Supportive care of female hormones in brain health: what and how?

Female hormones, functioning as neuroactive steroids, are utilized beyond menopausal hormone therapy. The rapid onset of allopregnanolone analogs, such as brexanolone and zuranolone, in treating depression, and the effectiveness of megestrol acetate in addressing appetite and weight gain, prompted the Food and Drug Administration to authorize the use of progesterone for treating postpartum depression and cancer-related cachexia. Progesterone has also been found to alleviate neuropathic pain in animal studies. These off-label applications offer a promising option for patients with advanced cancer who often experience various mood disorders such as depression, persistent pain, social isolation, and physical complications like cachexia. These patients have shown low tolerance to opioids and mood-regulating medications. However, the potential risks and uncertainties associated with hormone therapy treatment modalities can be daunting for both patients and medical professionals. This review aims to offer a comprehensive understanding of the non-reproductive functions and mechanisms of female hormones in brain health.

Promotive and protective effects of community-related positive childhood experiences on adult health outcomes in the context of adverse childhood experiences: a nationwide cross-sectional survey in Japan.

OBJECTIVE: Although adverse childhood experiences (ACEs) are associated with poor health in adulthood, positive childhood experiences (PCEs) can reduce the risk of negative health outcomes. This study aimed to investigate whether PCEs in the community (CPCEs, ie, trusted adults other than parents, supportive friends, belongingness to school, or community traditions) would have an independent effect on better health outcomes and moderate the association between ACEs and adult illnesses. DESIGN: Cross-sectional survey. SETTING: Data were gathered from a nationwide, cross-sectional internet survey conducted in Japan in 2022. PARTICIPANTS: This study included 28 617 Japanese adults aged 18-82 years (51.1% female; mean age=48.1 years). PRIMARY AND SECONDARY OUTCOME MEASURES: The associations among self-reported ACEs, CPCEs before the age of 18 years and current chronic diseases (eg, cancer and depression) were investigated using multivariable logistic regression models. RESULTS: CPCEs were associated with lower odds of adult diseases (such as stroke, chronic obstructive pulmonary disease (COPD), chronic pain, depression, suicidal ideation and severe psychological distress) after adjusting for ACEs. More CPCEs weakened the association between ACEs and adult diseases. Specifically, among those with ACEs, ≥3 CPCEs (vs 0-2 CPCEs) lowered the adjusted prevalence by ≥50% for stroke (2.4% to 1.2%), COPD (2.2% to 0.7%) and severe psychological distress (16.4% to 7.4%). CONCLUSION: CPCEs could reduce ACE-related risk of poor physical and mental health in later life. Early-life interventions that enhance PCEs in schools and/or neighbourhoods are recommended.

The role of fatty acid-binding protein 5 and 7 on locomotor, anxiety and social behavior: Interaction with NMDA signaling.

The endocannabinoid system has been shown to be a powerful mediator of anxiety, learning and memory, as well as nociception behaviors. Exogenous cannabinoids like delta-9-tetrahydrocannabinol mimic the naturally occurring endogenous cannabinoids found in the mammalian central and peripheral nervous system. The hydrophobic properties of endocannabinoids mean that these psychoactive compounds require help with cellular transport. A family of lipid intracellular carriers called fatty acid-binding proteins (FABPs) can bind to endocannabinoids. Pharmacological inhibition or genetic deletion of FABP subtypes 5 and 7 elevates whole-brain anandamide (AEA) levels, a type of endocannabinoid. This study examined locomotor behavior, anxiety-like behavior, and social behavior in FABP5-/- and FABP7-/- mice. Furthermore, we measured N-methyl-D-aspartate (NMDA) receptor levels in the brain to help identify potential underlying mechanisms related to the behavioral findings. Results showed that both male and female FABP5-/- mice exhibited significantly lower activity when compared with both FABP5/7+/+ (control) and FABP7-/-. For social behavior, male, but not female, FABP5-/- mice spent more time interacting with novel mice compared with controls (FABP5/7+/+) and FABP7-/- mice. No significant difference was found for anxiety-like behavior. Results from the NMDA autoradiography revealed [3H] MK-801 binding to be significantly increased within sub-regions of the striatum in FABP7-/- compared with control. In summary, these results show that FABP5 deficiency plays a significant role in locomotion activity, exploratory behavior, as well as social interaction. Furthermore, FABP7 deficiency is shown to play an important role in NMDA receptor expression, while FABP5 does not.

Autistic-like behaviour and changes in thalamic cell numbers a rat model of valproic acid-induced autism; A behavioural and stereological study.

