Digital Commons Network^™

Comparison Of Right Vs Left Accelerated Resting-State Fmri-Guided Theta Burst Stimulation To The Dlpfc For Late-Life Depression: A Pilot Study, Jude Chavez, Karen Luo, Crystal Garcia, Christopher Abbott, Davin Quinn

Brain & Behavioral Health Research Day

Background: While trials of accelerated, neuronavigated repetitive transcranial magnetic stimulation (rTMS) to the left dorsolateral prefrontal cortex (DLPFC) for depression have shown efficacy for depression, there has not yet been validation of this technique for late-life depression (LLD). Additionally, no studies have tested accelerated intermittent theta burst stimulation (iTBS) to the right DLPFC for depression, although it may benefit depression and anxiety.

Methods: We enrolled 36 elderly patients (ages 50-79 years) with a diagnosis of pharmacoresistant depression of at least 6 months. Each participant received 45 sessions (5 treatments/day over 9 days) of iTBS to their functional MRI (fMRI) …

Center For Brain Recovery And Repair: Clinical Core, Rick Campbell, Michel Torbey, Kevin Wilson, Jude Chavez, Karen Luo, Sarah Ward, Marcus Sterling, Adam Littleton, Ethan Campbell, John Romero, Marcus Sterling, Darbi Gill, Davin Quinn, Jessica Richardson, Jeremy Hogeveen

Brain & Behavioral Health Research Day

The Center for Brain Recovery and Repair at the Health Sciences Center aims to develop safe and effective interventions targeted at specific pathways or mechanisms to improve the quality of life of New Mexicans with brain and behavioral conditions. The Center, part of the NIH IDeA program and funded as a Center of Biomedical Research Excellence, opened in 2015 in UNM Domenici Hall. In addition to creating a critical mass of investigators in the field of brain recovery and repair, the Center's facilities are also available for use by other investigators on a fee-for-service basis. The Center received Phase II …

Midbrain Degeneration And Cognition In Parkinson’S Disease, Kayla Julio, Stephanie Nitschke, Nicholas Shaff, Christopher Wertz, Andrew Mayer, Andrei Vakhtin, Gerson Suarez Cedeno, Amanda Deligtisch, Sarah Pirio Richardson, Sephira G. Ryman

Brain & Behavioral Health Research Day

Neuromelanin imaging is an emerging biomarker for PD as it captures degeneration of the midbrain. Currently, it is unknown whether this degeneration contributes to cognitive dysfunction in PD beyond dysfunction associated with fronto-subcortical systems. Here, we examine whether neuromelanin signal is associated with broader cognitive dysfunction in PD patients with varying degrees of cognitive impairment: PD with normal cognition (PD-NC), PD with mild cognitive impairment (PD-MCI), and healthy controls (HC).

12 PD-NC, 18 PD-MCI and 19 HC underwent an MRI scan that included a neuromelanin-sensitive (NM-MRI) sequence. Contrast-to-noise-ratio of the substantia nigra pars compacta (SNc) and ventral tegmental area (VTA) …

Comparison Of Novel Virus-Like Particle Vaccines Against Tau In A Mouse Model Of Alzheimer’S Disease, Jonathan Hulse, Nicole Maphis, Julianne Peabody, Bryce Chackerian, Kiran Bhaskar

Brain & Behavioral Health Research Day

Alzheimer’s disease (AD) is characterized by the accumulation of tau tangles and amyloid-β plaques in the brain with accompanied neurodegeneration. Phosphorylation of tau at specific sites occurs early in the disease process and has been shown to drive tau pathology which correlates with disease progression. Promoting the clearance of pathological tau may be a useful therapeutic strategy. Previously, we developed Qβ bacteriophage virus-like particle (VLP) vaccines displaying phosphorylated Thr181 tau peptides that promoted robust immune response, tau clearance, and improved memory. Here we report characterization and comparison of a Qβ-PHF-1-VLP and a Qβ-AT8-VLP vaccine. Transgenic rTg4510 mice were administered three …

Altered Neuronal Firing Following A Spreading Depolarization: An In Vivo Study, Branki R. Hess, Natalie J. Pinkowski, Carissa J. Mehos, Betty Fish, Russell A. Morton

