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Plasmodium simium, a parasite of platyrrhine monkeys, is known to cause human malaria outbreaks in Southeast Brazil. It has been hypothesized that, upon the introduction of Plasmodium vivax into the Americas at the time of the European colonization, the human parasite adapted to neotropical anophelines of the Kerteszia subgenus and to local monkeys, along the Atlantic coast of Brazil, to give rise to a sister species, P. simium. Here, to obtain new insights into the origins and adaptation of P. simium to new hosts, we analysed whole-genome sequence (WGS) data from 31 P. simium isolates together with a global sequence dataset of 1086 P. vivax isolates. Population genomic analyses revealed that P. simium comprises a discrete parasite lineage with greatest genetic similarity to P. vivax populations from Latin America – especially those from the Amazon Basin of Brazil – and to ancient European P. vivax isolates, consistent with Brazil as the most likely birthplace of the species. We show that P. simium displays half the amount of nucleotide diversity of P. vivax from Latin America, as expected from its recent origin. We identified pairs of sympatric P. simium isolates from monkeys and from humans as closely related as meiotic half-siblings, revealing ongoing zoonotic transmission of P. simium. Most critically, we show that P. simium currently causes most, and possibly all, malarial infections usually attributed to P. vivax along the Serra do Mar Mountain Range of Southeast Brazil.
In the last ten years, the recovery movement has significantly influenced mental health services and workers, psychiatric reform, and the advocacy movement worldwide. Within Brazil’s public mental health care system, operates a cohesive, powerful advocacy coalition empowering recovery-oriented practices. This article aims to highlight successful initiatives spearheaded by individuals with lived experience in Brazil. We will also present some challenges, and discuss possible recovery strategies to strengthen mental health services by empowering people with lived experience and promoting social justice. Efforts and initiatives to implement recovery strategies in Brazil are underway, aiming to improve population mental health and substance misuse both within and outside mental health services. These initiatives include peer support, advocacy, testimonies and empowerment, employment, and social, cultural, and artistic initiatives. Some of the challenges to greater participation of individuals with lived experience in this ongoing process of Brazilian psychiatric reform include the following aspects: barriers to the autonomy and independence of lived experience organizations; the longstanding history of racism in Brazilian society; disparities in social indicators such as education and income, between professionals and people with lived experience in mental health and substance misuse. Although progress in Brazil’s psychiatric reform has advanced through recovery initiatives, challenges remain in ensuring leadership roles for people with lived experience. Ongoing success depends on their active involvement, alongside advocacy movements and involvement of broader society.
Recent changes to US research funding are having far-reaching consequences that imperil the integrity of science and the provision of care to vulnerable populations. Resisting these changes, the BJPsych Portfolio reaffirms its commitment to publishing mental science and advancing psychiatric knowledge that improves the mental health of one and all.
Previous research demonstrates that individuals vary in their social preferences. Less well-understood is how group composition affects the behavior of different social preference types. Does one bad apple really spoil the bunch? This paper exogenously identifies experimental participants’ social preferences, then systematically assigns individuals to homogeneous or heterogeneous groups to examine the impact of ‘bad apples’ on cooperation and efficiency. Consistent with previous research, we find that groups with more selfish types achieve lower levels of efficiency. We identify two mechanisms for the effect. First, the selfish players contribute less. Second, selfish players induce lower contributions from the conditional cooperators, and this effect increases in the number of selfish players. These results are not sensitive to information about the distribution of types in the group.
The primary causes of female mortality often involve diseases related to oxidative stress. Dietary total antioxidant capacity (TAC) evaluates its antioxidant content and potential health effects. This study, registered with PROSPERO (ID: CRD42024427784), explores the association between dietary TAC and women’s health outcomes, including endocrine conditions with gynaecological implications, obstetric outcomes, gynaecological conditions and oncological diseases related to the female reproductive system. We conducted a systematic search in MEDLINE (via PubMed), EMBASE, LILACS and CINAHL for observational studies published up to February 2024 that explored the relationship between dietary TAC and these health conditions. Data were analysed using RevMan 5·4 software. Nineteen studies met the eligibility criteria (sample sizes: 64–3209 women) and examined various conditions, including neoplasms (breast, endometrial and ovarian), bacterial vaginosis, menopause, polycystic ovary syndrome (PCOS), pre-eclampsia (PE), gestational diabetes mellitus (GDM), miscarriage, infertility and inflammation and oxidative stress markers. The meta-analysis identified a significant association between dietary TAC, measured in vitamin C equivalents, and breast cancer, revealing that women with the disease had a lower dietary TAC due to reduced antioxidant intake. Mixed results were found for endometrial cancer, while higher TAC levels were associated with a lower risk of PCOS and infertility. Among postmenopausal women, higher TAC correlated with fewer symptoms such as sleep issues and anxiety. In gestational conditions, higher dietary TAC was linked to a lower risk of miscarriage, GDM and PE. Twelve of the nineteen studies demonstrated significant associations between dietary TAC and the outcomes of interest.