The contribution of the thalamus to the development and behavioural changes in autism spectrum disorders (ASD), a neurodevelopmental syndrome, remains unclear. The aim of this study was to determine the changes in thalamic volume and cell number in the valproic acid (VPA)-induced ASD model using stereological methods and to clarify the relationship between thalamus and ASD-like behaviour. Ten pregnant rats were administered a single dose (600 mg/kg) of VPA intraperitoneally on G12.5 (VPA group), while five pregnant rats were injected with 5 ml saline (control group). Behavioural tests were performed to determine appropriate subjects and ASD-like behaviours. At P55, the brains of the subjects were removed. The sagittal sections were stained with cresyl violet and toluidine blue. The thalamic and hemispheric volumes with their ratios, the total number of thalamic cells, neurons and non-neuronal cells were calculated using stereological methods. Data were compared using a t-test and a Pearson correlation analysis was performed to examine the relationship between behaviour and stereological outcomes. VPA-treated rats had lower sociability and sociability indexes. There was no difference in social novelty preference and anxiety. The VPA group had larger hemispheric volume, lower thalamic volume, and fewer neurons. The highest percentage decrease was in non-neuronal cells. There was a moderate positive correlation between the number of non-neuronal cells and sociability, thalamic volume and the number of neurons as well as the time spent in the light box. The correlation between behaviour and stereological data suggests that the thalamus is associated with ASD-like behaviour.

Effects of association between resveratrol and ketamine on behavioral and biochemical analysis in mice.

Resveratrol (3,5,4'-trihydroxy-trans-stilbene), a phenol commonly found in grapes and wine, has been associated as protective in experimental models involving alterations in different neurotransmitter systems. However, studies are reporting that resveratrol could have adverse effects. This study evaluated if the association of a low dose of ketamine and resveratrol could induce behavioral manifestations associated with biochemical alterations. Moreover, the effects of treatment with resveratrol and/or ketamine on monoamine oxidase (MAO) activity, oxidative stress markers, and IL-6 levels in the brain were also investigated. Male Swiss mice received a low dose of ketamine (20 mg/kg) for 14 consecutive days, and resveratrol (10, 30, or 100 mg/kg) from day 8 up to day 14 of the experimental period, intraperitoneally. Locomotor, stereotyped behavior, Y-maze, novel recognition object test (NORT), and social interaction were quantified as well as ex vivo analysis of MAO activity, IL-6 levels, and oxidative stress markers (TBARS and total thiol levels) in brain tissues. Ketamine per se reduced the number of bouts of stereotyped behavior on day 8 of the experimental period. Resveratrol per se reduced the locomotor and exploratory activity in the open field, the time of exploration of new objects in the NORT, MAO-A activity in the striatum and increased the IL-6 levels in the cortex. These effects were attenuated when the mice were co-treated with ketamine and resveratrol. There was a decrease in MAO-A activity in the cortex of mice treated with ketamine + resveratrol 100 mg/kg. No significant alterations were found in oxidative stress markers. Resveratrol does not appear to cause summative effects with ketamine on behavioral alterations. However, the effect of resveratrol per se, mainly on locomotor and exploratory activity, should be better investigated.

Characterization of pain-related behaviors in a rat model of acute-to-chronic low back pain: single vs. multi-level disc injury.

Introduction: Low back pain is the most common type of chronic pain. We examined pain-related behaviors across 18 weeks in rats that received injury to one or two lumbar intervertebral discs (IVD) to determine if multi-level disc injuries enhance/prolong pain. Methods: Twenty-three Sprague-Dawley adult female rats were used: 8 received disc puncture (DP) of one lumbar IVD (L5/6, DP-1); 8 received DP of two lumbar IVDs (L4/5 & L5/6, DP-2); 8 underwent sham surgery. Results: DP-2 rats showed local (low back) sensitivity to pressure at 6- and 12-weeks post-injury, and remote sensitivity to pressure (upper thighs) at 12- and 18-weeks and touch (hind paws) at 6, 12 and 18-weeks. DP-1 rats showed local and remote pressure sensitivity at 12-weeks only (and no tactile sensitivity), relative to Sham DP rats. Both DP groups showed reduced distance traveled during gait testing over multiple weeks, compared to pre-injury; only DP-2 rats showed reduced distance relative to Sham DP rats at 12-weeks. DP-2 rats displayed reduced positive interactions with a novel adult female rat at 3-weeks and hesitation and freezing during gait assays from 6-weeks onwards. At study end (18-weeks), radiological and histological analyses revealed reduced disc height and degeneration of punctured IVDs. Serum BDNF and TNFα levels were higher at 18-weeks in DP-2 rats, relative to Sham DP rats, and levels correlated positively with remote sensitivity in hind paws (tactile) and thighs (pressure). Discussion: Thus, multi-level disc injuries resulted in earlier, prolonged and greater discomfort locally and remotely, than single-level disc injury. BDNF and TNFα may have contributing roles.