Brain & Behavioral Health Research Day

Spreading Depolarizations (SD) are slowly propagating waves of tissue depolarization that result in the suppression of neuronal firing for multiple minutes. SDs are known to occur in rodents suffering from moderate or severe traumatic brain injuries and are also associated with visual auras that often-proceeded migraines. Our previous work established that SDs initiate in a closed skull concussion model in mice. The presence of SDs in our injury model is tightly associated with acute behavioral deficits that last hours. The behavioral deficits are attributed to neurological impairment, but a mechanistic understanding of that impairment remains unclear. We hypothesize that there …

Preliminary Psychometric Testing Of The Treatment Self-Regulation Questionnaire For Assessing Motivations For Responsible Cannabis Use: An Application Of Self-Determination Theory, Haydee Andujo, Jakub D. Gren, Joey C. Mok, Ricardo A. Rubio, Dylan K. Richards, Matthew R. Pearson, Addictions Research Team

Brain & Behavioral Health Research Day

Cannabis use protective behavioral strategies (PBS) are cognitive–behavioral strategies used before, during, and/or after cannabis use to reduce cannabis use and related problems. Self-determination theory (SDT) provides a potentially useful framework to understand motivations for responsible cannabis use, which is operationalized in the present study as PBS use. In the present study, we examined the relation of motivations for responsible cannabis use, as assessed by the 15-item Treatment Self-Regulation Questionnaire (TSRQ), with cannabis PBS use and other cannabis-related outcomes. A sample of 408 past month cannabis users were recruited from a multisite study of college students (n=1856). Consistent with SDT …

Neurodevelopmental Outcomes For Children Participating In Navajo Birth Cohort Study (Nbcs), Heather Krapf, Brandon Rennie, Nbcs Team

Brain & Behavioral Health Research Day

Background: There are many (>500) abandoned mines on Navajo Nation with lots of families living within a short distance (within 10 km) of an abandoned site. Research has indicated higher concentrations of heavy metals among many individuals on Navajo Nation. The Environmental Influences on Child Health Outcomes (ECHO), a seven-year initiative funded by the National Institute of Health (NIH), allowed us to build on the Navajo Birth Cohort Study (NBCS) and continue to follow-up with existing participants. A main aim of NBCS/ECHO has been to examine the effects of environmental exposures such as heavy metals on childhood developmental outcomes. …

Comparison Of Stereoelectroencephalography Versus Subdural Electrodes For Invasive Epilepsy Monitoring In Pediatric Patients: A Meta-Aaalysis, Syed Faraz Kazim, Michael Kogan, James A. Botros, Ariana Barkley, Heather Stevens Spader

Brain & Behavioral Health Research Day

Introduction: Stereoelectroencephalography (SEEG) and subdural explorations (SDE, including grids, strips, and depth electrodes) represent the two main techniques utilized in pre-operative evaluation of medically refractory epilepsy. During the past two decades, some studies have explored the comparative safety and effectiveness of these two modalities in pediatric patients.

Methods: We conducted a systematic review with meta-analysis following PRISMA guidelines. We performed literature search using MeSH terms published until June 30, 2022 in four electronic databases. The R statistical software version 3.5.3 and MedCalc Statistical Software version 19.2.3 were used to perform the meta-analysis.

Results: We included 16 studies with 780 pediatric …

Preoperative Frailty Measured By Risk Analysis Index Predicts Complications And Poor Discharge Outcomes After Brain Tumor Resection In A Large Multi-Center Analysis, Syed Faraz Kazim, Rachel Thommen, Kavelin Rumalla, Alexander J. Kassicieh, Piyush Kalakoti, Meic H. Schmidt, Rohini G. Mckee, Daniel E. Hall, Christian A. Bowers

Brain & Behavioral Health Research Day

Background

To evaluate the independent effect of frailty, as measured by the Risk Analysis Index-Administrative (RAI-A) for postoperative complications and discharge outcomes following brain tumor resection (BTR) in a large multi-center analysis.

Methods

Patients undergoing BTR were queried from the National Surgical Quality Improvement Program (NSIQP) for the years 2015 to 2019. Multivariable logistic regression was performed to evaluate the independent associations between frailty tools (age, 5-factor modified frailty score [mFI-5], and RAI-A) on postoperative complications and discharge outcomes.

