Psychoeducation versus psychoeducation integrated with yoga for family caregivers of people with Alzheimer's disease: a randomized clinical trial.

We evaluate and compare the effectiveness of two psychoeducation programs on the burden and quality of life of family caregivers of people with Alzheimer's disease: one of psychoeducation alone and the other integrated with yoga. Forty-nine participants were randomly allocated to two groups, 25 to the psychoeducation integrated with yoga group (G1) and 24 to the psychoeducation group (G2). The programs took place online through Google Meet and consisted of eight weekly meetings, lasting 30 min for psychoeducation and 30 min for yoga. Participants were evaluated by the Burden Interview Scale (BI-Zarit), Quality of Life Scale in Alzheimer's Disease-Caregiver Version (CQOL-AD), Depression, Anxiety and Stress Scale (DASS-21), Mindfulness and Awareness Scale (MAAS) and a satisfaction survey. Both groups showed reduced overload according to the BI-Zarit scale (F(1) = 4.435, p = 0.041, η2p = 0.086) and improvement in the domains of physical health (F(1) = 4.881, p = 0.032, η2p = 0.094), memory (F(1) = 4.192, p = 0.046, η2p = 0.082) and money (F(1) = 4.862, p = 0.032, η2p = 0.094) in the CQOL-AD. We detected a significantly higher improvement of G1 in memory (F(1) = 4.192, p = 0.046 η2p = 0.082), money (F(1) = 7.147, p = 0.010, η2p = 0.132) and friends (F(1) = 4.828, p = 0.033, η2p = 0.093). The G1 when compared to the G2 did not demonstrate significant effects of the BI-Zarit, in the total scores CQOL-AD, MAAS and DASS-21. The study showed that both psychoeducation alone and integrated with yoga reduced the burden of family caregivers of people with Alzheimer's disease, and that the integration of online yoga practice with psychoeducation potentiated the improvement only in some aspects of the quality of life and subjective perception of burden reduction.Clinical trial registration https://ensaiosclinicos.gov.br/ , identifier RBR-794593r, retrospectively registered.

The use of functional near infrared spectroscopy and gait analysis to characterize cognitive and motor processing in early-stage patients with multiple sclerosis.

Background: Dual-task paradigms are a known tool to evaluate possible impairments in the motor and cognitive function in patients with multiple sclerosis (MS). A technique to evaluate the cortical function during movement is functional near-infrared spectroscopy (fNIRS). The evaluation of the MS course or its treatment by associating fNIRS with gait measurements may be flexible and low-cost; however, there are no feasibility studies in the literature using these combined techniques in early-stage patients with MS. Objective: To evaluate cortical hemodynamics using fNIRS and gait parameters in patients at early stages of MS and in healthy controls during a dual-task paradigm. Methods: Participants performed cognitive tasks while walking to simulate daily activities. Cortical activation maps and gait variability were used to evaluate differences between 19 healthy controls and 20 patients with MS. Results and conclusion: The results suggest an enhanced cortical activation in the motor planning areas already at the early stages of MS when compared to controls. We have also shown that a systematic analysis of the spatiotemporal gait variability parameters indicates differences in the patient population. The association of cortical and gait parameters may reveal possible compensatory mechanisms related to gait during dual tasking at the early stages of the disease.

Baseline emotional state influences on the response to animated short films: A randomized online experiment.

Introduction: Considering the relevance of the emotional state, it is necessary to understand how daily stimuli can modulate the emotions. Animated short films are common stimuli, but it is unknown how they can modulate the emotional state. The study aimed to evaluate: how participants' emotional state changed after watching animated short films with positive or negative emotional valence in an online experiment; the relationship between participants' baseline score on an Emotional Intensity Scale and their potential change in the main emotion after watching the films; and the association between the initial main emotion valence and the potential change in this emotion with participants' sociodemographic information. Methods: A sample of 2,269 participants recruited during COVID-19 pandemic were randomly assigned to either watch a negative or positive animated short film. Results: The results showed that, after watching a film with negative valence, participants were in a more negative emotional state than at baseline and compared with those who watched the film with positive valence. Also, individuals who had a negative baseline emotion and maintained the same emotion after the film had presented higher baseline emotional state scores (more negative emotion) than those who changed their emotions. In addition, the individuals who kept the baseline emotion had an association with age, marital status, level of education and psychiatric disorders, use of medication, and emotional awareness, while the individuals who changed the baseline emotion had an association with age, gender, and following or not social distancing recommendations. Conclusion: Baseline emotional state may influence the response to animated short films and sociodemographic characteristics are associated with the initial main emotion valence and its potential change in this emotion.

