Search

For caregivers of people living with major neurocognitive disorders (MNCD), adapting and applying methods optimizing learning (MOL) to a specific situation, based on preserved cognitive skills, can be challenging. This study aimed to 1) co-develop workshops, a web application and accompanying materials to support the operationalization of MOL; 2) better understand the factors influencing caregivers' use of MOL, and 3) evaluate the perceived effects of the workshops. A participatory action research study was conducted in collaboration with family caregivers of people living with MNCD and healthcare and community organization workers (HCOW). Qualitative questionnaires and interviews were conducted and transcribed in verbatim. Thematic content analysis was conducted. Workshops and accompanying materials were co-developed and continuously improved based on conceptual framework and feedback from the participants. The final version of the workshops consisted of seven two-hour sessions structured around the type of cognitive deficits affecting the realization of activities. Facilitators (e.g. help to identify the person's capabilities) and barriers (e.g. fluctuation of MNCD symptoms) for caregivers' use of the MOL were reported. The identification of the cause of reactive behavioral expressions could be challenging for some family caregivers, reducing the use of MOL. Caregivers mentioned their increased preparedness to support and relationship with the person living with MNCD and feeling of competence for analyzing the reactive behavioral expressions and to use MOL. This participatory action research has shown that caregivers can acquire abilities to adapt and apply MOL in specific situations with people living with MNCD. [ABSTRACT FROM AUTHOR]

Many frail older adults have difficulty maintaining social participation. We developed an innovative, personalized intervention to help frail older adults pursue meaningful leisure activities through the use of compensatory strategies. This pre-experimental pilot study conducted with 10 community-dwelling frail older adults (≥80 years) showed that the intervention improved their knowledge regarding the compensatory strategies learned and their participation in meaningful leisure activities. However, results also showed a decrease in feelings of well-being. This study provides promising results to support the implementation of an innovative intervention tailored to the needs of frail seniors and designed to foster their participation. However, further research is needed to improve our understanding of the impact of the intervention on well-being and explain the results obtained. [ABSTRACT FROM PUBLISHER]

The regulation of energy intake is complex and many biological, psychosocial and environmental influences have been identified. To our knowledge, no study has yet investigated how eating patterns could mediate associations between eating behaviors and self-reported energy intake in premenopausal overweight women. Therefore, objectives of this study were to examine associations between eating behaviors and eating patterns in premenopausal overweight women and to test if eating patterns could mediate the associations between eating behaviors and self-reported energy intake. Women completed a 3-day food record and the Three-Factor Eating Questionnaire was used to assess eating behaviors (dietary restraint, disinhibition, hunger). In the total sample of women, flexible restraint was negatively (r=-0.18; p=0.03) and binge eating severity was positively (r=0.24; p=0.004) associated with self-reported energy intake. Moreover, flexible restraint was positively associated with the proportion of energy intake at breakfast (r=0.24; p=0.004), whereas disinhibition and binge eating severity were positively associated with the proportion of energy intake from snacks consumed after 5:00 pm (r=0.22, p=0.007 and r=0.22, p=0.01, respectively). In addition, mediational analyses showed that proportion of energy intake from snacks consumed after 5:00 pm explained 24.1% of the association between binge eating severity and self-reported energy intake. In conclusion, these results suggest that eating patterns are important factors to consider in order to explain the associations between eating behaviors and self-reported energy intake. [ABSTRACT FROM AUTHOR]