Results

We identified 30,951 patients who underwent craniotomy for BTR; the median age of our study sample was 59 (IQR 47–68) …

Age-Specific Prognostic Hub Genes Associated With Immune Cell Infiltration In Glioblastoma Multiforme: An Analysis Of Tcga Data, Syed Faraz Kazim, Devin W. Vidrine, Meic H. Schmidt, Christian A. Bowers

Brain & Behavioral Health Research Day

Introduction

Glioblastoma multiforme (GBM) is the most common malignant brain tumor and carries a poor prognosis with median survival time (MST) of approximately 18-20 months. Increasing evidence has revealed that infiltrating immune cells and other stromal components in the tumor microenvironment (TME) are associated with prognosis of GBM. The present study was conducted to identify age group-specific prognostic hub genes associated immune cell infiltration in GBM patients.

Methods

We extracted clinical and gene expression data [based on RNA-Sequencing (RNA-Seq) and microarray] of 593 primary GBM patients from The Cancer Genome Atlas (TCGA) (www.cancergenome.nih.gov). For analysis, the data was distributed into …

Long-Term Effects Of Prenatal Alcohol Exposure On Gabaergic System In Posterior Parietal Cortex, V Licheri, B J. Jacquez, D Sainz, C F. Valenzuela, J L. Brigman

Brain & Behavioral Health Research Day

Fetal Alcohol Spectrum Disorders (FASDs) are a group of neurobehavioral deficits including physical, cognitive, learning and behavioral disabilities that persist throughout the lifespan. Our recent investigation showed that moderate prenatal alcohol exposure (PAE) during first and second-trimesters equivalent impairs cognitive control on a touchscreen continuous performance task accompanied by frontal and cortical power alterations. The literature to date had extensively investigated the molecular abnormalities underlying the PAE impairments in cognitive functions mediated by cortical areas, but there are no studies exploring the long-term effects of PAE in the posterior parietal cortex (PPC). The PPC represents one of the major cortical …

Improving The Detection Of Behavioral Health Conditions Through Positive And Unlabeled Learning: Self-Harm And Opioid Use Disorder, Praveen Kumar, Jonathan K. Tsosie, Christophe G. Lambert

Brain & Behavioral Health Research Day

Accurate detection and estimation of behavioral health conditions, such as self-harm and opioid use disorder (OUD), is crucial for identifying at-risk individuals, determining treatment needs, tracking prevention and intervention efforts, and finding treatment-naive individuals for clinical trials. Despite the underdiagnosis and undercoding of these conditions in electronic health records (EHRs), our work aims to accurately estimate both the probability of a given patient having these conditions and the overall population prevalence.

We have developed a novel machine learning algorithm, “Positive Unlabeled Learning Selected Not At Random (PULSNAR)”, to estimate the prevalence of undiagnosed or unrecorded behavioral health conditions. Positive unlabeled …

Is There An Association Between Anxiety And Response Confidence?, Sofia Miranda, Garima Singh, Mark Levelle, James F. Cavanagh

Brain & Behavioral Health Research Day

This project investigates the neuro-behavioral relationship between anxiety, error monitoring, and decision confidence. Individuals with heightened anxiety have larger neurobiological action monitoring signals, such as the Error Response Negativity (ERN) or Correct-Response Negativity (CRN): negative deflections in the trial-averaged EEG that occur when participants commit an erroneous or correct choice, respectively. Anxiety is associated with larger ERN amplitudes and lower decision confidence. Yet, response confidence is associated with both higher CRN amplitude as well as faster response time. It remains unknown how anxiety is related to these neural systems underlying decision confidence. The current study investigated ERN and CRN amplitudes …

Association Of Neurofascin155 With Severe, Rapidly Progressive Sensory Axonal Polyneuropathy In A Cohort Of Native American Women: A Novel Case Series And Review Of The Literature, Christine Meadows, Jonathan Cauchi, Clover Youn, Kayleigh Martin, Cynthia Olivas, Ilhem Messaoudi

Brain & Behavioral Health Research Day

Objective: Paranodal antibodies against neurofascin155 (NF155) have been well-described in chronic and acute demyelinating diseases of both the central and peripheral nervous system, but have not yet been associated with acute axonal pathology¹. Here we characterize the demographic, clinical, laboratory, and electrodiagnostic features in a cohort of adult women of Native American ethnicity who presented with rapidly progressive, severe, subacute painful paresthesias and were found to have axonal polyneuropathy associated with positive serum NF155 antibody.