Impact of social isolation on corticosterone release and recovery after stroke in aged rats: A behavioral and biochemical analysis.

Social isolation (SI) after stroke reduces recovery. The aim of this study was to evaluate the effects of SI on corticosterone release and recovery after stroke in aged rats. A total of 64 male Wistar rats (aged 24 months) were used in the present study. All rats were housed in pairs for two weeks. After two weeks, rats were randomly assigned to one of four groups: (1) rats underwent sham surgery and kept socially isolated (control/social isolated (CO/SI) group); (2) rats underwent sham surgery and kept pair housed (control/pair housed (CO/PH) group); (3) rats underwent middle cerebral artery occlusion (MCAO) surgery and kept socially isolated (stroke/isolated (ST/SI) group); (4) rats underwent MCAO surgery and kept pair housed (stroke/pair housed (ST/PH)) group. Behaviors were assessed using the adhesive removal test, rotarod test and social interaction test at 1st, 7th, 14th and 21st days after stroke. Serum biochemical analysis was also performed on the behavioral testing days. Results showed THAT serum corticosterone and MDA levels in CO/PH group were significantly lower than CO/SI group. Serum BDNF levels in CO/PH group was significantly higher than CO/SI group. Serum corticosterone and MDA levels in ST/PH group were lower than ST/SI group. In ST/PH group, serum Total antioxidant capacity (TAC) and BDNF levels were significantly higher than ST/SI group. Biochemical analysis of certain regions of the brain (hippocampus, striatum and cerebral cortex) was performed on 21st day after stroke. In the hippocampus of CO/PH group, BDNF and TAC levels were significantly higher than CO/SI group. The hippocampal MDA level of CO/PH group were significantly lower than CO/SI group. BDNF and TAC levels in the hippocampus, striatum and cerebral cortex of ST/PH group were significantly higher and MDA level was significantly lower as compared with ST/SI group. Both ischemic groups showed sensorimotor recovery over a 21-day period, but recovery of ST/PH group was significantly greater than ST/SI group. Total social interaction time in ST/PH group was significantly longer than ST/SI group. Based on the results of this study, social interaction after stroke enhances histologic and sensorimotor recovery through reduction of HPA activity and corticosterone release, leading to increased TAC and BDNF levels.

Racial/ethnic minority females smoke more cigarettes after social interaction with others who smoke.

The present study investigated the effects of social interaction with others who smoke on daily cigarette use among diverse females via ecological momentary assessment methods. Ninety-eight premenopausal females (29.6% White, 70.4% racial/ethnic minority) who smoke daily reported their social interactions and cigarette use over 35-days. Greater than usual levels of social interaction with others who smoke was associated with increased cigarette use that day among racial/ethnic minority females. Future smoking cessation interventions targeting racial/ethnic minority females should consider the impact of social environments on smoking behaviors, such as the frequency of peer interactions with others who smoke.

Neurophysiological analysis of disadvantageous social inequity: Exploring emotional behavior changes and c-Fos expression in a male rat model.

Humans and other animals exhibit aversive behavioral and emotional responses to unequal reward distributions compared with their conspecifics. Despite the significance of this phenomenon, experimental animal models designed to investigate social inequity aversion and delve into the underlying neurophysiological mechanisms are limited. In this study, we developed a rat model to determine the effects of socially equal or unequal reward and stress on emotional changes in male rats. During the training session, the rats were trained to escape when a sound cue was presented, and they were assigned to one of the following groups: all escaping rats [advantageous equity (AE)], freely moving rats alongside a restrained rat [advantageous inequity (AI)], all restrained rats [disadvantageous equity (DE)], and a rat restrained in the presence of freely moving companions [disadvantageous inequity (DI)]. During the test session, rats in the advantageous group (AE and AI) escaped after the cue sound (expected reward acquisition), whereas rats in the disadvantageous group (DE and DI) could not escape despite the cue being presented (expected reward deprivation). Emotional alteration induced by exposure to restraint stress under various social interaction circumstances was examined using an open field test. Notably, the DI group displayed reduced exploration of the center zone during the open field tests compared with the other groups, indicating heightened anxiety-like behaviors in response to reward inequity. Immunohistochemical analysis revealed increased c-Fos expression in the medial prefrontal and orbitofrontal cortices, coupled with reduced c-Fos expression in the striatum and nucleus accumbens under DI conditions, in contrast to the other experimental conditions. These findings provide compelling evidence that rats are particularly sensitive to reward inequity, shedding light on the neurophysiological basis for distinct cognitive processes that manifest when individuals are exposed to social equity and inequity situations.