The effects of a short-term meditation-based mindfulness protocol in patients receiving hemodialysis.

Mindfulness-based approaches that promote health, improve quality of life, and reduce the impact of comorbidities are key aspects in chronic diseases management. We aimed to verify the impact of a short-term meditation protocol on psychosocial and physiological parameters in chronic hemodialysis patients. We enrolled twenty-two patients, median age of 69.5 years old, into a 12-week meditation protocol that occurred during each hemodialysis session for 10-20 minutes, 3x/week, in a private tertiary hospital. We then evaluated clinical, psychological, and laboratorial parameters pre- and post-meditation. Patients exhibited a better control of serum phosphorus (-0.72 mg/dL; P = 0.002), a decrease in systolic blood pressure (-1.90 mmHg; P = 0.009), a 23% decrease in depressive symptoms (P = 0.014), and an increase of 7% in the self-compassion scale (P = 0.048) after meditation. To note, we observed an increase in 13% of the mindfulness score (P = 0.019). Our preliminary study describes the effects of a short-term meditation protocol in chronic hemodialysis setting. We observed a decrease in depressive symptoms and in blood pressure values, an improvement in self-compassion and serum phosphorous levels. In conjunction with the promising results of meditation in chronic kidney disease setting, this encouraging preliminary study supports the need for additional clinical trials.

COVID-19 news valence effects on emotion and its modulation by a relaxation: A randomized online experiment during COVID-19 pandemic.

This study evaluated how news with positive and negative content about COVID-19, as well as a relaxation pause, affect the emotional state. We also investigated the association between emotional state and practicing meditation/yoga, physical activity or having a mental disease. For that, a sample of 717 participants, recruited through social media, were randomly assigned to listen to negative or positive news about COVID-19. After that, both groups were guided through a short relaxation pause. Their emotional state was measured before they listened to the audios and after each audio. Mixed linear models were used to evaluate the effects of news group, relaxation pause, mental health and well-being practices. Negative news worsened their emotional state, whereas positive news improved it. A brief relaxation pause improved the effects of negative news content and may mitigate the effects of this valence of information. Practicing physical activity, meditation/yoga was associated with better emotional responses.

Quantitative assessment of pilot-endured workloads during helicopter flying emergencies: an analysis of physiological parameters during an autorotation.

The procedures to be performed after sudden engine failure of a single-engine helicopter impose high workload on pilots. The maneuver to regain aircraft control and safe landing is called autorotation. The safety limits to conduct this maneuver are based on the aircraft height versus speed diagram, which is also known as "Dead Man's Curve". Flight-test pilots often use subjective methods to assess the difficulty to conduct maneuvers in the vicinity of this curve. We carried out an extensive flight test campaign to verify the feasibility of establishing quantitative physiological parameters to better assess the workload endured by pilots undergoing those piloting conditions. Eleven pilots were fully instrumented with sensors and had their physiological reactions collected during autorotation maneuvers. Our analyses suggested that physiological measurements (heart rate and electrodermal activity) can be successfully recorded and useful to capture the most effort-demanding effects during the maneuvers. Additionally, the helicopter's flight controls displacements were also recorded, as well as the pilots' subjective responses evaluated by the Handling Qualities Rate scale. Our results revealed that the degree of cognitive workload was associated with the helicopter's flight profile concerning the Height-Speed diagram and that the strain intensity showed a correlation with measurable physiological responses. Recording flight controls displacement and quantifying the pilot's subjective responses show themselves as natural effective candidates to evaluate the intensity of cognitive workload in such maneuvers.

Can news with positive or negative content affect and a relaxation pause improve the emotional state of health care professionals? A randomized online experiment during COVID-19 pandemic.