The incidence of congenital malformations (CM) among non-Hispanic White American (NHWA) mothers was reviewed to identify and evaluate the geographic differences in the most frequent CM subtypes associated with smoking and other risk factors. Data on CM were obtained from 150,775 children (2000-2004) from the Centers for Disease Control and Prevention. Risk factors associated with CM development were the mother’s age < 21 and > 35 years, body weight gain during pregnancy, anemia, diabetes mellitus, eclampsia (cases of preeclampsia were omitted), smoking, and alcohol use during pregnancy. Among smoking mothers, the most common CM was omphalocele, club foot, cleft lip, and polydactyly. The highest incidences (CM/10,000 births/year) of observed CM in children of smoking mothers were clubfoot, 25.51 cases (Utah), cleft lip, 22.47 (South Dakota), polydactyly, 21.23 (North Dakota), and omphalocele, 13.14 (Montana). The presence of maternal comorbidities, tobacco and alcohol consumption, and their association with other environmental factors can affect the incidence of CM in NHWA mothers. Further comparisons among the American states regarding the overall changes in CM over the last two decades should uncover crucial outcomes in terms of CM and smoking.
Understanding the determinants of malnutrition is pivotal for public health interventions. This study aimed to identify socio-economic, demographic, dietary and maternal determinants of wasting and overweight among Brazilian children between 6 and 59 months. Data from the Brazilian National Survey on Child Nutrition were analysed (n 11 789). Children’s weight-for-height Z-scores were calculated according to the WHO growth standard and classified as wasting (Z < −2), normal weight (–2 ≤ Z ≤ 1), overweight risk (1 < Z ≤ 2) and overweight (Z > 2). Socio-economic, demographic, dietary and maternal covariables were considered. Adjusted multinomial logistic regression (OR and 95 % CI) was employed. The prevalence of overweight and wasting was 9·5 and 2·6 %, respectively. In the adjusted model, younger age (6–23 months: OR: 1·7; 95 % CI: 1·3, 2·2), consumption of ≥ 5 ultra-processed food groups (OR: 1·8; 95 % CI: 1·1, 3·1), maternal underweight (OR: 0·4; 95 % CI: 0·2, 0·9), overweight (OR: 1·5; 95 % CI: 1·2, 1·9) and mild food insecurity (OR: 0·8; 95 % CI: 0·6, 1·0) were associated with child overweight. The Brazilian Northeast (OR: 4·9; 95 % CI: 2·1, 11·3), Southeast (OR: 7·1; 95 % CI: 3·0, 16·6), South (OR: 4·7; 95 % CI: 1·8, 12·1), Midwest regions (OR: 2·7; 95 % CI: 1·2, 6·2) and maternal underweight (OR: 5·4; 95 % CI: 2·7, 10·7) were associated with wasting. Overweight in Brazil is prevalent among children between 6 and 59 months, while wasting is not a major public health problem. The main determinants of these Brazilian children’s nutritional status were age, ultra-processed food consumption and maternal nutritional status.
A limitation in fine-tuned tree-ring radiocarbon (14C) data is normally associated with overall data uncertainty. Tree-ring 14C data variance as a result of sample heterogeneity can be reduced by adopting best practices at the time of sample collection and subsequent preparation and analysis. Variance-reduction of 14C data was achieved by meticulous sample handling during increment core or cross-sectional cuttings, in-laboratory wood reductions, and cellulose fiber homogenization of whole rings. To demonstrate the performance of those procedures to final 14C results, we took advantage of the replicated data from assigned calendar years of two Pantropical post-1950 AD tree-ring 14C reconstructions. Two Cedrela fissilis Vell. trees spaced 22.5 km apart, and two trees of this species together with one Peltogyne paniculata Benth tree spaced 0.2 to 5 km apart were sampled in a tropical dry and moist forest, respectively. Replicate 14C data were then obtained from grouped tree-ring samples from each site. A total of 88% of the replicated 14C results fell into a remarkably consistent precision/accuracy range of 0.3% or less, even though multiple tree species were used as pairs/sets. This finding illustrates how adopting a few simple strategies, in tandem with already established chemical extraction procedures and high-precision 14C analysis, can improve 14C data results of tropical trees.