Family characteristics and childcare patterns associated with early social functioning in cancer-bereaved parents.

BACKGROUND: Bereaved parents experience life-long grief after the death of their child from cancer. Parents who can integrate their grief and maintain their social functioning early in bereavement, even in the setting of concurrent psychosocial distress, have improved outcomes. Identifying the factors associated with bereaved parents' early social functioning can guide future supportive interventions. METHODS: The authors surveyed parents of children who died from cancer at two large centers 6-24 months after death, assessing bereavement experiences using validated and pilot tested tools. Univariable and multivariable logistical regression models were used to examine which family and child demographic, treatment, and end-of-life (EOL) factors were associated with maintained parental social functioning (T scores ≥40 on the Patient-Reported Outcomes Measurement Information System Ability to Participate in Social Roles and Activities-Short Form questionnaire). RESULTS: One hundred twenty-eight parents of 88 children participated (38% household response rate); most parents identified as female (63%) and White (88%). Parents' median age was 47 years (interquartile range, 10 years); and the median time from the child's death to survey completion was 13 months (interquartile range, 10 months). In multivariate modeling, parents without household material hardship and those who felt prepared for EOL circumstances had increased odds of maintained social functioning (odds ratio, 4.7 [95% confidence interval, 1.6-13.7; p < .004] and 5.5 [95% confidence interval, 1.9-15.9; p < .002], respectively). CONCLUSIONS: Parents who felt prepared for their child's EOL and those without household material hardship were more likely to have maintained social functioning in the first 2 years after their child's death. Interventions targeting EOL preparedness and alleviating household material hardship may improve bereavement outcomes.

Angiotensin II involvement in the development and persistence of amphetamine-induced sensitization: Striatal dopamine reuptake implications.

Amphetamine (AMPH) exposure induces behavioural and neurochemical sensitization observed in rodents as hyperlocomotion and increased dopamine release in response to a subsequent dose. Brain Angiotensin II modulates dopaminergic neurotransmission through its AT1 receptors (AT1-R), positively regulating striatal dopamine synthesis and release. This work aims to evaluate the AT1-R role in the development and maintenance of AMPH-induced sensitization. Also, the AT1-R involvement in striatal dopamine reuptake was analysed. The sensitization protocol consisted of daily AMPH administration for 5 days and tested 21 days after withdrawal. An AT1-R antagonist, candesartan, was administered before or after AMPH exposure to evaluate the participation of AT1-R in the development and maintenance of sensitization, respectively. Sensitization was evaluated by locomotor activity and c-Fos immunostaining. Changes in dopamine reuptake kinetics were evaluated 1 day after AT1-R blockade withdrawal treatment, with or without the addition of AMPH in vitro. The social interaction test was performed as another behavioural output. Repeated AMPH exposure induced behavioural and neurochemical sensitization, which was prevented and reversed by candesartan. The AT1-R blockade increased the dopamine reuptake kinetics. Neither the AMPH administration nor the AT1-R blockade altered the performance of social interaction. Our results highlight the AT1-R's crucial role in AMPH sensitization. The enhancement of dopamine reuptake kinetics induced by the AT1-R blockade might attenuate the neuroadaptive changes that lead to AMPH sensitization and its self-perpetuation. Therefore, AT1-R is a prominent candidate as a target for pharmacological treatment of pathologies related to dopamine imbalance, including drug addiction and schizophrenia.

Black seed oil reverses chronic antibiotic-mediated depression and social behaviour deficits via modulation of hypothalamic mitochondrial-dependent markers and insulin expression.