BACKGROUND: Obesity is frequently associated with eating disorders, and evidence indicates that both conditions are influenced by genetic factors. However, little is known about the genes influencing eating behaviors. OBJECTIVE: The objective was to identify genes associated with eating behaviors. DESIGN: Three eating behaviors were assessed in 660 adults from the Quebec Family Study with the use of the Three-Factor Eating Questionnaire. A genome-wide scan was conducted with a total of 471 genetic markers spanning the 22 autosomes to identify quantitative trait loci for eating behaviors. Body composition and macronutrient and energy intakes were also measured. RESULTS: Four quantitative trait loci were identified for disinhibition and susceptibility to hunger. Of these, the best evidence of linkage was found between a locus on chromosome 15q24-q25 and disinhibition (P <0.0058) and susceptibility to hunger (P <0.0001). After fine-mapping, the peak linkage was found between markers D15S206 and D15S201 surrounding the neuromedin beta (NMB) gene. A missense mutation (p.P73T) located within the NMB gene showed significant associations with eating behaviors and obesity phenotypes. The T73T homozygotes were 2 times as likely to exhibit high levels of disinhibition (odds ratio: 1.8; 95% CI: 1.07, 2.89; P=0.03) and susceptibility to hunger (odds ratio: 1.9; 95% CI: 1.15, 3.06; P=0.01) as were the P73 allele carriers. Six-year follow-up data showed that the amount of body fat gain over time in T73T subjects was >2 times that than in P73P homozygotes (3.6 compared with 1.5 kg; P <0.05). CONCLUSION: The results suggest that NMB is a very strong candidate gene of eating behaviors and predisposition to obesity. Copyright © 2004 American Society for Clinical Nutrition [ABSTRACT FROM AUTHOR]

"The aim of the present study was to assess the impact of a ""Health-at-every-size"" (HAES) intervention on psychological variables and body weight the weight-preoccupied overweight/obese women. Those women were randomized into three groups (1) HAES, (2) social support (SS), (3) waiting-list (WL), and were tested at baseline, post-treatment and six-month and one-year follow-ups. All participants presented significant psychological improvement no matter if they received the HAES intervention or not. However, even if during the intervention, the three groups showed improvements, during the follow up, the HAES group continued to improve while the other groups did not, even sometimes experiencing some deterioration. Furthermore, in the HAES group only, participant's weight maintenance 12 months after the intervention was related to their psychological improvement (quality of life, body dissatisfaction, and binge eating) during the intervention. Thus, even if, in the short-term, our study did not show distinctive effects of the HAES intervention compared to SS and WL on all variables, in the long-term, HAES group seemed to present a different trajectory as psychological variables and body weight are maintained or continue to improve, which was not the case in other groups. These differential long-term effects still need to be documented and further empirically demonstrated." [ABSTRACT FROM AUTHOR]

