Journal Digest: Secondhand Vape Smoke and Kids, Wounds and Substance Use, and More

Children absorb more nicotine from secondhand smoke than from secondhand e-cigarette vapor, a study in JAMA Network Open has found. However, children exposed to secondhand vapor still had roughly five times the nicotine absorption than those who were not exposed to either secondhand smoke or secondhand vapor.

Researchers at University College London examined data from 1,777 children 3 to 11 years old who were part of the U.S. National Health and Nutrition Examination Survey (NHANES) from 2017 to 2020. Proxy respondents for the children answered questions about whether the children were exposed to someone else’s smoke or e-cigarette vapor in the previous seven days. The researchers then divided the children into three groups: secondhand tobacco smoke only (270 children), secondhand vapor only (43 children), or neither (1,464 children). Children who were exposed to both secondhand smoke and secondhand vapor were not included in the study. The children’s nicotine absorption was measured via blood tests for concentrations of serum cotinine, a metabolite of nicotine.

Children exposed to secondhand vapor had 83.6% lower nicotine absorption than those exposed to secondhand smoke. However, mean cotinine levels in children with no reported secondhand nicotine exposure were 96.7% lower than those with secondhand smoke exposure and 80.1% lower than those with secondhand vapor exposure. Children exposed to secondhand vapor had 402% higher cotinine levels than those with no reported secondhand nicotine exposure.

“This suggests that switching from smoking to vaping indoors may substantially reduce but not eliminate children’s secondhand exposure to nicotine and other noxious substances,” the researchers wrote.

Roughly one-fourth of people who use substances have wounds, many of which need tending, a study in Drug and Alcohol Dependence suggests.

Researchers at Columbia University collaborated with the Bronx Opioid Collective, a harm reduction organization that conducts mobile outreach, to recruit 586 adults who use substances. The researchers asked the participants about how they used substances and if they had any wounds.

Overall, 23% of the participants reported having at least one wound, although 18 of these 133 participants did not disclose the location of their wounds so the researchers could verify the severity.

Most of the verified wounds (78%) were small, about the size of a cherry. Roughly 50% of the wounds had signs of infection such as swelling, redness, or warmth, and 7.5% of participants had wounds severe enough to warrant a referral to outpatient or emergency care.

The more often participants used stimulants or heroin, the more likely they were to have wounds. Also, intravenous substance use increased the likelihood of wounds.

The researchers provided instructions on wound care and prevention and a wound-prevention kit to 71% of participants. They also provided a wound-treatment kit to 54% of the participants, including some who did not have an active wound but intended to share the kit or save it in case they needed it in the future.

The researchers noted that participants were often reluctant to seek medical care in a traditional setting but were willing to receive care at the mobile outreach site. “Thus, this study adds to the growing body of literature showing the benefits of mobile or street outreach to [people who use substances],” they wrote.

A content analysis of Spanish-language news articles about schizophrenia and psychosis has revealed that most stigmatize these conditions. The results of the analysis were published in Psychiatric Services.

Researchers at Washington University in St. Louis reviewed 108 Spanish-language news articles about schizophrenia and/or psychosis that were published on the websites of either Telemundo or Univision. They grouped the articles in four main categories: stigmatizing stereotypes (i.e., violence, incompetence, criminal activity, etc.), recovery themes (stories of recovery, reporting on positive emotions, or educational information), overall frame of the news article (stigmatizing or counter-stigmatizing), and use of best practices for reporting on mental health issues (person-first language, treatment options, etc.).

Overall, 62% of the news articles included stigmatizing stereotypes of people with schizophrenia or psychosis. The majority involved stories reporting on people with these conditions committing violent or nonviolent criminal acts such as murder, assault, and property destruction. Depictions of people with schizophrenia or psychosis as incompetent (i.e., being unfit to stand trial) were also common.

Only 19% of the articles included at least one recovery theme, which was primarily the inclusion of educational information about schizophrenia or psychosis. Fifteen percent of the articles analyzed focused on the recovery experiences of people with schizophrenia or psychosis, while only 11% presented themes of optimism and hope when describing people with these conditions.

“The lack of an emphasis on recovery and treatment in Spanish-language news media is alarming and represents a missed opportunity to combat public stigma and enhance mental health literacy in the Latinx population,” the researchers wrote.

Patients with irritable bowel syndrome (IBS) and major depressive disorder (MDD) have similar impairments in neural circuits connected to the dorsal striatum, a study in the Journal of Affective Disorders suggests. The dorsal striatum is a subcortical structure in the brain that is composed of the caudate nucleus and the putamen, involved in motor and executive function.

In 2020 and 2021, researchers at Peking University enrolled 39 patients with IBS, 39 patients with MDD, and 40 healthy controls and matched them for sex, age, and educational level. All patients underwent eight-minute resting-state functional magnetic resonance imaging (fMRI). The researchers evaluated the patients’ fMRI results to determine the functional connectivity of the 12 subregions of the striatum with respect to different regions throughout the brain.

Compared with healthy controls, patients with IBS and patients with MDD both had a decrease in the functional connectivity between the dorsal striatum and regions of the hippocampus, sensorimotor cortex, and prefrontal cortex—areas of the brain related to memory, sensorimotor function, and cognition.

The researchers found that among IBS patients, reduced striatal connectivity was associated not only with greater frequency of abdominal pain, but also with patient levels of anxiety and alexithymia (difficulty recognizing one’s emotions). “IBS and MDD exhibit shared functional abnormalities in the frontal-striatal circuitry, which may represent a potential neural basis for their high comorbidity and similar behavioural abnormalities and treatment responses,” they wrote.

Interventions that include physical and cognitive training in a single protocol are the most effective nonpharmacological therapy for older people with cognitive impairment, a meta-analysis in the American Journal of Geriatric Psychiatry has found.

Researchers at the Universidad de Castilla-La Mancha in Spain analyzed data from 121 studies with a combined 9,361 participants (average age of 74.6). The studies included participants with both mild cognitive impairment (MCI) and dementia.

The nonpharmacological interventions assessed were aerobic exercise, strength exercise, multicomponent physical exercise, other physical exercises, tai chi, other mind-body exercises, traditional cognitive rehabilitation, computer-based cognitive rehabilitation, occupational therapy, music therapy, physical-cognitive rehabilitation, and reminiscence therapy.

Among individuals with any cognitive impairment (dementia or MCI), physical-cognitive exercise was the most effective nonpharmacological intervention, distantly followed by computerized cognitive training. Regular cognitive intervention and multicomponent physical exercise also showed minor benefits. Physical-cognitive exercise was also the most effective intervention for individuals diagnosed with dementia, followed again by computerized cognitive training.

For people with MCI, occupational therapy—provided as a dual-task intervention that targeted both motor skills and cognitive functioning—was the most effective intervention, followed by multicomponent physical exercise and physical-cognitive exercise. In this case, the difference between the interventions was less profound.

The researchers noted that physical exercise has been reported to improve learning ability in healthy adults and modulate inflammation associated with cognitive decline, while cognitive training has been shown to affect neuroplasticity and neural networks in aging and disease.

“The combination of these interventions seems to enhance their effects, and cognitive training could increase the number of surviving new neurons generated in response to physical exercise,” they wrote. ■