Several real-world optimization problems are dynamic and involve a number of objectives. Different researches using evolutionary algorithms focus on these characteristics, but few works investigate problems that are both dynamic and many-objective. Although widely investigated in formulations with multiple objectives, the evolutionary approaches are still challenged by the dynamic multiobjective optimization problems defining a relevant research topic. Some models have been proposed specifically to attack them as the well-known DNSGA-II and MS-MOEA algorithms, which have been extensively investigated on formulations with two or three objectives. Recently, the D-MEANDS algorithm was proposed for dynamic many-objective problems (DMaOPs). In a previous work, D-MEANDS was confronted to DNSGA-II and MS-MOEA solving dynamic many-objective scenarios of the knapsack problem: up to six objectives with five changes or four objectives with ten changes. In this work, we evaluate the behavior of such algorithms in instances up to eight objectives and twenty environmental changes. These enabled us to better understand D-MEANDS weak points which led us to the proposition of D-MEANDS-MD. The proposal offers a better balance between memory and diversity. We also included a more recent MOEA in this comparison: the DDIS-MOEA/D-DE. From the results obtained using 27 instances of the dynamic multiobjective knapsack problem, D-MEANDS-MD showed promise for solving discrete DMaOPs compared with the others.
Recently, farmers in Brazil have observed a decline in efficacy of glyphosate, chlorimuron, and imazethapyr control of smooth pigweed (Amaranthus hybridus L.). The objectives of this study were to quantify the resistance of Amaranthus in Brazil to glyphosate and acetolactate synthase (ALS)-inhibiting herbicides, elucidate the mechanism of resistance, and assess the frequency of shifts in sensitivity to glyphosate and chlorimuron in Brazil. Dose–response assays were conducted in a greenhouse with glyphosate, chlorimuron, and imazethapyr. This was followed by sequencing of the EPSPS and ALS genes. Additionally, 740 Amaranthus populations across several Brazilian states were monitored over 4 yr, subjected to a single discriminatory dose of glyphosate and chlorimuron. The populations BR18Asp051 and BR21Asp205 were resistant to glyphosate, chlorimuron, and imazethapyr. The elevated resistance level to glyphosate in these populations is attributed to multiple amino acid substitutions (TAP-IVS) in the EPSPS gene; and cross-resistance to sulfonylureas and imidazolinones is conferred by the Trp-574-Leu substitution in the ALS gene in both populations. Overall, resistance distribution indicated that 88% of the sampled populations were considered sensitive to glyphosate, while 66% were sensitive to chlorimuron. Furthermore, 10% of the samples demonstrated multiple resistance to both active ingredients. A shift in glyphosate sensitivity was observed in four states in Brazil; however, sensitivity shifts to chlorimuron were more widely dispersed in Brazilian agricultural regions.
This is a descriptive cross-sectional clinical study with professionals from the Nursing Team (Nursing Assistant, Nursing Technician and Nurse).
Objectives
To assess the psychological impact of the Covid-19 pandemic on nursing staff professionals.
Methods
A descriptive, quantitative, cross-sectional study will be applied to a structured interview aimed at collecting sociodemographic and occupational data, Mental Health Scales evaluating professional exhaustion - Oldenburg Burnout Inventory and Beck’s Anxiety Rating Scale to assess the state of anxiety.
Results
About 13,587 nursing professionals were interviewed, including nurses, technicians and nursing assistants. They were evidenced through the behavior indexes related to insomnia, the desire to cry and appetite variation may be related to the long working hours, the fear of contamination and the consequent absence from work, as well as the fear of getting sick may be related to the fact that the professional stops being a caregiver and starts to be cared for.