A cause of mental distress during the COVID-19 pandemic is media exposure, which can impact health care professionals (HCPs) who must keep up to date with the statistics and procedures to fight the outbreak. This study aimed to evaluate the effects of listening to negative and positive news about COVID-19 pandemic and a relaxation pause audio. For that, we measured the emotional state through Likert items in a scale developed to assess how anxious, stressed, hopeful, conscious about emotions, irritated, despondent, joyful, optimistic, and preoccupied, he or she was feeling in the moment of evaluation. In an online experiment, an HCPs sample of 245 participants were randomly assigned to either listen to negative or positive news contents about COVID-19. After that, both groups were guided by a relaxation pause activity in which they paid attention to the body and breath. They were assessed before and after listening to each audio. After listening to negative news, participants entered in a more negative emotional state than at baseline (p < 0.001) and compared with participants who listened to positive news (p < 0.001). Both groups improved their emotional state after performing the proposed brief relaxation (p < 0.001). These results show the importance of HCPs being aware and controlling the content of consumed news. A brief relaxation practice can mitigate the negative effects of consuming information with negative content.

Mindfulness-Based Versus Story Reading Intervention in Public Elementary Schools: Effects on Executive Functions and Emotional Health.

INTRODUCTION: In this study we compared the effects of a mindfulness-based intervention (MBI) with a story reading intervention (SI) on the executive functions and psychological profile of children in two different public schools in São Paulo, Brazil. METHODS: In this controlled clinical trial, 207 children aged 8 to 9 years old responded to the Five-Digit Test (FDT), stress levels, depression, anxiety, positive and negative affect, at baseline (T0) and 8 weeks later (T1). From T0 to T1, school 1 participated in MBI classes and school 2 in IS classes. RESULTS: In school 1 (MBI), children improved their scores on all tests except reading (errors) and counting (errors) compared with school 2. No differences were observed between groups in terms of emotional health. CONCLUSION: It is feasible to implement MBI or SI in Brazilian public schools. Students in the MBI group presented broader effects in executive functions, while students in the SI group showed a trend toward reduced negative affect and depression symptoms.

The Child Emotion Facial Expression Set: A Database for Emotion Recognition in Children.

Background: This study developed a photo and video database of 4-to-6-year-olds expressing the seven induced and posed universal emotions and a neutral expression. Children participated in photo and video sessions designed to elicit the emotions, and the resulting images were further assessed by independent judges in two rounds. Methods: In the first round, two independent judges (1 and 2), experts in the Facial Action Coding System, firstly analysed 3,668 emotions facial expressions stimuli from 132 children. Both judges reached 100% agreement regarding 1,985 stimuli (124 children), which were then selected for a second round of analysis between judges 3 and 4. Results: The result was 1,985 stimuli (51% of the photographs) were produced from 124 participants (55% girls). A Kappa index of 0.70 and an accuracy of 73% between experts were observed. Lower accuracy was found for emotional expression by 4-year-olds than 6-year-olds. Happiness, disgust and contempt had the highest agreement. After a sub-analysis evaluation of all four judges, 100% agreement was reached for 1,381 stimuli which compound the ChildEFES database with 124 participants (59% girls) and 51% induced photographs. The number of stimuli of each emotion were: 87 for neutrality, 363 for happiness, 170 for disgust, 104 for surprise, 152 for fear, 144 for sadness, 157 for anger 157, and 183 for contempt. Conclusions: The findings show that this photo and video database can facilitate research on the mechanisms involved in early childhood recognition of facial emotions in children, contributing to the understanding of facial emotion recognition deficits which characterise several neurodevelopmental and psychiatric disorders.

Microstates in complex and dynamical environments: Unraveling situational awareness in critical helicopter landing maneuvers.

