfung der Pandemie: Schutzmaßnahmen konsequent einhalten, schnell und gezielt testen, Quarantäne- und Isolationszeiten verkürzen, verantwortungsvolles Handeln erleichtern, soziale und psychische Folgen abmildern