Conclusions
the study denotes the importance and need for interventions to promote and prevent mental well-being in health professionals exposed to COVID-19, these need to be implemented immediately, for nursing professionals, as they are on the front line, demanding attention Special. In this sense, the Nursing Council of the State of São Paulo created and implemented some bills such as the Obligation of Rest Rooms in Health Units, the Cuidando de Quem Cuida Program and the Yellow September Campaign in Allusion to actions for Nursing professionals for the prevention and promotion in mental health category.
Mental Health problems and substance misuse during pregnancy constitute a serious social problem due to high maternal-fetal morbidity (Cook et al, 2017; JOCG, 39(10) ,906-915) and low detection and treatment rates (Carmona et al. Adicciones. 2022;34(4):299-308)
Objectives
Our study aimed to develop and test the feasibility and acceptability of a screening and treatment clinical pathway in pregnancy, based on the combination of e-Health tools with in-person interventions and, secondly, describe the prevalence of mental illness and substance use problems in this population.
Methods
1382 pregnant women undergoing her first pregnancy visit were included in a tailored clinical pathway and sent a telematic (App) autoapplied questionnaire with an extensive battery of measures (WHO (Five) Well-Being [WHO-5],Patient Health Questionnaire [PHQ-9], General Anxiety Disorder [GAD-7], Alcohol Use Disorders Identification Test [AUDIT], Drug Abuse Screening Test [DAST], Columbia Suicide Severity Rating Scale [C-SSRS] and specifically designed questions on self-harm and psychopharmacological drugs).
Patients who did not respond to the questionnaire on their own received a counseling call.
Based on the screening results, patients were classified into five groups according to severity (Figure 1) and assigned a specific action pathway (Figure 2) that included a range of intervention intensity that goes from an individual psychiatric appointment to no intervention.
Results
Of the 1382 women included in the clinical pathway, 565(41%) completed the evaluation questionnaires. Of these, 205 (36%) were screened as positive (Grades III,IV or V. Table 1) and 3(0.5%) were classified as needing urgent care. Of the patients offered on-line groups (100), 40% (40) were enrolled in them.Table 1:
Grade distribution of those screened as positives
Grade III
97 (17,2%)
Grade IV
105 (18,6%)
Grade V
3 (0,5%)
Concerning prevalence rates, 73 (12,9%) patients endorsed at least moderate anxiety according to GAD-7 (≥10), 65 (11,5%) endorsed at least moderate depression according to PHQ-9 (≥ 10), 17 were positive on DAST (3%) and 63 (11%) patients scored above the threshold in AUDIT-C(≥ 3) for alcohol use.
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Image 2:
Conclusions
High prevalence rates suggest that effective detection and treatment mechanisms should be integrated into usual care. The use of standardized clinical pathways can help with this aim, allowing better clinical management and referral to treatment, but still face challengues to increase retention. The use of e-health tools offers the opportunity to improve accessibility and therapeutic outcomes through online interventions.
Eating disorders are characterized by a persistent disturbance in eating and/or eating-related behavior, resulting in altered food consumption or absorption, which can significantly compromise physical health as well as psychosocial functioning. These disorders are closely linked with stressful experiences which university students configure a group prone to development.
Objectives
The objective is to evaluate the impact of eating disorders on young people when entering and staying at university.
Methods
This is an observational, quantitative, analytical and cross-sectional study, in which 1300 (one thousand and three hundred) medical students were invited, of both sexes and over 18 years of age from the 1st (first) to the 12th (twelfth) year. period of the Medicine course at the University of Oeste Paulista (UNOESTE) with 91 students joining. A structured interview was applied via online, aiming at collecting sociodemographic and occupational data in conjunction with the application of the Periodic Eating Compulsion Scale - ECAP, assessing the existence and degree of eating disorders in medical students.
Results
Mean age 22.7 ± 3.9 years, predominantly female (76.9%) and white ethnicity (86.8%). Most live alone or with a parent (82.5%). With regard to eating habits, 81 (89.0%) said they did not follow a nutrition professional’s diet, and 84 (92.3%) have at least 3 meals a day. Lunch is eaten by 100% of the participants, while supper is the least consumed meal (17.6%). A total of 24 (26.4%) participants said they had little time to eat, and almost half (46.2%) did not prepare their own meals, with 12.5% choosing to eat salted or not. eating a certain meal. The ECAP binge eating score had a median of 9 (11.5) points, with a minimum score equal to 1 and a maximum equal to 41. Sixty-eight (74.7%) of the participants were classified as having no binge eating, with moderate binge eating 15 (16.5%), and severe, 8 (8.8%).