Understanding decision-making in complex and dynamic environments is relevant for designing strategies targeting safety improvements and error rate reductions. However, studies evaluating brain dynamics in realistic situations are scarce in the literature. Given the evidence that specific microstates may be associated with perception and attention, in this work we explored for the first time the application of the microstate model in an ecological, dynamic and complex scenario. More specifically, we evaluated elite helicopter pilots during engine-failure missions in the vicinity of the so called "dead man's curve," which establishes the operational limits for a safe landing after the execution of a recovery maneuver (autorotation). Pilots from the Brazilian Air Force flew a AS-350 helicopter in a certified aerodrome and physiological sensor data were synchronized with the aircraft's flight test instrumentation. We assessed these neural correlates during maneuver execution, by comparing their modulations and source reconstructed activity with baseline epochs before and after flights. We show that the topographies of our microstate templates with 4, 5, and 6 classes resemble the literature, and that a distinct modulation characterizes decision-making intervals. Moreover, the source reconstruction result points to a differential activity in the medial prefrontal cortex, which is associated to emotional regulation circuits in the brain. Our results suggest that microstates are promising neural correlates to evaluate realistic situations, even in a challenging and intrinsically noisy environment. Furthermore, it strengthens their usage and expands their application for studying cognition under more realistic conditions.

The Integration of Meditation and Positive Psychology Practices to Relieve Stress in Women Workers (Flourish): Effects in Two Pilot Studies.

Meditation and positive psychology have been reported as promising approaches to deal with stress. This exploratory pilot study aims to evaluate the efficacy of meditation and positive psychology-based intervention on stress. Two experiments are reported; in the first one, 29 healthcare professionals were included (intervention = 14; control = 15), and the second one included 57 women managers (intervention = 27; control = 30). All participants were evaluated before and after eight weeks for levels of stress, anxiety, depression, and psychiatric symptoms. In Experiment 1, intervention group participants showed a reduction in stress levels and anxiety symptoms, and in Experiment 2, participants in the intervention group showed a decrease in stress, psychiatric symptoms, and sleep quality, when compared to the control group. A multi-component intervention based on positive psychology and meditation practices was effective at reducing stress as well as improving related stress parameters such as anxiety, psychiatric symptoms, and sleep quality.

Age-related effects on the neural processing of semantic complexity in a continuous narrative: Modulation by gestures already present in young to middle-aged adults.

The processing of semantically complex speech is a demanding task which can be facilitated by speech-associated arm and hand gestures. However, the role of age concerning the perception of semantic complexity and the influence of gestures in this context remains unclear. The goal of this study was to investigate if age-related differences are already present in early adulthood during the processing of semantic complexity and gestures. To this end, we analyzed fMRI images of a sample of 38 young and middle-aged participants (age-range: 19-55). They had the task to listen and to watch a narrative. The narrative contained segments varying in the degree of semantic complexity, and they were spontaneously accompanied by gestures. The semantic complexity of the story was measured by the idea density. Consistent with previous findings in young adults, we observed increased activation for passages with lower compared to higher complexity in bilateral temporal areas and the precuneus. BOLD signal in the left frontal and left parietal regions correlated during the perception of complex passages with increasing age. This correlation was reduced for passages presented with gestures. Median-split based post-hoc comparisons confirmed that group differences between younger (19-23 years) and older adults within the early adult lifespan (24-55 years) were significantly reduced in passages with gestures. Our results suggest that older adults within early adulthood adapt to the requirements of highly complex passages activating additional regions when no gesture information is available. Gestures might play a facilitative role with increasing age, especially when speech is complex.

An Intervention to Increase Situational Awareness and the Culture of Mutual Care (Foco) and Its Effects During COVID-19 Pandemic: A Randomized Controlled Trial and Qualitative Analysis.

Situational awareness is especially important to decision-making in health care. Comprehending the situation is crucial for anticipating any change in the environment and delivering optimal care. The objective of this study was to evaluate the effects of a training to increase situational awareness and mutual care designed for health care workers (FoCo) in a randomized controlled trial with additional qualitative analysis. We also investigated the perception of the training for the COVID-19 pandemic moment, in May 2020, almost 6 months after we finished the data collection at the Emergency Care Unit, which became a COVID-19 treatment reference for the care of a population depending on the public health system, in Sao Paulo, Brazil. We conclude that FoCo training can be an important instrument for health care professionals both in times of pandemic and "normal times," to increase situational awareness, the culture of mutual care and decrease the possibility of occupational injuries and illnesses.

COVID-19 information exposure in digital media and implications for employees in the health care sector: findings from an online survey.