Chronic antibiotic use has been reported to impair mitochondrial indices, hypothalamus-mediated metabolic function, and amygdala-regulated emotional processes. Natural substances such as black seed (Nigella sativa) oil could be beneficial in mitigating these impairments. This study aimed to assess the impact of black seed oil (NSO) on depression and sociability indices, redox imbalance, mitochondrial-dependent markers, and insulin expression in mice subjected to chronic ampicillin exposure. Forty adult male BALB/c mice (30 ± 2 g) were divided into five groups: the CTRL group received normal saline, the ABT group received ampicillin, the NSO group received black seed oil, the ABT/NSO group concurrently received ampicillin and black seed oil, and the ABT+NSO group experienced pre-exposure to ampicillin followed by subsequent treatment with black seed oil. The ampicillin-exposed group exhibited depressive-like behaviours, impaired social interactive behaviours, and disruptions in mitochondrial-dependent markers in plasma and hypothalamic tissues, accompanied by an imbalance in antioxidant levels. Moreover, chronic antibiotic exposure downregulated insulin expression in the hypothalamus. However, these impairments were significantly ameliorated in the ABT/NSO, and ABT+NSO groups compared to the untreated antibiotic-exposed group. Overall, findings from this study suggest the beneficial role of NSO as an adjuvant therapy in preventing and abrogating mood behavioural and neural-metabolic impairments of chronic antibiotic exposure.

Protocol for a scoping review of how people with ME/CFS use the internet.

INTRODUCTION: Myalgic encephalomyelitis (ME) is a chronic neurological illness affecting many bodily systems, commonly the nervous and immune systems. Also known as chronic fatigue syndrome (CFS), key symptoms are extreme fatigue, post-exertional malaise, cognitive problems and sleep disturbance. With reported higher levels of online activity for people with ME/CFS than other patient groups (Westerby 2013 cited in Ytre-Arne) it is crucial to gain more knowledge of usage characteristics and experience of online use, and its integration into everyday life. This scoping review protocol details the proposed methods for gaining insight into this little known phenomenon. METHODS AND ANALYSIS: This review uses the methodological framework for conducting a scoping review by Arksey and O'Malley, with further guidance by Levac et al, and the Joanna Briggs Institute. It also refers to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols reporting guidelines. The following bibliographic databases will be searched: Embase, Medline, PsychINFO, Cinahl, AMED, and ASSIA, plus Web of Science, ProQuest Dissertations and Theses Global, Scopus, and Google Scholar for grey literature. Reference lists of included papers will be studied. Two reviewers will independently screen title abstracts, and then full text of studies against inclusion criteria. Remaining studies will be quality assessed using appropriate critical appraisal tools. Findings will be charted and mapped to gain in-depth knowledge of the use of the internet in people with ME/CFS. ETHICS AND DISSEMINATION: The findings from this review will be disseminated through peer-reviewed publication and a report for leading charities of ME/CFS. The review will collect secondary data only and therefore does not need ethical approval.

Understanding barriers and enablers to participation in a proposed online lifestyle intervention for older adults with age-related macular degeneration to guide programme implementation.

Age-related macular degeneration (AMD) is a blinding condition associated with depression, loneliness and unhealthy lifestyle behaviours which drives AMD progression. We have proposed the first online lifestyle intervention for AMD, called Movement, Interaction and Nutrition for Greater Lifestyles in the Elderly (MINGLE) to promote positive lifestyle changes and reduce loneliness. This qualitative grounded-theory study explored enablers and barriers to future participation in MINGLE for older adults with AMD. Thirty-one participants were interviewed and thematic analysis revealed nine themes. Enablers to participation were: socialising and learning about AMD, motivation to improve health, programme accessibility and structure. Barriers were: lack of time, technology, limited knowledge regarding holistic interventions, vision-related issues, mobility and negative perception of group interactions. These factors must be considered when developing lifestyle interventions for AMD patients to maximise participation. Supporting technology use and raising awareness about benefits of healthy lifestyle behaviours for AMD may help overcome these barriers.

O lado obscuro da internet: uma revisão de literatura sobre o comportamento antissocial online / The internet's dark side: a literature review on antissocial online behaviour / El lado oscuro de internet: una revisión de la literatura sobre el comportamiento antisocial online

O objetivo do estudo foi realizar uma revisão sistemática da literatura acerca do comportamento antissocial online e, também, categorizar esses comportamentos e observar aspectos psicossociais relacionados. Para tanto, foi utilizada uma síntese qualitativa, incluindo estudos quantitativos publicados entre 2016-2020 nas bases de dados Scopus, PsycInfo, Pepsic e Scielo. Vinte e cinco estudos se adequaram às análises. Os resultados demonstraram a existência de quatro categorias de comportamento antissocial online: cyberbullying, trollagem, comportamento antissocial sexual, e cyberstalking. A tétrade sombria (narcisismo, psicopatia, Maquiavelismo e sadismo) mostrou-se o preditor mais consistente dessas categorias nos estudos. O estudo alcançou os objetivos propostos, preenchendo duas lacunas: a inexistência de categorização do comportamento antissocial online e a escassez de estudos brasileiros sobre o tema