Conclusions
There is a need for changes in lifestyle aspects in order to present healthier meals in appropriate amounts, in addition to an adequate therapeutic approach to these disorders. Research funding agency We also declare that we received financial support from the Institutional Program for Scientific Initiation Scholarships (PROBIC).
Craniofacial malformations have long been associated with a heightened risk of psychiatric disorders. Understanding this link is crucial, as it can inform early intervention and support for affected individuals, enhancing their overall well-being. Research in this area aims to shed light on the prevalence and nature of these disorders within the craniofacial population, ultimately improving healthcare and quality of life for affected individuals.
Objectives
This study aims to establish a comprehensive understanding of the relationship between craniofacial malformations and psychiatric disorders. Specifically, our objectives include: assessing prevalence, identifying risk factors, evaluating impact and informing clinical practice. This research aims to improve the holistic care and mental well-being of individuals with craniofacial malformations, contributing to a more comprehensive approach in the field of psychiatry.
Methods
This cross-sectional study was conducted at a prominent referral hospital named Hospital de Clínicas de Porto Alegre during the month of August 2023.
Participant Selection: Patients with craniofacial malformations of all ages and both genders.
Data Collection: We conducted structured interviews with participants to gather demographic information, medical history, and details of their craniofacial conditions.
Medical Records Review: Medical records were reviewed to corroborate craniofacial diagnoses and identify any comorbid conditions.
Statistical Analysis: Data were analyzed using appropriate statistical techniques to assess the association between craniofacial malformations and psychiatric disorders.
Ethical Considerations: The study adhered to all ethical guidelines, with informed consent obtained from participants or their legal guardians. Ethical approval was obtained from the hospital’s Institutional Review Board.
Data Handling: Confidentiality and data security were ensured throughout the study, with all data anonymized to protect participant privacy.
Results
In our study, we assessed 132 different patients, comprising 62 females and 70 males. The youngest patient was 2 months old, while the oldest was 56 years old. The mean age of the patients was 16.22 years, with a median of 9 years, a harmonic mean of 18 years, and a standard deviation of 15.23 years.
Among the patients, 24 exhibited psychiatric disorders, evenly split between 12 males and 12 females. Their average age was 16.21 years, with a median of 10 years, a harmonic mean of 6.13, and a standard deviation of 14.57. The youngest patient with evidence of a psychiatric disorder was 2 years old.
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Image 2:
Conclusions
Our study underscores the prevalence of psychiatric disorders among craniofacial patients, which seems to be greater than the general population, emphasizing the need for integrated care that considers both medical and psychological aspects, thus enhancing the overall well-being of these individuals.
Alcohol and illicit drug use are highly prevalent among the homeless population. Religiosity and spirituality (RS) have been widely associated with lower substance use. However, evidence of this relationship among the homeless is still scarce.
Objectives
To assess the association between RS and the use of alcohol and illicit drugs among the homeless population of a large Brazilian urban center.
Methods
This cross-sectional study was conducted in São Paulo, Brazil. Aspects such as spirituality (FACIT-Sp12), religiosity (P-DUREL), religious-spiritual coping (Brief-RCOPE), and self-applied questions about current substance use (alcohol and illicit drugs) were evaluated. Adjusted Logistic Regression models were performed.
Results
A total of 456 homeless individuals were included, with an average age of 44.5 (SD=12.6) years. More than half of the participants used alcohol (55.7%) weekly and 34.2% used illicit drugs weekly. The adjusted Logistic Regression models identified that aspects of RS were associated with a lower propensity for alcohol and illicit drug use, whereas negative religious-spiritual coping strategies were associated with a higher propensity for the use of both.
Conclusions
The prevalence of alcohol and illicit drug use among participants was high. Positive RS and religious-spiritual coping were significant protective factors against the use of these substances. Conversely, negative religious-spiritual coping strategies were associated with risk factors.
Cancer causes an impact in the face of its news, whether due to feelings of anguish, stress and suffering due to the presence of the disease, which can be shared between patients, family members and loved ones. The news regarding the diagnosis generates, in addition to the psychological impact, financial difficulties, as the patient himself can often be responsible for a large part of the family income. Other complications are the difficulties in understanding the disease by the family members and/or the patient, denial of the disease in order to spare the patient from suffering and other loved ones, family conflicts related to the need to adapt to the new routine of daily life that the family should carry out aiming at the well-being of the patient and his treatment.
