Effects of the Mental Health Supporter Training Program on mental health-related public stigma among Japanese people: A pretest/posttest study.

Aim: The Mental Health Supporter Training Program is a national project conducted in Japan. This study aimed to determine the effects on mental health-related stigma, mental health literacy, and knowledge about mental health difficulties and support techniques among program participants. Methods: The target population was local residents of a wide range of generations in Japan. Outcomes were assessed at baseline (T1), immediately postintervention (T2), and at the 6-month follow-up (T3). A mixed model for repeated-measures conditional growth model analyses were employed to examine the effects of the intervention over time (T1, T2, T3). We also calculated effect sizes using Cohen's d. Results: The program had a significantly favorable pooled effect on the Japanese version of the Reported and Intended Behaviour Scale score after adjusting for covariates (reported behavior [t = 3.20, p = 0.001]; intended behavior [t = 8.04, p < 0.001]). However, when compared at each time point, only intended behavior from T1 to T2 showed a significant difference (t = 8.37, p < 0.001). Significant pooled effects were found for mental health literacy (knowledge: t = 19.85, p < 0.001; attitude: t = 15.02, p < 0.001), knowledge of mental health (t = 28.04, p < 0.001), and psychological distress (t = -2.41, p = 0.016). Conclusion: The results suggest that the program might be effective for improving intended, but not reported, behavior in the short term and for improving mental health literacy, knowledge of mental health, and psychological distress.

Online physical exercise program with music improves working memory.

Objective: The spread of coronavirus disease (COVID-19) has limited the implementation of face-to-face non-pharmacological treatment for the prevention of dementia. As a result, online non-pharmacological treatment has become increasingly important. In this study, we used an online conferencing system to implement an online version of a physical exercise program with music, and examined its effect on cognitive function. Methods: The participants were 114 healthy older adults [63 men and 51 women; mean age of 70.7 years (standard deviation = 4.6)]. Seventy-five participants were allocated to the physical exercise with music group (60 min, once a week, total 20 sessions), while the remaining 39 participants were assigned to the control group, and only underwent the examinations. In the physical exercise with music group, we performed neuropsychological examinations and brain tests both before and after the exercise program. Neuropsychological tests included the Mini-Mental State Examination, Raven's Colored Progressive Matrices (RCPM), the Rivermead Behavioral Memory Test, graphic imitation, word fluency (WF) (animal names and initial sounds), and the Trail Making Test-A/B. As an assessment of brain function, we developed an online examination of subtle cognitive decline, including tests of number and word memory, spatial grasp, the N-back task, and change inference. Results: In the N-back task, the physical exercise with music group improved significantly relative to the control group (p = 0.008). Discussion: The present findings suggest that the online version of the physical exercise with music program improved working memory, which mainly involves the frontal lobe.

An Online Version of Physical Exercise with Musical Accompaniment Might Facilitate Participation by Subjects Who Cannot Participate in Person: A Questionnaire-Based Study.

Introduction: Due to the ongoing outbreak of the coronavirus disease 2019 (COVID-19), it is currently difficult to conduct in-person exercise classes. We thus started the program of an online physical exercise with musical accompaniment. Several interesting differences were found in the characteristics of the online participants compared with our previous in-person interventions. Participants and Methods: The total number of subjects was 88 (71.2 ± 4.9 years old; male 42, female 46). The questionnaire included the attributes of the participants, the perceived advantages of the exercise classes, and the presence or absence of noticeable changes in cognitive and physical function after participating in the classes. Results: The personal computers used to attend the online classes were operated by the participants themselves. About 42% of the participants felt that their sense of day of the week and volition were improved by attending the exercise classes for 3 months. The most frequent answer to the reason for participation was because it was free (81.8%). The second most frequent answer was because the classes were held online (75.0%). Almost half of the participants answered that they would not participate if it was held in person because of the risk of COVID-19 infection (75.0%) and the difficulty getting to the site where the exercise classes were held (59.1%). Conclusion: Online physical exercise with musical accompaniment improved the perceived orientation, volition, activity, exercise habits, and health condition in 30-40% of the participants and also stimulated greater participation by males compared to classes held in person.

Shorter Version of the Brain Assessment Is Suitable for Longitudinal Public Cognitive Evaluations.

INTRODUCTION: We have developed an online cognitive test (Brain Assessment [BA]) which exhibits moderate correlations with established neuropsychological tests. We made a short version of the BA that requires only 10 min and investigated correlations with the original version. PARTICIPANTS AND METHODS: Three hundred and twenty-three subjects (26-82 years old, mean age 41.9 years) were recruited via the internet and performed the original version of the BA online, and, for the analyses of the original and short version, the results of the whole and of the first 2 min were utilized, respectively. Correlations were evaluated between both versions, and 144 subjects agreed to be interviewed about BA utilization. RESULTS: Correlations between the short and original versions of the BA were strong (memory of numbers, r = 0.72: total, r = 0.73) or moderate (memory of words, r = 0.66; visuospatial, r = 0.42; working memory, r = 0.53; judgment, r = 0.54). We found a strong negative correlation between the "memory of words" subtest and age (short version, r = -0.85; original version, r = -0.88). Regarding the interview, most wanted to be assessed by the short version every year. In the case of a concerning score, they would then want to be examined by the original version of the BA and/or more specific neuropsychological tests. DISCUSSION: We found that the short and the original versions of the BA exhibited strong correlations, and the correlation coefficients between age and subtest scores were almost the same between the two versions. CONCLUSION: The short version of the BA will be useful to perform cognitive assessments in the clinic.

The Correlation between a New Online Cognitive Test (the Brain Assessment) and Widely Used In-Person Neuropsychological Tests.