Methods: Five patients presented with severe, rapidly progressive, symmetric, painful paresthesias, and were found to have sensory greater than motor axonal polyneuropathy. All …

Agonizing The 5-Ht2c Receptor Attenuates Methamphetamine-Induced Conditioned Place Preference In Adolescent Male Rats, Nicole C. Reyna, Nathan S. Pentkowski

Brain & Behavioral Health Research Day

Methamphetamine use disorder (MUD) and other s􀆟mulant use remains high in the Western area of the United States, with New Mexico having one of the highest s􀆟mulant use percentages in adolescents, at 11.4%. Addi􀆟onally, adolescence is a 􀆟me of enhanced sensi􀆟vity to drug reward and there are currently no FDA approved treatments for MUD. Therefore, there is a cri􀆟cal need to develop effec􀆟ve interven􀆟ons for adolescents using methamphetamine. The present study u􀆟lized a condi􀆟oned place preference paradigm (CPP) for determining if agonizing the serotonin-2C (5-HT2c) receptor atenuates expression of methamphetamine reward in adolescent Sprague-Dawley rats (PND 30). Rats were randomly …

Effect Of Prenatal Ethanol Exposure On Histamine H3 Receptor-Effector Coupling And Sigma-1 Receptor Modulation Of Histamine H3 Receptor Function, D E. Nelson, S Davies, D D. Savage

Brain & Behavioral Health Research Day

We have reported that the histamine H3 receptor (H3R) inverse agonist ABT-239 ameliorates prenatal alcohol exposure (PAE)-induced deficits in synaptic plasticity and learning. It has been reported that different H3R inverse agonists have variable affinities for also binding to Sigma-1 receptors (S1Rs), including ABT-239, which is roughly equipotent at both receptor types. Given this dual action of ABT-239 and other H3R inverse agonists on both H3Rs and S1Rs, we examined whether PAE would affect that actions of the more selective H3R inverse agonist JNJ5207852 compared to the specific S1R agonist PRE-084 on H3R receptor-effector coupling.

Radiohistochemical studies of [^{35 …}

Ascl1 Regulates Astrocyte And Oligodendrocyte Cell Fate, Proliferation, And Migration In The Dorsal Cortex, Luis E. Paez-Beltran, Milindu Lyanapathirana, Tou Y. Vue

Brain & Behavioral Health Research Day

Background: Astrocytes and oligodendrocytes are part of the macroglia cell family, which is the most abundant cell type in the CNS. Glia progenitor cells (GPC) give rise to both lineages by differentiating in either astrocyte precursor cells (APC) or oligodendrocyte precursor cells (OPC), fate determined mainly by a few master regulators. ASCL1, a basic-helix-loop-helix (bHLH) transcription factor, is one of these developmental regulators expressed in progenitors’ cells during neurogenesis and gliogenesis, but its specific role in fate, migration and proliferation remains yet to be elucidated. Methods: We employed an initial descriptive study to examine ASCL1 and OLIG2 distribution in the …

A Novel Methodological Approach Of Studying Heart Rate Variability During Still Face Paradigm In Infants Of Enrich Prospective Birth Cohort Study, R Rai, J Didomenico, S M. Rodriguez, J Maxwell, J Lowe, C Aragón, L N. Bakhireva, J M. Stephen

Brain & Behavioral Health Research Day

Introduction: Prevalence of Fetal Alcohol Spectrum Disorders (FASD) among school age children in the U.S. might be as high as 1-5%. Diagnosis of FASD is often delayed as higher-order cognitive deficits manifest later. The inability to regulate autonomic activity during social interactions is believed to contribute to social and emotional dysregulation in children. Heart rate variability (HRV) consists of changes in the time intervals between consecutive heartbeats called interbeat intervals. It is regulated by Autonomic Nervous System through synergistic activity of the sympathetic and parasympathetic branches. Still Face Paradigm (SFP) is used as an experimental social stressor paradigm to …

Nows In Covid - Neonatal Opiate Withdrawal Hospital Course After Implementation Of Covid-19 Infection Control Practices, Dane G. Winter, Sofia Chavez, Lorena Galvan, Peggy Maclean, Jessie Maxwell, Chelsea Wilhite, Heather Pratt-Chavez

Brain & Behavioral Health Research Day

Background: The SARS-COVID-19 pandemic requires hospitals to increase infection control practices and implement policies calling for universal face masks. These policies dramatically changed the hospital milieu for newborns as visitors were either limited or entirely restricted. For newborns experiencing neonatal opiate withdrawal syndrome (NOWS) due to exposure to opioids during pregnancy, hospitalization is often prolonged. Protocols for care for infants with NOWS emphasize the importance of non-pharmacologic care as first-line treatment, recommending holding infants, swaddling, and rooming-in caregivers. With changes to infection control policies, providers are concerned infants with NOWS are experiencing complications including longer stays and more complex clinical …