Objectives
To evaluate the psychological impact and interpersonal relationships in patients with breast cancer treated in the city of Presidente PrudenteSP by a support association.
Methods
This is an observational, quantitative, analytical and cross-sectional study, in which 200 patients with malignant breast cancer will be invited.
Results
The sociodemographic results found were: 62.5% white women, 65.6% aged between 45-65 years, 56.3% married, 46.9% have completed higher education, 56.3% had no family history of cancer, predominance of stages II, III and IV when discovered, 93.5% did not drink, 84.4% did not smoke. On the anxiety scale, 53.1% and 43.8% report getting tired easily and feeling like crying, respectively. On the social adequacy scale, 72.5% continued working only with some limitation during treatment, despite this, 41.4% had minor financial difficulties, 34.5% had difficulties expressing feelings with family members, 40.7% had a relationship well with family members with small arguments and finally 34.8% felt affection for the partner all the time, despite this 36.4% did not have sexual intercourse with them in the last month.
Conclusions
It was concluded, therefore, that when a family member gets sick, they all feel impacted, and each family will deal with the experience in a particular way, therefore, it is worth highlighting the encouragement of family participation in therapy sessions.
Craniofacial surgery is a specialized field that addresses congenital and acquired deformities of the head and face. While the physical outcomes of craniofacial surgery are well-documented, less attention has been given to the psychological well-being of adult patients. This abstract aims to explore self-esteem issues among adult patients treated at the Craniofacial Surgery Sector of HCPA (Hospital de Clínicas de Porto Alegre), where a substantial proportion of adult patients have reported self-esteem problems.
Objectives
1. To assess the prevalence of self-esteem issues among adult patients (≥18 years old) attending the HCPA Craniofacial Surgery Sector.
2. To examine potential contributing factors to self-esteem problems in this specific patient population.
3. To evaluate the impact of self-esteem on the mental health and psychosocial functioning of adult craniofacial surgery patients.
4. To propose recommendations for psychosocial support and intervention strategies tailored to the needs of adult patients in this context.
Methods
This cross-sectional study involved 132 adult patients who had undergone or were scheduled for craniofacial surgery at HCPA. Participants reported self-esteem issues in their talk with the hospital’s physicians, and their medical records were reviewed to collect demographic and clinical data. Additionally, participants provided information about their mental health status and psychosocial functioning.
Results
Among the 39 adult patients included in the study, 37 (94.9%) reported experiencing self-esteem issues, such as lack of confidence or feeling unattractive. The most commonly reported contributing factors were visible facial differences, social interactions, and prior surgical experiences. Patients with lower self-esteem had a higher likelihood of reporting symptoms of depression and anxiety and reported lower overall psychosocial functioning compared to those with higher self-esteem.
Conclusions
This reveals a strikingly high prevalence of self-esteem issues among adult patients attending the Craniofacial Surgery Sector at HCPA. These findings underscore the importance of recognizing and addressing the psychological well-being of adult craniofacial surgery patients. Comprehensive psychosocial support, including counseling, peer support, and interventions to enhance self-esteem, should be integrated into the care of these patients. By addressing self-esteem concerns, healthcare providers can improve the mental health and overall quality of life of adult craniofacial surgery patients.
The Pierre-Robin sequence (PRS), characterized by micrognathia, glossoptosis, and cleft palate, has long been a subject of clinical interest. Recent research suggests a potential association between PRS and cognitive or psychiatric disorders. This study explores this intriguing connection, shedding light on the complex interplay between craniofacial anomalies and mental health.
Objectives
This study aims to establish a comprehensive understanding of the relationship between Pierre-Robin Sequence and psychiatric disorders. Specifically, our objectives include: assessing prevalence, evaluating impact and informing clinical practice. This research aims to improve the holistic care and mental well-being of individuals with craniofacial malformations, contributing to a more comprehensive approach in the field of psychiatry.
Methods
This cross-sectional study was conducted at a prominent referral hospital named Hospital de Clínicas de Porto Alegre, an international reference in Pierre-Robin Sequence, during the month of August 2023.
Participant Selection: Patients with PRS. Inclusion criteria encompassed individuals of all ages and both genders.