INTRODUCTION: There are several problems with standard in-person neuropsychological assessments, such as habituation, necessity of human resources, and difficulty of in-person assessment under societal conditions during the outbreak of coronavirus disease 2019. Thus, we developed an online cognitive test (the Brain Assessment [BA]). In this study, we investigated the correlation between the results of the BA and those of established neuropsychological tests. PARTICIPANTS AND METHODS: Seventy-seven elderly persons (mean 71.3 ± 5.1 years old; range 65-86; male:female = 45:32) were recruited through the internet. Correlations were evaluated between the BA and the following widely used neuropsychological tests: the mini-mental state examination (MMSE), the Raven's colored progressive matrices (RCPM), the logical memory I and II of the Rivermead Behavioral Memory Test, the word fluency (WF) test, and the Trail-Making TestA/B. RESULTS: We found moderate correlations between the total cognitive score of the BA and the total score of the MMSE (r = 0.433, p < 0.001), as well as between the total BA score and the total RCPM score (r = 0.582, p < 0.001) and time to complete the RCPM (r = 0.455, p < 0.001). Moderate correlations were also observed between the cognitive score of the memory of words BA subtest and the LM-I (r = 0.518, p < 0.001), the mental rotation subtest and figure drawing (r = 0.404, p < 0.001), the logical reasoning subtest and total RCPM score (r = 0.491, p < 0.001), and the memory of numbers and words subtests and WF (memory of numbers and total WF: r = 0.456, p < 0.001; memory of words and total WF: r = 0.571, p < 0.001). DISCUSSION: We found that the BA showed moderate correlations between established neuropsychological tests for intellect, memory, visuospatial function, and frontal function. The MMSE and the RCPM reflect Spearman's s-factor and g-factor, respectively, and thus the BA also covered both factors. CONCLUSION: The BA is a useful tool for assessing the cognitive function of generally healthy elderly persons.

Effect of celecoxib, a selective cyclooxygenase-2 inhibitor on carbon tetrachloride intoxication in rats.

CCl(4) (0.5 ml/kg as CCl(4)) was orally administered to rats. Twelve hours after administration of CCl(4), plasma alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, indicators of liver necrosis, were significantly higher than those in the control group showing that active liver necrosis took place. At the same time the level of liver vitamin C was decreased significantly compared to that in the control group. Oral administration of 100 mg/kg each of celecoxib 3 and 8 h after CCl(4) treatment did not change plasma ALT and AST and liver vitamin C levels 12 h after CCl(4) treatment, but 24 h after CCl(4) treatment, significantly decreased plasma ALT and AST levels and elevated liver vitamin C level. These finding suggested that celecoxib effectively ameliorated the necrotic action and the oxidative stress induced by CCl(4) in the second phase. Although the plasma levels of all ceramide species were significantly increased 24 h after CCl(4) intoxication, treatment with celecoxib significantly reduced the total ceramide concentration in plasma. These results indicated that celecoxib significantly ameliorated the toxicity of CCl(4) in the second phase.

Neutral sphingomyelinase-induced ceramide accumulation by oxidative stress during carbon tetrachloride intoxication.

Ceramide is a biologically active lipid causing apoptosis in a variety of cells. In this study, we examined the effect of CCl4 on the ceramide metabolism and indicators of oxidative stress. After 12 h of oral administration of CCl4 (4 ml/kg body weight as a 1:1 mixture of CCl4 and mineral oil) to rats, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were increased. Antioxidants such as vitamins C and E were decreased in the liver and kidney. In addition, the ratio of GSH/GSSG in the liver, plasma, kidney, and brain decreased at 2h. The total ceramide in the liver significantly increased as early as 2h after CCl4 administration. After 24 and 36 h, the total ceramide in plasma and the kidney was also augmented. In the brain, the total ceramide dramatically increased at 36 h. These results suggested that the increased ceramide in plasma was transferred to the kidney and the brain. The activity of neutral sphingomyelinase (SMase), which was reported to be enhanced by the decrease of GSH, was significantly increased after CCl4 treatment in the liver, kidney, and brain. However, acid SMase activities were not increased in the liver and kidney. Thus, the activation of neutral SMase via oxidative stress induced the increase of ceramide during CCl4 intoxication in not only the liver but also other tissues. These results suggested that the excess accumulation of ceramide causes damage in other organs including the kidney and brain during fulminant hepatic failure.

Effects of dietary cholesterol on tissue ceramides and oxidation products of apolipoprotein B-100 in ApoE-deficient mice.

Oxidized LDL (oxLDL) has been shown to activate the sphingomyelinase pathway producing ceramide in vascular smooth muscle cells. Therefore ceramide, which is a biologically active lipid causing apoptosis in a variety of cells, may be involved in the apoptotic action of oxLDL. In this study, we examined whether cholesterol enriched diets affected ceramide metabolism and oxidation product of LDL, represented by degradation of apolipoprotein B-100 (apoB) in apoE-deficient (apoE-/-) mice. ApoE-/- and wild type mice were fed a standard (AIN-76) diet or 1% cholesterol-enriched diet for 8 weeks. Tissue ceramide levels were analyzed using electrospray tandem mass spectrometry (LC-MS/MS). Ceramide levels in the plasma and the liver of apoE-/- mice were intrinsically higher than those of the wild type. In apoE-/- mice, dietary cholesterol significantly increased several ceramides and degradation products of apoB in plasma compared to those fed the control diet. Dietary cholesterol did not affect tissue ceramide levels in the wild type mice. Based on these results, plasma ceramides possibly correlate with the increase in LDL oxidation and are a risk factor for atherosclerosis.