A new study has found that women with urinary incontinence report higher rates of depression and lower levels of self-worth than those who don’t suffer from the condition.

The research was presented recently at the European Association of Urology Congress, EAU21. The team behind the study is urging clinicians to ask women with incontinence about their mental health and to offer potential treatments.

Female urinary incontinence is a common disorder, particularly among older women, but there has been very little research into its impact on women’s mental health.

Margarida Manso and colleagues at the University Hospital Centre of Sao Joao drew on data from a population-based survey run by the Portuguese Health Ministry every five years, which asks respondents about various aspects of health and wellbeing. They analysed the responses of around 10,000 women aged 18 or above, comparing the prevalence of depression diagnosis, use of mental health consultations, dimensions of mental health disease, and addictive behaviours — smoking and alcohol consumption — between women who did and did not report urinary incontinence.

They found that around one in ten women reports having urinary incontinence, increasing to four in ten for over 75s. Women who reported incontinence were 66 per cent more likely to be diagnosed with depression and saw their doctor more frequently for mental health reasons. They were 65 per cent more likely to report their health status as bad, had greater difficulty concentrating and had more feelings of guilt and lower self-worth than women without incontinence. There were no substantial differences in smoking or alcohol consumption between the two groups. Urologist, Margarida Manso, said: “The high levels of depression and low self-worth in women who reported having incontinence are very concerning. Urinary incontinence can be treated and although there are some potential side effects from treatment, for some women these may be preferable to the mental health impacts of the condition.”

“We believe the conversation between patients and their urologists needs to change. Clinicians should be asking patients about their mental health when discussing treatments, because treating their physical challenges could help with the psychological cost of the condition,” Manso added. “Personally, I will be emphasising this more with my patients and trying to understand better the mental burden of living with incontinence,” Manso further said. Professor Christopher Chapple, EAU Secretary General, from Sheffield Teaching Hospitals NHS Foundation Trust, UK, said: “Urinary incontinence is an extremely important clinical condition which is often not recognised by doctors until patients have been suffering for some time. It has a devastating impact on anyone affected by it – predominantly women but also some men.”

“However, in the majority of cases, urinary incontinence can be significantly improved or cured by the right treatment, based on clinical evaluation as detailed in the European Association of Urology 2021 Guidelines. It is important that patients with urinary incontinence are identified at an early stage after it develops and investigated and treated appropriately,” Chapple concluded.

Adults with ADHD are at an increased risk of a wide range of physical conditions, including nervous system, respiratory, musculoskeletal, and metabolic diseases, according to a large register-based study from Karolinska Institutet in Sweden.

The findings of the study were published in the journal ‘The Lancet Psychiatry’. “Identifying co-occurring physical diseases may have important implications for treating adults with ADHD and for benefiting the long-term health and quality of life of patients,” said lead author Ebba Du Rietz, and postdoctoral researcher at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet.

ADHD is a common neuropsychiatric disorder characterised by inattention, impulsiveness and hyperactivity, and commonly treated with stimulant therapy (methylphenidates or amphetamines).

Previous studies suggest increased risk for a number of physical health conditions in adults with ADHD, but only a limited number of these associations have been thoroughly researched. Moreover, detailed treatment guidelines for adults with ADHD and co-occurring physical disease are largely lacking.

Now, researchers at Karolinska Institutet have examined possible associations between ADHD and a wide range of physical diseases in adulthood, and whether genetic or environmental factors are involved. Over four million individuals (full-sibling and maternal half-sibling pairs) born between 1932-1995 were identified through Swedish registers and followed between 1973-2013.

Clinical diagnoses were obtained from the Swedish National Patient Register. The researchers examined the risk of 35 different physical conditions in individuals with ADHD compared to those without, and in siblings of individuals with ADHD compared to siblings of those without. Individuals with ADHD had a statistically significant increased risk of all studied physical conditions except arthritis. The strongest associations were found for nervous system, respiratory, musculoskeletal, and metabolic diseases.

The diagnoses most strongly associated with ADHD were alcohol-related liver disease, sleep disorders, chronic obstructive pulmonary disease (COPD), epilepsy, fatty liver disease and obesity. ADHD was also linked to a slightly increased risk of cardiovascular disease, Parkinson’s disease and dementia. “These results are important because stimulant therapy requires careful monitoring in ADHD patients with co-occurring cardiac disease, hypertension and liver failure,” said senior author Henrik Larsson, professor at Orebro University and affiliated researcher at Karolinska Institutet.

The increased risk was largely explained by underlying genetic factors that contributed both to ADHD and the physical disease, with the exception of nervous system disorders and age-related diseases. Full siblings of individuals with ADHD had significantly increased risk for most physical conditions. The researchers now aim to study the underlying mechanisms and risk factors as well as the impact of ADHD on the management and prognosis of physical diseases in adults.

A new study has shown that dancing with music can halt the most debilitating symptoms of Parkinson’s disease. The study, published in the journal ‘Brain Sciences’, found that patients with mild-to-moderate Parkinson’s disease (PD) can slow the progress of the disease by participating in dance training with music for one-and-a-quarter hours per week. Over the course of three years, this activity was found to reduce daily motor issues such as those related to balance and speech, which often lead to social isolation.