Background: Consumption of locally produced foods is generally perceived as being part of a healthy dietary pattern. Accordingly, in 2020, the provincial government of Québec (Canada) promoted the purchase of local foods for economic and health benefits. The present cross-sectional study aimed to document the association between the behavior of local food procurement and overall diet quality in a sample of adults from the province of Québec., Methods: Data were collected in a sample of 834 adults (86.6% females) from the NutriQuébec project, a web-based longitudinal population study that aims to document the lifestyle and eating habits of adults in Québec, Canada. Dietary intakes were measured using a validated web-based 24-h recall tool and diet quality was assessed using the Healthy Eating Food Index (HEFI-2019), which measures adherence to the 2019-Canada's Food Guide recommendations on healthy food choices. Local food procurement behavior was measured using the Locavore-I-SF score, which assesses the frequency of short food supply chain use as well as the geographical origin of three locally produced foods., Results: The Locavore-I-SF score was weakly correlated with the HEFI-2019 score (r = 0.08, p < 0.02). Positive correlations were observed for the Vegetables and fruits (r = 0.09, p = 0.005), Beverages (r = 0.08, p = 0.04) and Free sugars (r = 0.14, p < 0.001) components of the HEFI-2019. Associations between the Locavore-I-SF and the HEFI-2019 scores were found in specific subgroups of participants: males (r = 0.33, p < 0.001), participants aged between 50 and 70 years (r = 0.16, p = 0.003), participants with a greater education level (r = 0.13, p = 0.003) and higher income (r = 0.12, p = 0.02), non-vegetarian participants (r = 0.10, p = 0.008) and participants living in Census Metropolitan Areas (r = 0.11, p = 0.004)., Conclusion: These results suggest that the behavior of local food procurement is only weakly associated with better overall diet quality among a sample of adults from Québec, raising doubts on the relevance of promoting local food procurement as an effective public health measure for improving diet quality in Québec., Study Registration Number: NCT04140071., Competing Interests: Declarations Ethics approval and consent to participate Participants included in this study were part of the NutriQuébec project and informed written consent was obtained from all participants. The NutriQuébec project was approved by the Ethics Board of Université Laval (2018-042 Phase II et IV A-16 / 25-04-2023). Consent for publication Not applicable. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Updating behavior based on feedback from the environment is a crucial means by which organisms learn and develop optimal behavioral strategies 1-3 . Norepinephrine (NE) release from the locus coeruleus (LC) has been shown to mediate learned behaviors 4-6 such that in a task with graded stimulus uncertainty and performance, a high level of NE released after an unexpected outcome causes improvement in subsequent behavior 7 . Yet, how the transient activity of LC-NE neurons, lasting tens of milliseconds, influences behavior several seconds later, is unclear. Here, we show that NE acts directly on cortical astrocytes via Adra1a adrenergic receptors to elicit sustained increases in intracellular calcium. Chemogenetic blockade of astrocytic calcium elevation prevents the improvement in behavioral performance. NE-activated calcium invokes purinergic pathways in cortical astrocytes that signal to neurons; pathway-specific astrocyte gene expression is altered in mice trained on the task, and blocking neuronal adenosine-sensitive A1 receptors also prevents post-reinforcement behavioral gain. Finally, blocking either astrocyte calcium dynamics or A1 receptors alters encoding of the task in prefrontal cortex neurons, preventing the post-reinforcement change in discriminability of rewarded and unrewarded stimuli underlying behavioral improvement. Together, these data demonstrate that astrocytes, rather than indirectly reflecting neuronal drive, play a direct, instrumental role in representing task-relevant information and signaling to neurons to mediate a fundamental component of learning in the brain., Competing Interests: Competing interests: The authors declare that they have no competing interests.

The brainstem region, locus coeruleus (LC), has been remarkably conserved across vertebrates. Evolution has woven the LC into wide-ranging neural circuits that influence functions as broad as autonomic systems, the stress response, nociception, sleep, and high-level cognition among others. Given this conservation, there is a strong possibility that LC activity is inherently similar across species, and furthermore that age, sex, and brain state influence LC activity similarly across species. The degree to which LC activity is homogenous across these factors, however, has never been assessed due to the small sample size of individual studies. Here, we pool data from 20 laboratories (1,855 neurons) and show diversity across both intrinsic and extrinsic factors such as species, age, sex and brain state. We use a negative binomial regression model to compare activity from male monkeys, and rats and mice of both sexes that were recorded across brain states from brain slices ex vivo or under different anesthetics or during wakefulness in vivo . LC activity differed due to complex interactions of species, sex, and brain state. The LC became more active during aging, independent of sex. Finally, in contrast to the foundational principle that all species express two distinct LC firing modes ("tonic" or "phasic"), we discovered great diversity within spontaneous LC firing patterns. Different factors were associated with higher incidence of some firing modes. We conclude that the activity of the evolutionarily-ancient LC is not conserved. Inherent differences due to age and species-sex-brain state interactions have implications for understanding the role of LC in species-specific naturalistic behavior, as well as in psychiatric disorders, cardiovascular disease, immunology, and metabolic disorders., Competing Interests: Qi Wang and Charles Rodenkirch are the founders of Sharper Sense, a company developing methods of enhancing sensory processing with neural interfaces. Alfred P. Kaye receives or has received research funding from Transcend Therapeutics and Freedom Biosciences, and has filed a provisional patent for combination psychedelic pharmacotherapies in PTSD. Anthony E Pickering reports research funding from Eli Lilly and is a member of the advisory board for Lateral Pharma. All other authors report no disclosures or conflicts of interest. Nelson K. Totah has filed a provisional patent for a head-fixation attachment for the skull of a rat and method for installing the attachment.