Tyrosine Phosphatase Step Is A Key Regulator Of Post-Ischemic Inflammatory Response Under Hypertensive Condition, Prabu Paramasivam, Seong Won Choi, Ranjana Poddar, Surojit Paul

Brain & Behavioral Health Research Day

Background: Hypertension, the most common comorbid condition in stroke patients worsens stroke outcome. The canonical pathway of stroke-induced brain damage involves excessive glutamate receptor activation. Post-ischemic inflammation further contributes to the pathogenesis of stroke outcome under comorbid conditions. In earlier studies we developed a novel therapeutic target TAT-STEP, derived from the brain-enriched and neuron specific tyrosine phosphatase STEP, which has been shown to be effective in reducing stroke induced brain damage in the absence of any associated comorbidities. In the current study we evaluated the post-ischemic inflammatory pathways that contribute to the exacerbation of ischemic brain injury under hypertensive conditions …

Meg Reveals Multiple Sources To The Reward Positivity, Only One Of Which Is Affected By Major Depression, Christopher Jh Pirrung, Garima Singh, Davin Quinn, Jeremy Hogeveen, James F. Cavanagh

Brain & Behavioral Health Research Day

Anhedonia is a primary symptom of Major Depressive Disorder (MDD). In order to better understand this phenotypic dimension, we investigated a marker of reward that is sensitive to information content and valence, the Reward Positivity (RewP). This study used concurrent EEG and MEG to establish the source of the RewP in control and MDD participants. The RewP emerged as a distributed network involving ventromedial prefrontal cortex (vmPFC), anterior midcingulate cortex (aMCC), and bilateral insulae. Only the vmPFC differed between groups, whereas the aMCC/insula “salience network” areas were similarly responsive to reward prediction error. This suggests specific deficits in affective valuation …

Repeated Concussions And Spreading Depolarizations Are Associated With Acute Behavioral Deficits, Natalie J. Pinkowski, Betty Fish, Carissa J. Mehos, Russel A. Morton

Brain & Behavioral Health Research Day

It is estimated that more than 42 million individuals have a concussion or mild traumatic brain injury every year. These injuries are accompanied by acute symptoms including disorientation, impaired motor coordination, and altered mental state. These symptoms are attributed to neurological impairment caused by disruptions in ion gradients and neurotransmitters. Recently, spreading depolarizations (SDs) have been shown to occur in concussion model injuries. SDs are massive waves of chemical and electrical changes that spread slowly in a unique way through grey matter of the brain. Our previous work found that an SD is sufficient to produce the acute symptoms of …

Participation In Echo Is Associated With Expanding Buprenorphine Treatment For Opioid Use Disorder In Rural Primary Care, Julie Salvador, Snehal Bhatt, Vanessa Jacobsohn, Larissa Lindsey, Heidi Rishel Brakey, Rana Alkhafaji, Jesus Fuentes, Magdalena Mcwethy, Laura Rombach, Rachel Abeyta, Julia Martinez, Andrew Sussman, Orrin Myers

Brain & Behavioral Health Research Day

Context: Access to medications for opioid use disorders (MOUD) is limited, especially in rural communities. Documented barriers limit integration of treatment for opioid use disorder (OUD) in primary care settings, inhibiting provider training and delivery of treatment. Innovative delivery mechanisms are needed to enhance integration of services.

Objective: Examine impact of participation in the Extensions for Community Healthcare Outcomes model (ECHO) intervention on expansion of OUD treatment using buprenorphine among rural primary care providers.

Study Design: Quasi-experimental single group design to assess achievement of benchmark measures related MOUD expansion.

Analysis: We estimated the strength of the …

Progressive Endothelial S1pr1 Disruption And Bbb Dysfunction In Cerebral Microvasculature Induced By Chronic Hypoxic Hypoperfusion, Y Yang, J Thompson, K Duval, S Hobson, K Santacruz, M Griego

Brain & Behavioral Health Research Day

Background: Clinical and neuroimaging studies suggested a fundamental role of BBB leakage in the progressive development of cerebral small vessel disease (SVD) pathology. The capillary barrier and survival are regulated by sphingosine-1-phoshate (S1P) and its receptor isoforms (S1PRs). Disruption of endothelial S1P signalling leads to capillary dysfunction, BBB breakdown, and perivascular inflammation.