The study aimed to conduct a systematic literature review on antisocial online behavior. The objective was also to categorize these behaviors and observe related psychosocial aspects. To this end, a qualitative synthesis was used, including quantitative studies published between 2016-2020 in the Scopus, PsycInfo, Pepsic, and Scielo databases. 25 studies fitted the analyzes. The results demonstrated the existence of four antisocial online behavior categories: cyberbullying, trolling, sexual antisocial behavior, and cyberstalking. The dark tetrad (narcissism, sychopathy, Machiavellianism, and sadism) was the most consistent predictor of these categories among studies. The research fulfilled the proposed purposes, filling two literature gaps: The lack of categorization of antisocial online behavior; and the scarcity of Brazilian studies on the topic

El objetivo del estudio fue realizar una revisión sistemática de la literatura sobre el comportamiento antisocial online. El objetivo también fue categorizar estos comportamientos y observar aspectos psicosociales relacionados. Para ello, se utilizó una síntesis cualitativa, incluyendo estudios cuantitativos publicados entre 2016-2020 en las bases de datos Scopus, PsycInfo, Pepsic y Scielo. 25 estudios se ajustan a los análisis. Los resultados demostraron la existencia de cuatro categorías de comportamiento antisocial en línea: cyberbullying, trolling, comportamiento sexual antisocial y cyberstalking. La tétrada oscura (narcisismo, psicopatía, maquiavelismo y sadismo) fue el predictor más consistente de estas categorías entre los estudios. El estudio cumplió con los objetivos propuestos, llenando dos vacíos: La falta de categorización de la conducta antisocial en línea; y la escasez de estudios brasileños sobre el tema

Effects of dialogic reading for comprehension (LuDiCa) on the social interaction of autistic adolescents and their peers

Abstract Background In today's contemporary world, relationships take a prominent role in the lives of adolescents. However, challenges related to mutual understanding and a lack of inclusive environments can often lead to autistic teens feeling excluded. Objective In order to assess the impact of naturalistic interventions on interpersonal relationships, we conducted an experimental test utilizing Dialogic Reading for Comprehension (LuDiCa) in online reading circles with groups comprising both autistic and neurotypical adolescents. Our focus was on exploring its relevance for enhancing social interaction, particularly in terms of conversational acts, sharing experiences, initiations, and questions. Methods Five autistic and five neurotypical students between 11 and 15 years old from a public school in Brasilia, Federal District, participated. We paired groups A and B (made up of trios of teenagers) and groups C and D (made up of pairs) in a multiple baseline design per reading group, in which all groups went through the baseline conditions (BL), intervention (LuDiCa) and maintenance. Results LuDiCa increased the frequency of conversational acts of both autistic participants and neurotypical peers. In addition, the intervention favored initiations, questions, and sharing experiences, through the shared activity of reading and talking about a work of fiction. Participants rated the intervention in relation to the platform, the book, the reading facilitator, and interaction with peers. We discuss the potential of the facilitator's role in favoring interactions and the potential of LuDiCa as a joint activity for the engagement of adolescents. We also include suggestions for future research focused on the online context and discuss some limitations of the LuDiCa intervention. Conclusion In summary, our study offers initial experimental evidence demonstrating the positive impact of LuDiCa on social interaction behaviors among both autistic and neurotypical adolescents within an inclusive setting.

Guides or guidelines for interacting and playing with medical complex children: a qualitative documentary research / Guías o directrices para interactuar y jugar con niños con condiciones clínicas complejas: investigación cualitativa documental / Guias ou diretrizes para interagir e brincar com crianças clinicamente complexas: uma pesquisa qualitativa documental

Objectives: to identify content on play and interaction with children with special health care needs recommended in clinical guidelines; analyze play and interaction activities applicable to children with special health care needs and complex care requirements. Method: qualitative documentary research based on guides, protocols, or guidelines on playing and interacting with children with special and living with complex care. Search terms in English (guidelines, playing OR play, complex needs, OR chronic disease) and in Portuguese ( guia, brincar ou brincadeiras, condições crônicas ) on the first ten pages of_Google Search ® . Thematic analysis was applied to the information extracted from the documents. Results: a total of nine documents with similar content were grouped into units of analysis, keeping only the interacting and playing activities applicable to children with special health care needs and living with complex care requirements, namely stimulation of potential, stimulation of adult-child interaction, and stimulation of the senses (touch, sight, and hearing), to be carried out by health professionals and family caregivers in the different care contexts. Conclusion: interaction and play are potential promoters of adult-child interaction, with application in the stimulating and life-delivering complex care for children.