OBJECTIVE: To estimate coronavirus disease 2019-related information consumption and related implications for health care professionals (medical and nonmedical personnel) during the pandemic. METHODS: A cross-sectional on-line survey was distributed to employees of a major health care institution located in São Paulo, Brazil between April 3 and April 10, 2020. Data were analyzed using descriptive statistics. RESULTS: The sample comprised 2,646 respondents. Most participants (44.4%) reported excessive or almost excessive access to information about the novel coronavirus and 67.6% reported having increased their average time spent on social media. When asked how frequently they consider it was easy to determine the reliability of information, "sometimes" corresponded to 43.2% of the answers in contrast to 14.6% responding "always". Answers related to potential signs of information overload associated with the pandemic indicated that 31% of respondents felt stressed by the amount of information they had to keep up with almost every day or always. Overall, 80.0% of respondents reported having experienced at least one of the following symptoms: headache, eye twitching, restlessness or sleeping difficulty. The frequency of symptoms was higher among participants with a more negative information processing style regarding when dealing with large volumes of information relative to those with a positive information processing style. Likewise, symptoms were more frequently reported by participants who had increased their social media access relative to those reporting reduced access during the pandemic. CONCLUSION: Our survey provides a description of how health professionals consume COVID-19 related information during the pandemic, and suggests that excessive information exposure and high processing demands may impose psychological distress and affect mental health.

A Critical Analysis on Characterizing the Meditation Experience Through the Electroencephalogram.

Meditation practices, originated from ancient traditions, have increasingly received attention due to their potential benefits to mental and physical health. The scientific community invests efforts into scrutinizing and quantifying the effects of these practices, especially on the brain. There are methodological challenges in describing the neural correlates of the subjective experience of meditation. We noticed, however, that technical considerations on signal processing also don't follow standardized approaches, which may hinder generalizations. Therefore, in this article, we discuss the usage of the electroencephalogram (EEG) as a tool to study meditation experiences in healthy individuals. We describe the main EEG signal processing techniques and how they have been translated to the meditation field until April 2020. Moreover, we examine in detail the limitations/assumptions of these techniques and highlight some good practices, further discussing how technical specifications may impact the interpretation of the outcomes. By shedding light on technical features, this article contributes to more rigorous approaches to evaluate the construct of meditation.

Effects of Yoga Respiratory Practice (Bhastrika pranayama) on Anxiety, Affect, and Brain Functional Connectivity and Activity: A Randomized Controlled Trial.

Pranayama refers to a set of yoga breathing exercises. Recent evidence suggests that the practice of pranayama has positive effects on measures of clinical stress and anxiety. This study explored the impact of a Bhastrika pranayama training program on emotion processing, anxiety, and affect. We used a randomized controlled trial design with thirty healthy young adults assessed at baseline and after 4 weeks of pranayama practices. Two functional magnetic resonance imaging (MRI) protocols were used both at baseline and post-intervention: an emotion task as well as a resting-state acquisition. Our results suggest that pranayama significantly decreased states of anxiety and negative affect. The practice of pranayama also modulated the activity of brain regions involved in emotional processing, particularly the amygdala, anterior cingulate, anterior insula, and prefrontal cortex. Resting-state functional MRI (fMRI) showed significantly reduced functional connectivity involving the anterior insula and lateral portions of the prefrontal cortex. Correlation analysis revealed that changes in connectivity between the ventrolateral prefrontal cortex and the right anterior insula were associated with changes in anxiety. Although it should be noted that these analyses were preliminary and exploratory, it provides the first evidence that 4 weeks of B. pranayama significantly reduce the levels of anxiety and negative affect, and that these changes are associated with the modulation of activity and connectivity in brain areas involved in emotion processing, attention, and awareness. The study was registered at https://www.ensaiosclinicos.gov.br/rg/RBR-2gv5c2/(RBR-2gv5c2).

Neural correlates of meditation: a review of structural and functional MRI studies.

Here, we review the neurophysiological and neuroimaging changes that mediation induces in structural and functional MRI. The available evidence from structural studies suggests that mediation impacts neuronal plasticity and the functional MRI suggest that there are changes in gray and white matter in subjects who meditate. FMRI studies show that meditation is associated with decreased activity of default mode network and activation of brain regions involved in cognitive and emotional control. Together, the available imaging techniques have revealed that rather than impacting specific brain regions, meditation causes structural and functional changes in large-scale brain networks.