Data Collection: Trained medical personnel conducted structured interviews with participants to gather demographic information, medical history, and details of their craniofacial conditions.
Medical Records Review: Medical records were reviewed to corroborate craniofacial diagnoses and identify any comorbid conditions.
Statistical Analysis: Data were analyzed using appropriate statistical techniques to assess the association between PRS and psychiatric disorders.
Ethical Considerations: The study adhered to all ethical guidelines, with informed consent obtained from participants or their legal guardians. Ethical approval was obtained from the hospital’s Institutional Review Board.
Data Handling: Confidentiality and data security were ensured throughout the study, with all data anonymized to protect participant privacy.
Results
In our study, we assessed 28 different patients with Pierre-Robin Sequence, comprising 13 females and 15 males. The youngest patient was 2 months old, while the oldest was 22 years old. The mean age of the patients was 4.75 years, with a median of 3 years and a standard deviation of 5.36 years.
Among the patients, 6 exhibited psychiatric disorders, split between 4 males and 2 females. Their average age was 10 years, with a median of 9 years and a standard deviation of 4.2. The youngest patient with evidence of a psychiatric disorder was 5 years old.
Conclusions
This study underscores a concerning reality within the Pierre-Robin population, pointing to a high prevalence of psychiatric disorders. These findings highlight the urgent need for integrated care, emphasizing the importance of early psychiatric assessment and tailored interventions to enhance the overall well-being of individuals facing the challenges of PRS.
Subjective cognitive decline (SCD), the self-reported experience of worsening cognitive abilities (Jessen et al., 2014), is associated with increased risk of developing Alzheimer’s disease and Mild Cognitive Impairment. Modifiable factors such as purpose in life (PiL), the experience of living a meaningful life where one’s life goals are attainable or being achieved (Boyle et al., 2009), and loneliness, an individual’s perceived social isolation (Luhmann & Hawkley, 2016), are known to be associated with SCD. These relationships are understudied among ethnically diverse groups. Using an online survey, we examined associations between PiL, loneliness and SCD in older ethnically diverse individuals living in the US.
Participants and Methods:
870 older adults (126 Latino, 74 Black, 33 Asian, and 637 White; average age=67.0 [7.6]) completed an online survey including the Life Purpose Questionnaire, the Gierveld Loneliness Scale, and the Everyday Cognition scale (ECog), which measures subjective cognitive concerns in memory, language, executive function, and divided attention. Chi-square tests and analyses of variance were conducted to assess group differences in SCD and demographic/lifestyle predictors. Multiple regressions and correlations were conducted to assess the relationships between ethnicity and PiL with SCD, and the moderating effect of race/ethnicity. Multiple regressions and correlations were conducted to identify sociodemographic and lifestyle predictors of SCD in each study group.
Results:
White participants were older (p<.001), and White and Asian groups had higher levels of education (p=.009) compared to Latinos. The White group had a higher proportion of female (p=.016) and middle-income (p=.019) respondents. Black participants had higher PiL (p=.035) and lower loneliness (p=.047) compared to White participants; there were no group differences in ECog ratings (p=.143). Regression results indicated that higher PiL associated with lower SCD in the whole sample (β=-.435, p<.001). The interaction between PiL and ethnic group was significant (β=.078, p=.025), suggesting the relationship between PiL and SCD was strongest in White participants, followed by Asian, then Latino, and finally Black participants. In Latinos, female sex (β=-.281, p=.004) and higher PiL (β=-.240, p=.034) predicted lower SCD ratings. In White participants, higher PiL (β = -.394, p < .001), and lower loneliness (β = .128, p = .003) predicted lower SCD ratings. Correlation analyses revealed no significant associations with SCD in the Black group, although the correlation between loneliness and SCD was trending (r=.222, p=.063). In the Asian group, greater PiL was associated with lower SCD ratings (r=-.439, p=.011).
Conclusions:
Our findings suggest that PiL may be protective against SCD, particularly in Latino, Asian, and White adults. Differential predictive factors of SCD were also identified for our study groups, suggesting certain groups may benefit from specific targeted interventions. Overall, findings suggest that interventions geared toward increasing PiL and/or mitigating loneliness may help reduce SCD and the risk of cognitive decline in older adults in the US. As the current study was cross-sectional and faced sample size limitations in Asian and Black groups, future studies should include longitudinal assessment of these associations with larger and more representative samples to confirm our findings.