Objetivos: identificar contenido sobre juego e interacción con niños con necesidades de especiales atención en salud recomendados en guías clínicas; analizar las actividades de juego e interacción que se pueden implementar niños con necesidades especiales de atención en salud y demandas de cuidados clínicamente complejos. Método: investigación cualitativa documental basada en guías, protocolos o directrices para jugar e interactuar con niños con necesidades especiales de atención en salud. Búsqueda de los términos en inglés ( guidelines, playing o play, complex needs OR chronic disease ) y en portugués ( guia, brincar o brincadeiras, condições crônicas ), en las primeras 10 páginas de Google Search ® . Se aplicó análisis temático a la información extraída de los documentos. Resultados: se agruparon en unidades de análisis nueve documentos con contenido similar, se extrajeron solo las actividades para interactuar y jugar que se pueden implementar con niños con necesidades especiales de atención en salud y demandas de cuidados clínicamente complejos, a saber: estimular las potencialidades, estimular la interacción adulto-niño y estimular los sentidos (tacto, visión y oído), que realizan los profesionales de la salud y los cuidadores familiares en diferentes contextos de cuidado. Conclusión: interactuar y jugar pueden promover la interacción adulto-niño e implementarse en el cuidado estimulante y vivificante de niños con condiciones clínicas complejas.

Objetivos: identificar conteúdos sobre brincar e interagir com crianças com necessidades de saúde especiais recomendados em guias clínicos; analisar as atividades de brincar e interagir aplicáveis às crianças com necessidades de saúde especiais e demandas de cuidados clinicamente complexas. Método: pesquisa qualitativa documental baseada em guias, protocolos ou diretrizes sobre brincar e interagir com crianças com necessidades de saúde especiais. Busca dos termos em inglês ( guidelines, playing ou play, complex needs OR chronic disease ) e em português (guia, brincar ou brincadeiras, condições crônicas), nas 10 primeiras páginas do Google Search ® . Aplicou-se a análise temática às informações extraídas dos documentos. Resultados: agruparam-se nove documentos com conteúdo similares em unidades de análise, mantendo-se somente as atividades do interagir e brincar aplicáveis às crianças com necessidades de saúde especiais e demandas de cuidados clinicamente complexas, a saber: estimulação das potencialidades, estimulação da interação adulto-criança e estimulação dos sentidos (tato, visão e audição), a serem realizadas por profissionais de saúde e familiares cuidadores nos diferentes contextos de cuidado. Conclusão: o interagir e o brincar são potenciais promotores da interação adulto-criança, com aplicação no cuidado estimulador e vivificante de crianças clinicamente complexas.

Intervención sobre habilidades sociales mediante un juego de rol: un estudio de diseño mixto con jóvenes con discapacidad intelectual / Social skills intervention through role-playing: a mixed-design study with youth with intellectual disability

Resumen Objetivos. Identificar si existen mejoras en la interacción social de jóvenes con discapacidad intelectual a través del uso de una metodología basada en el juego de rol. Método. Se realizó un estudio de diseño mixto a partir de un programa de intervención breve, de ocho sesiones de duración, con un total de siete participantes. Para la recolección de datos, se utilizaron técnicas cualitativas y cuantitativas como la observación sistemática, la observación directa no sistematizada y la Escala de Autoevaluación de Habilidades Sociales. Resultados. La intervención arrojó resultados modestos. La prueba W de Wilcoxon muestra diferencias significativas a nivel general. Las observaciones evidencian cambios en los comportamientos de los participantes, sobre todo en lo referente a respuestas alternativas a la agresión, la cuales fueron rápidamente sustituidas por estrategias pacíficas y actitudes dialogantes.

Abstract Objectives. The objective of this study was to identify if there are improvements in social interaction in young people with intellectual disabilities, using a methodology based on role playing. Method. A mixed design study based on a brief intervention program of eight sessions, with a total of seven participants, was used. Qualitative and quantitative techniques were used for data collection: systematic observation, non-systematized direct observation and the Social Skills Self-Assessment Scale. Results. The intervention yielded modest results. The Wilcoxon W test shows significant differences at the general level. Observations show changes in participants' behaviors, especially in terms of alternative responses to aggression, which were quickly replaced by peaceful strategies and dialogic attitudes.