Joseph DeSouza, senior author, principal investigator, and associate professor in the Department of Psychology at York University and PhD candidate Karolina Bearss, found people with Parkinson’s (PwPD) who participated in weekly dance training, had less motor impairment and showed significant improvement in areas related to speech, tremors, balance and rigidity compared to those who did not do any dance exercise.

Their data showed significant improvements in experiences of daily living, which include cognitive impairment, hallucinations, depression, and anxious moods such as sadness. The study showed overall that non-motor aspects of daily living, motor experiences of daily living, motor examination symptoms and motor complications did not show any impairment across time among the dance-trained PwPD group compared to PwPD who do not dance.

The study is the first of its kind to follow PwPD over a three-year period during weekly dance participation with music, providing additional information regarding the nature of the progression of motor and non-motor PD symptoms. “The experience of performing and being in a studio environment with dance instructors appears to provide benefits for these individuals,” said DeSouza.“Generally, what we know is that dance activates brain areas in those without PD. For those with Parkinson’s disease even when it’s mild motor impairment can impact their daily functioning — how they feel about themselves. Many of these motor symptoms lead to isolation because once they get extreme, these people don’t want to go out. These motor symptoms lead to further psychological issues, depression, social isolation and eventually the symptoms do get worse over time. Our study shows that training with dance and music can slow this down and improve their daily living and daily function,” added DeSouza. The goal of the research was to create a long-term neurorehabilitation strategy to combat the symptoms of PD.

In the study, researchers looked at how a multi-sensory activity, (like dance with music learning), which incorporated the use and stimulation of several sensory modalities in the dance environment including vision, audition, tactile perception, proprioception, kinesthesia, social organization and expression, olfactory, vestibular and balance control — may influence many of the mood, cognitive, motor and neural challenges faced by PwPD.

Researchers followed collected data from PwPD over three-and-a-half years while they learned choreography over the first year and performed it, which is designed to be adaptable to the disease stage and current symptoms for PwPD.In the study, 16 participants with mild-to-moderate PD (11 males, five females) with an average age of 69, were tested between October 2014 and November 2017. They were matched for age and severity of the disease.Each participant took part in a 1.25-hour dance class at Canada’s National Ballet School (NBS) and Trinity St. Paul’s church locations. Dancers participated in dance exercises that provided both aerobic and anaerobic movements.

This group was then compared to 16 non-dance PwPD participants (the reference group) chosen from a larger PwPD cohort from the Parkinson’s Progression Marker Initiative (PPMI), a longitudinal research project funded by the Michael J. Fox Foundation for Parkinson’s Research (MJFF) and related funding partners.Classes began with live music accompaniment during the seated warm-up, followed by barre work, and ended with moving across the floor. All participants learned choreography for an upcoming performance. Researchers recorded videos, conducted paper and pen questionnaires of all participants and performed statistical analyses.

“Dance is so complex, it’s a multi-sensory type of environment,” said Bearss.Bearss added, “It incorporates and stimulates your auditory, tactile, visual and kinesthetic senses and adds an interactive social aspect. Regular exercise does not offer these aspects. There’s so much more to dance.” Researchers will next examine what occurs in the brain immediately before and after a dance class to determine what neurological changes take place. “Currently there is no precise intervention with PD and usual remedies are pharmacological interventions, but not many options are given for alternate exercises or additional interventions to push their brains,” said DeSouza.

“Hopefully this data will shed light on additional therapies for this group and be used in the treatment process. There may be changes in the brain that occur with dance with music, but more research is necessary,” concluded DeSouza.

Conversations between seriously-ill people, their families, and palliative care specialists really matter and lead to a better quality of life. Understanding what happens during these conversations — and particularly how they vary by cultural, clinical, and situational contexts — is essential to guide healthcare communication improvement efforts.

To gain true understanding, new methods to study conversations in large, inclusive, and multi-site epidemiological studies are required. A new computer model offers an automated and valid tool for such large-scale scientific analyses. The results of this model were published recently in the journal ‘PLOS ONE’.

Developed by a team of computer scientists, clinicians and engineers at the University of Vermont, the approach — called CODYM (Conversational DYnamics Model) analysis — uses simple behavioral state-based models (Markov Models) to capture the flow of information during different conversations, based on patterns in the lengths of alternating speaker turns.

To date, the conversation analysis process has typically relied on time-consuming manual transcription, detailed annotations, and required access to the highly private content of conversations.

“CODYMs are the first Markov Model to use speaker turn length as the fundamental unit of information and the first model of any type to provide concise, high-level, quantitative summaries of overall dependencies in sequences of speaker turn lengths,” said Laurence Clarfeld, PhD, lead author on the study and a University of Vermont postdoctoral associate whose doctoral dissertation in computer science focused on this research topic.

Using a time-based definition of speaker turn length means that real-time automation and analysis of conversational dynamics can occur without transcription or stored audio, thus protecting the privacy of the conversation content, add the authors.