Understanding the risks in the months following hospital discharge is crucial for healthcare professionals to ensure the need for assistance is met. However, this may be challenging in the case of patients living with a major neurocognitive disorder (PLMNCD). Thus, it is important to incorporate patients' and caregivers' experiences of the transition from hospital to home in the risk assessment. This multiple case study comprised 7 PLMNCD, their caregivers, and occupational therapists. Fifty-four interviews, conducted just before, as well as 3 weeks and 3 to 6 months after hospital discharge, were qualitatively analyzed. Results revealed that risk management during the hospital-to-home transition is a dynamic process aimed at establishing a satisfactory routine while avoiding adverse events. This risk management process, which identifies challenges over time and between stakeholders, involves (a) determining the seriousness and acceptability of risks, (b) reflecting on ways to manage risks, and (c) taking steps to manage risks. This knowledge will help to provide more appropriate care and services that strike a balance between safety and autonomy., Competing Interests: The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Background and Aims: A health warning label (HWL) cautioning about the link between alcohol and cancer may be able to communicate alcohol risks to consumers and potentially counter health-oriented nutrition advertising on ready-to-drink alcoholic beverages. This study aimed to examine the independent and combined effects of nutrient content claims (e.g. 0 g sugar) and a HWL on perceived product characteristics and intentions to consume, and whether these effects differed by gender and age., Design: A between-subjects randomized experiment. Participants were randomized to view one of six experimental label conditions: nutrient content claims plus nutrition declaration (NCC + ND), ND only, NCC + ND + HWL, ND + HWL, HWL only and no NCC, ND or HWL, all on a ready-to-drink (RTD) vodka-based soda container., Setting and Participants: Alcohol consumers (n = 5063; 52% women) in Canada aged 18-64 recruited through a national online panel., Measurements: Participants completed ratings of perceived product characteristics, perceived product health risks, and intentions to try, buy, binge and drink the product., Findings: Compared with the reference condition NCC + ND (current policy scenario in Canada), the other five experimental label conditions were associated with lower ratings for perceiving the product as healthy. All experimental conditions with a HWL were associated with lower product appeal, higher risk perceptions and reduced intentions to try, buy and binge. The experimental condition with a HWL only was associated with intentions to consume fewer cans in the next 7 days (β = -0.72, 95% confidence interval [CI] = -1.37,-0.08) versus the reference. Few interactions were observed, suggesting that label effects on outcomes were similar by gender and age., Conclusions: Health warning labels on alcohol packaging appear to be associated with lower product appeal, higher perceived health risks and reduced consumption intentions, even in the presence of nutrient content claims., (© 2024 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.)

Background: As the world population is aging, considerable efforts need to be put towards developing and maintaining evidenced-based care for older adults. Respite services are part of the selection of homecare offered to informal caregivers. Although current best practices around respite are rooted in person centeredness, there is no integrated synthesis of its flexible components. Such a synthesis could offer a better understanding of key characteristics of flexible respite and, as such, support its implementation and use., Methods: To map the literature around the characteristics of flexible at-home respite for informal caregivers of older adults, a scoping study was conducted. Qualitative data from the review was analyzed using content analysis. The characterization of flexible at-home respite was built on three dimensions: WHO, WHEN and HOW. To triangulate the scoping results, an online questionnaire was distributed to homecare providers and informal caregivers of older adults., Results: A total of 42 documents were included in the review. The questionnaire was completed by 105 participants. The results summarize the characteristics of flexible at-home respite found in the literature. Flexibility in respite can be understood through three dimensions: (1) WHO is tendering it, (2) WHEN it is tendered and (3) HOW it is tendered. Firstly, human resources (WHO) must be compatible with the homecare sector as well as being trained and qualified to offer respite to informal caregivers of older adults. Secondly, flexible respite includes considerations of time, duration, frequency, and predictability (WHEN). Lastly, flexible at-home respite exhibits approachability, appropriateness, affordability, availability, and acceptability (HOW). Overall, flexible at-home respite adjusts to the needs of the informal caregiver and care recipient in terms of WHO, WHEN, and HOW., Conclusion: This review is a step towards a more precise definition of flexible at-home respite. Flexibility of homecare, in particular respite, must be considered when designing, implementing and evaluating services., (© 2024. The Author(s).)