Age-gender differences in the relationships between physical and mental health.

Previous studies have identified that smoking, exercise and breadth of social interaction mediate the strong associations between physical and mental health. However, these studies have been restricted to older populations, have not explored differences by gender, and have not considered online social interaction. We explore how the effects of four mediators (exercise, smoking, in-person and online social interaction) of the two-way relationships between past and future physical and mental health vary across eight age and gender groups. We use data from a representative sample of the UK population consisting of 175,779 observations on 41,995 adults from Understanding Society (UKHLS) between 2009 and 2019. Within a mediation framework, we estimate the percentage of the total effects that can be explained by the proposed mediating factors. We show that exercise, smoking, in-person and online social interaction are significant mediators of the effect of mental health on future physical health. In-person social interaction is the largest of these, accounting for 2.3% of the total effect. Smoking, in-person and online interaction are significant mediators of the effect of physical health on future mental health. Again, in-person interaction is the largest of these, accounting for 3.0% of the total effect. The percentages of the total effects mediated by each factor differ substantially by age and gender. Seeking to avoid the harmful effects of poor physical health on future mental health should focus on increasing physical activity in older men, and on increasing in-person social interaction in both men and women. Seeking to avoid the harmful effects of poor mental health on future physical health should focus on increasing physical activity and in-person social interaction in older men and women, and on reducing smoking in younger men and women.

Social support network, functional capacity and mental health in older adults / Rede de suporte social, capacidade funcional e saúde mental em pessoas idosas / Red de apoyo social, capacidad funcional y salud mental en personas mayores

This study aimed to describe the characteristics of the social networks of older adults and to assess associations between social support, functional capacity and mental health. The sample consisted of 134 community-dwelling older adults, assessed in terms of their social network through the Minimum Map of Older Adult Relationships; functional capacity for performance in activities of daily living; depressive symptoms, assessed through the Geriatric Depression Scale and; anxiety, assessed through the Beck Anxiety Inventory. Cluster analyses were performed. The social network was characterized by being informal, functioning as affective support that occurs through visits. Social support perceived as insufficient was more frequent in men, in those who were dependent regarding instrumental activities of daily living, and in those with anxiety and depressive symptoms. Reduced social support networks and lack of support were associated with limitations in functional capacity and worse mental health, sparking debate about the centrality of the family in the provision of support.(AU)

Este estudo objetivou descrever as características da rede social de pessoas idosas e avaliar associações entre apoio social, capacidade funcional e saúde mental. A amostra foi composta por 134 idosos comunitários, avaliados quanto à rede social pelo Mapa Mínimo das Relações do Idoso; capacidade funcional pelo desempenho em atividades de vida diária; sintomas depressivos, avaliados pela Escala de Depressão Geriátrica e; ansiedade, avaliada pelo Inventário de Ansiedade de Beck. Foram realizadas análises de conglomerados. A rede social caracterizou-se por ser informal, funcionando como suporte afetivo que ocorre por meio de visitas. O apoio social percebido como insuficiente foi mais frequente no sexo masculino, entre idosos dependentes em atividades instrumentais de vida diária, com ansiedade e sintomas depressivos. Redes de suporte social reduzidas e com baixo apoio estão associadas com limitações na capacidade funcional e pior saúde mental, colocando em debate a centralidade da família na provisão de suporte.(AU)

Este estudio tuvo como objetivo describir las características de la red social de personas mayores y evaluar las asociaciones entre el apoyo social, la capacidad funcional y la salud mental. La muestra estuvo compuesta por 134 ancianos comunitarios, quienes fueron evaluados en cuanto a su red social mediante el Mapa Mínimo de Relaciones del Anciano; su capacidad funcional en las actividades de la vida diaria; los síntomas depresivos mediante la Escala de Depresión Geriátrica; y la ansiedad a través del Inventario de Ansiedad de Beck. Se realizaron análisis de conglomerados. La red social se caracterizó por ser informal, funcionando como apoyo afectivo que se manifiesta a través de visitas. El apoyo social percibido como insuficiente fue más frecuente en el sexo masculino, entre los ancianos dependientes en actividades instrumentales de la vida diaria, y aquellos con síntomas de ansiedad y depresión. Las redes de apoyo social reducidas y con bajo apoyo se asocian con limitaciones en la capacidad funcional y un peor estado de salud mental, lo que plantea el debate sobre el papel central de la familia en la provisión de apoyo.(AU)