“We developed a computational model of information flow in serious illness that could become a fundamental tool in conversational epidemiology,” said co-author Robert Gramling, M.D., D.Sc., professor of family medicine, Miller Chair in Palliative Medicine, and director of the Vermont Conversation Lab at the University of Vermont’s Larner College of Medicine. “It predicts important and complex conversational processes, like emotion expression and future patterns of speaker turns.”

For the study, the researchers performed analyses to validate the CODYM model, “identify normative patterns of information flow in serious illness conversations and show how these patterns vary across narrative time and differ under expressions of anger, fear and sadness,” the authors wrote.

In addition to serving as a means for assessing and training healthcare providers, CODYMs could also be used to compare “conversational dynamics across language and culture, with the prospect of identifying universal similarities and unique ‘fingerprints’ of information flow,” the study authors stated.

This publication represents the latest of several serious illness conversation dynamics studies conducted collaboratively by members of the University of Vermont’s Larner College of Medicine (Gramling) and College of Engineering and Mathematical Sciences (Margaret Eppstein, PhD, Laurence Clarfeld, PhD, and Donna Rizzo, PhD) over the past several years.

Researchers have discovered lymph node-like structures close to the tumour in brain cancer patients, where immune cells can be activated to attack the tumour. The research was conducted at Uppsala University in Sweden. In their study, the researchers found that immunotherapy enhanced the formation of these structures in a mouse model. This discovery suggests new opportunities to regulate the anti-tumour response of the immune system. Glioma is a deadly brain tumour with a dismal prognosis. One reason why brain tumours are very hard to treat is that our immune system, which is designed to detect and destroy foreign cells including cancer cells, cannot easily reach the tumour site due to the barriers that surround the brain.

To fight a developing tumour, killer immune cells such as T lymphocytes must be activated and primed in our lymph nodes, before travelling to the tumour site to effectively kill the cancer cells. Because of the barriers around the brain, it is a challenging process for T lymphocytes to reach the tumour.

The researchers describe their discovery of structures similar to lymph nodes in the brain where T lymphocytes could be activated.

“It was extremely exciting to discover for the first time the presence of lymph node-like structures in glioma patients. These structures are known as TLS and they are not found in healthy individuals. They have all the components needed to support lymphocyte activation on-site which means that they could have a positive effect on the anti-tumour immune response,” said Alessandra Vaccaro, PhD student at the Department of Immunology, Genetics and Pathology.

The researchers also showed that the formation of TLS in the brain can be induced by a type of immunotherapy in glioma-bearing mice. “Learning that immunotherapies can modulate the formation of tertiary lymphoid structures in the brain offers exciting opportunities to find new ways of regulating the anti-tumour immune response in glioma,” said Anna Dimberg. aCD40 is currently being tested to treat brain tumours in a number of clinical trials.

At least 22.5% of children developed a significant fear of Covid-19 while 42.3% suffering from irritability and inattention, a study by the All Indian Institute of Medical Sciences (AIIMS) showed.

Children with pre-existing behavioural problems have a high probability of worsening of their behavioural symptoms, said the study titled ‘Psychological and behavioural impact of lockdown and quarantine measures for Covid-19 children on the pandemic, adolescents and caregivers.’

Children as young as two years of age are aware of the changes around them and get affected by them, the study observed.

“Fifteen studies describing 22,996 children/adolescents fulfilled the eligibility criteria from a total of 219 records. Overall 34.5%, 41.7%, 42.3%, and 30.8% of children were found to be suffering from anxiety, depression, irritability and inattention,” the study said.

It further observed, “52.3%, and 27.4% of caregivers developed anxiety and depression, respectively, while being in isolation with children.”

Dr Sheffali Gulati, faculty AIIMS, Department of Paediatrics who headed the analysis said: “Although the behaviour/psychological state of a total of 79.4% of children was affected negatively by the pandemic and quarantine, at least 22.5% of children had a significant fear of Covid-19, and 35.2%, and 21.3% of children had boredom and sleep disturbance.”

“Anxiety, depression, irritability, boredom, inattention and fear of Covid-19 are predominant new-onset psychological problems in children during the Covid-19 pandemic, children with pre-existing behavioural problems like autism and attention deficit hyperactivity disorder have a high probability of worsening of their behavioural symptoms,” Dr Gulati told ANI.

Studies that were previously done on epidemics caused by SARS, Ebola and Middle East respiratory syndrome came up with a high prevalence of ‘adverse psychological consequences on both children and adults.

A meta-analysis of observational studies in epidemiology and preferred reporting items for systematic reviews and meta-analysis guidelines were followed during the study.

Different electronic databases were searched for articles describing psychological /behavioural complications in children/adolescents with/without pre-existing behavioural abnormalities and their caregivers related to the Covid-19 pandemic.

However, only original articles with/without comparator arms and a minimum sample size of 50 were included in the analysis.

The conclusion of the study observes that to mitigate this far-reaching and significant negative impact on the psychological well-being of the children multifaceted age and developmentally appropriate strategies are required to be adopted by healthcare authorities.