Background: Improving the nutritional quality of the food supply increases access to nutritious foods, which improves dietary habits and population health. Yet, knowledge mobilization initiatives between public health nutrition researchers and food industries are often not adequately considered and understood. This study explored what elements related to this specific context need to be recognized so that researchers can better mobilize nutrition science knowledge with the food industry to promote the nutritional improvement of food products., Method: A case study qualitative approach was selected to answer the research question, using semi-structured interviews as the data collection technique. Québec baking industry actors were shown a mock-up of an online mobilization platform sharing the results of the Food Quality Observatory that describes the nutritional quality of breads offered in Québec, Canada. They were asked to think aloud as they explored the web platform and were interviewed. Two coders analyzed the data using an inductive approach and thematic content analysis, starting with individual open coding, and then put forward their analyses and drafted the final themes., Results: The final data consisted of 10 semi-structured interviews conducted between October 2019 and August 2020. Four main themes were identified: the industry's context, the knowledge mobilization initiative, the product-related matters stemming from the information shared and the motivation within the industry. Within each theme, sub-themes were highlighted and related to the industries' motivation to improve their products' nutritional quality. This study also specified key considerations for changes to the sodium and fiber content in bread., Conclusion: Other steps beyond using simple language and a website format could be taken to better mobilize scientific knowledge with food industries, such as providing more consumer information, using an integrated knowledge mobilization approach that includes a consideration of ethics, working with communication professionals, collaborating with food science experts, and providing resources to act on shared information. Legislation such as the front-of-pack regulations could accelerate the pace of collaboration between researchers and industry. Overall, establishing a prior relationship with industries could help gain a better understanding of the themes highlighted in this study. Future research could build on this case study to provide more insights and solidify these findings., Classification Codes: Public Health, Public Private, Policy Making, Research Institutions, Use of Knowledge., (© 2024. The Author(s).)

Fluctuations in global arousal are key determinants of spontaneous cortical activity and function. Several subcortical structures, including neuromodulator nuclei like the locus coeruleus (LC), are involved in the regulation of arousal. However, much less is known about the role of cortical circuits that provide top-down inputs to arousal-related subcortical structures. Here, we investigated the role of a major subdivision of the prefrontal cortex, the anterior cingulate cortex (ACC), in arousal modulation. Pupil size, facial movements, heart rate, and locomotion were used as non-invasive measures of arousal and behavioral state. We designed a closed loop optogenetic system based on machine vision and found that real time inhibition of ACC activity during pupil dilations suppresses ongoing arousal events. In contrast, inhibiting activity in a control cortical region had no effect on arousal. Fiber photometry recordings showed that ACC activity scales with the magnitude of spontaneously occurring pupil dilations/face movements independently of locomotion. Moreover, optogenetic ACC activation increases arousal independently of locomotion. In addition to modulating global arousal, ACC responses to salient sensory stimuli scaled with the size of evoked pupil dilations. Consistent with a role in sustaining saliency-linked arousal events, pupil responses to sensory stimuli were suppressed with ACC inactivation. Finally, our results comparing arousal-related ACC and norepinephrinergic LC neuron activity support a role for the LC in initiation of arousal events which are modulated in real time by the ACC. Collectively, our experiments identify the ACC as a key cortical site for sustaining momentary increases in arousal and provide the foundation for understanding cortical-subcortical dynamics underlying the modulation of arousal states., Competing Interests: Declaration of interests The authors declare no competing interests.