Aim: To test the hypothesis that chronic hypoxic hypoperfusion down-regulates capillary endothelial S1P receptor 1 (S1PR1), compromising BBB integrity and leading to neuroinflammation, using a rat model of SVD.

Method: Spontaneously hypertensive stroke-prone rats underwent unilateral carotid artery occlusion (UCAO) followed by a Japanese permissive diet (JPD) for …

Mechanisms Contributing To Aberrant Vascular Development In The Brain Following Prenatal Alcohol Exposure Through Elevation Of Mir-150-5p, Marissa Westenskow, Roxana Gutierrez, Gabriela Perales, Amy S. Gardiner

Brain & Behavioral Health Research Day

Fetal Alcohol Spectrum Disorders (FASD) are conditions impacting development in children exposed to alcohol in utero. Among other associated anatomical defects, the organization of the brain microvasculature is altered in severe forms of FASD. Other vascular anomalies such as defective angiogenesis, permeability, vessel reactivity, and blood flow are found in animal models of prenatal alcohol exposure (PAE). The underlying mechanisms of these vascular defects are not fully understood. We previously found miR-150-5p to be upregulated in brain microvascular endothelial cells (BMVECs) isolated from embryonic mouse cortices following moderate PAE. We identified targets of miR-150-5p in BMVECs and demonstrated that …

Examining The Psychometric Properties Of The Reward And Relief Inventory Of Drinking Situations, Victoria R. Votaw, Rylee Brachle, Jenny Fillebrown, Matthew Lopez, Ethan Van, Isabel Weisberg, Katie Witkiewitz

Brain & Behavioral Health Research Day

Recent work has examined the extent to which individuals seek alcohol to enhance positive experiences (reward drinking) or relieve aversive states (relief drinking), and processes underlying reward/relief drinking correspond to neurobiological adaptations within the addiction cycle. Previous findings indicate the utility of reward/relief drinking phenotypes in matching patients to AUD pharmacotherapies, with high reward drinkers responding better to naltrexone versus placebo. Practical reward/relief drinking measures with good psychometric properties are needed to translate these findings to clinical practice. We examined the reliability and construct validity of a recently developed brief measure of reward /relief drinking, the Reward and Relief Inventory …

Epic Scenery In New Zealand, Faith Bonacorsi

2022-23 Postcards

Postcard from Faith Bonacorsi, during the Linfield University Spring Semester Abroad at University of Otago in New Zealand.

Usa V. David Serrano-Munoz

2023 Decisions

USDC for the Middle District of Pennsylvania

Placenta Programming Of Fetal Hpa Axis, Ludmila Bakhireva, Elizabeth Solomon, Melissa Roberts, Xingya Ma, Erin Milligan

Brain & Behavioral Health Research Day

Background: Maternal stress and prenatal alcohol exposure (PAE) alter fetal programming of hypothalamic-pituitary-adrenal (HPA) axis, including glucocorticoid regulation of the stress response in placenta, leading to lifelong health issues. While preclinical studies began underlining the importance of placenta-mediated programming of the glucocorticoid signaling system in PAE, clinical studies are extremely limited.

The amount of cortisol that crosses the placenta is a function of relative expression of 11-β hydroxysteroid dehydrogenases (11β-HSD): 11β-HSD2 oxidizes active maternal cortisol into inactive 11-dehydrocortisone, while 11β-HSD1 acts as a reductase and converts inactive 11-dehydro-corticostisone to active cortisol. Down regulation of 11β-HSD2 is associated with altered glucocorticoid …

The Community-Based Integrated Care System In The Context Of The Novel Coronavirus Disease (Covid-19) Pandemic, Koichi Asakura

Japanese Society and Culture

Abstract

Since the establishment of the Long-term Care Insurance System in 2000, the promotion of the Community-based Integrated Care System has been advocated in COVID-19 Pandemic. But "H30 Research Report on Community-based Integrated Care" expects mutual aid based on self-help, while accepting economic and health disparities on the ground of "inevitable disparities". We will discuss the Community-based Integrated Care System in the era of emerging viruses with a view to infectious disease pandemics such as the novel coronavirus pandemic in relation to the significance and prospects of ACP (Advance Care Planning).